美国医疗帐单外包市场规模、份额和趋势分析报告：按组件、最终用途、服务和细分市场预测（2026-2033 年）

美国医疗帐单外包市场概览

据估计，2025 年美国医疗帐单外包市场规模为 69.5 亿美元，预计到 2033 年将达到 176.9 亿美元。

预计从 2026 年到 2033 年，该产业将以 12.56% 的复合年增长率成长。医疗服务提供者在管理大量帐单和报销方面面临的挑战日益增加，导致收入大幅下降，这也是美国对医疗帐单外包服务需求不断增长的一个因素。

此外，患者数量的增长以及医疗专业人员日益繁重的病历和帐单处理工作也是促成因素。为了应对这些挑战，医院正在将医疗帐单处理外包，从而推动市场成长。医院将医疗帐单处理外包给对《平价医疗法案》(ACA)、医疗补助计划 (Medicaid) 和其他健康保险项目拥有全面了解的公司。此外，由于强制性的复杂 ICD-10 编码系统、不断上涨的医疗成本以及为维持报销水平而实施电子健康记录的监管压力，医疗保健行业也越来越多地将账单处理外包。医疗服务在理赔处理和准确结算方面面临着许多挑战，预计这将推动对创新收入週期管理 (RCM) 解决方案的需求。利用信誉良好的第三方服务供应商提供的先进创新 RCM 解决方案，医疗机构既可以充分发挥这些 RCM 解决方案的经济价值和有效性，又能同时专注于改善患者照护。

此外，便捷的理赔结算流程（包括应收帐款和理赔管理）以及精通最新医疗编码的专家编码员，是医疗机构选择外包计费的关键原因。然而，与医疗计费相关的资料外洩风险较高，预计将在预测期内阻碍市场成长。例如，根据美国卫生与公众服务部 (HHS) 民权办公室 (OCR) 于 2025 年 1 月发布的《2024 年医疗保健资料外洩报告》，预计 2024 年将报告超过 500 起资料外洩事件。

此外，计费服务供应商正越来越多地采用人工智慧 (AI)、机器人流程自动化和预测分析等先进技术来变革医疗计费流程。人工智慧驱动的编码引擎能够自动从临床文件中提取和分配代码，从而减少人为错误并提高首次理赔核准率。

自动化简化了重复性任务，例如理赔输入、保险资格确认和帐单提交，从而加快了计费週期。进阶分析功能可即时识别拒付模式、特定付款方问题和收入流失风险。这些功能提高了准确性，缩短了报销时间，并提升了合规性。例如，2025 年 6 月，Collectly 发布了 Billie，这是第一个用于患者计费和收入管理 (RCM) 的 AI 语音助理。它可透过聊天、电子邮件、简讯和语音全天候提供服务。 Billie 利用即时电子健康记录 (EHR) 和保险数据，能够提供个人化的理赔解释和结算，无需人工干预即时解决 85% 的咨询，从而将现金流提高 32%，降低 20-30% 的收款成本，并消除漏接电话。

目录

第一章调查方法和范围

第二章执行摘要

第三章 美国医疗帐单外包市场变数、趋势与范围

• 市场谱系展望
  • 母市场展望
  • 相关及附随市场展望
• 市场动态
• 美国医疗帐单外包市场分析工具
  • 产业分析：波特五力模型
  • PESTEL 分析
• 用例洞察

第四章 美国医疗帐单外包市场：按组成部分划分、估算和趋势分析

• 美国医疗帐单外包市场组成部分差异分析
• 美国医疗帐单外包市场规模及趋势分析（按组成部分划分，2021-2033年）
• 内部处理
• 外包

第五章 美国医疗帐单外包市场：按服务类型分類的估算和趋势分析

• 美国医疗帐单外包市场服务波动分析
• 美国医疗帐单外包市场规模及趋势分析（按服务类型划分，2021-2033 年）
• 前端服务
• 中阶服务
• 后端服务

6. 美国医疗帐单外包市场：按最终用户分類的估算和趋势分析

• 美国医疗帐单外包市场最终用途变化分析
• 美国医疗帐单外包市场规模及应用趋势分析（2021-2033年）
• 医院
• 诊所
• 其他的

第七章 竞争情势

• 公司/竞争对手分类
• 策略规划
• 2025年商业市场分析
• 公司简介/列表
  • R1RCM Inc.
  • Veradigm LLC（Allscripts Healthcare, LLC）
  • Oracle（Cerner Corporation）
  • eClinicalWorks
  • Kareo, Inc.
  • McKesson Corporation
  • Quest Diagnostics
  • Promantra Inc.
  • AdvancedMD, Inc.
  • eBilling Inc

U.S. Medical Billing Outsourcing Market Summary

The U.S. medical billing outsourcing market size was estimated at USD 6.95 billion in 2025 and is projected to reach USD 17.69 billion by 2033, growing at a CAGR of 12.56% from 2026 to 2033. Increasing challenges faced by healthcare providers in managing a large volume of claims and reimbursements, resulting in significant revenue losses, are attributed to the rising demand for medical billing outsourcing services in the U.S.

Moreover, amplifying patient load and the need to address the growing records and bills burden medical practitioners. Hospitals are outsourcing the medical billing process to counter such a situation, thus anticipating market growth. Moreover, hospitals outsource medical billing to companies that have end-to-end knowledge of the Affordable Medical Care Act, Medicaid, and other healthcare and insurance programs. In addition, the healthcare industry is observing an increase in the outsourcing of billing activities by physicians and hospitals due to mandatory implementation of the intricate ICD-10 coding structure, growing care costs, and regulatory pressure to implement electronic medical records to sustain compensation levels. Medical services are facing complex challenges in billing and precise payment, which is anticipated to drive the demand for innovative RCM solutions. The availability of advanced innovative RCM solutions offered by renowned third-party service providers can help healthcare organizations leverage the economic value and efficacy of these RCM solutions while simultaneously focusing on improving patient care.

Furthermore, hassle-free claims settlement processes featuring accounts receivable management and claims management and the availability of professional coders acquainted with the latest medical codes are the primary reasons practices outsource their billing services. However, high threats of data breaches associated with medical billing are expected to hinder market growth during the forecast period. For instance, according to the 2024 Healthcare Data Breach Report published in January 2025 by the Department of Health and Human Services (HHS) Office for Civil Rights (OCR), more than 500 data breach records were reported in 2024.

Furthermore, billing service providers are increasingly deploying advanced technologies such as artificial intelligence (AI), robotic process automation, and predictive analytics to transform medical billing operations. AI-driven coding engines automatically extract and assign codes from clinical documentation, reducing human error and improving first-pass claim acceptance rates.

Automation streamlines repetitive tasks, including charge entry, eligibility verification, and claims submission, accelerating billing cycles. Advanced analytics identify denial patterns, payer-specific issues, and revenue leakage risks in real time. These capabilities enhance accuracy, reduce reimbursement timelines, and improve compliance. For instance, in June 2025, Collectly launched Billie, the first AI voice agent for patient billing and RCM, available 24/7 via chat, email, text, and voice. It resolves 85% of inquiries instantly without staff assistance, boosts cash flow by 32%, reduces collection costs by 20-30%, and eliminates missed calls, utilizing real-time EHR/insurance data for personalized bill explanations and payments.

U.S. Medical Billing Outsourcing Market Report Segmentation

This report forecasts revenue growth at the country level and provides an analysis of the latest industry trends in each of the sub-segments from 2021 to 2033. For this study, Grand View Research has segmented the U.S. medical billing outsourcing market report based on component, service, and end-use:

• Component Outlook (Revenue, USD Million, 2021 - 2033)
• In-House
• Outsourced
• Service Outlook (Revenue, USD Million, 2021 - 2033)
• Front-end Services
• Middle-end Services
• Back-end Services
• End-use Outlook (Revenue, USD Million, 2021 - 2033)
• Hospitals
• Physician Offices
• Others

Table of Contents

Chapter 1. Methodology and Scope

• 1.1. Market Segmentation & Scope
• 1.2. Market Definitions
  • 1.2.1. Component Segment
  • 1.2.2. Service Segment
  • 1.2.3. End Use Segment
• 1.3. Information analysis
  • 1.3.1. Market formulation & data visualization
• 1.4. Data validation & publishing
• 1.5. Information Procurement
  • 1.5.1. Primary Research
• 1.6. Information or Data Analysis
• 1.7. Market Formulation & Validation
• 1.8. Market Model
• 1.9. Total Market: CAGR Calculation
• 1.10. Objectives
  • 1.10.1. Objective 1
  • 1.10.2. Objective 2

Chapter 2. Executive Summary

• 2.1. Market Outlook
• 2.2. Segment Snapshot
• 2.3. Competitive Insights Landscape

Chapter 3. U.S. Medical Billing Outsourcing Market Variables, Trends & Scope

• 3.1. Market Lineage Outlook
  • 3.1.1. Parent market outlook
  • 3.1.2. Related/ancillary market outlook.
• 3.2. Market Dynamics
  • 3.2.1. Market driver analysis
    • 3.2.1.1. Growing focus on increasing profitability and revenue generation
    • 3.2.1.2. Federal mandate to implement digital record keeping by healthcare providers
    • 3.2.1.3. Rapidly changing healthcare regulations
  • 3.2.2. Market restraint analysis
    • 3.2.2.1. High threat of data breaching
    • 3.2.2.2. Hidden outsourcing costs
• 3.3. U.S. Medical Billing Outsourcing Market Analysis Tools
  • 3.3.1. Industry Analysis - Porter's
    • 3.3.1.1. Supplier power
    • 3.3.1.2. Buyer power
    • 3.3.1.3. Substitution threat
    • 3.3.1.4. Threat of new entrant
    • 3.3.1.5. Competitive rivalry
  • 3.3.2. PESTEL Analysis
    • 3.3.2.1. Political landscape
    • 3.3.2.2. Technological landscape
    • 3.3.2.3. Economic landscape
    • 3.3.2.4. Environmental Landscape
    • 3.3.2.5. Legal Landscape
    • 3.3.2.6. Social Landscape
• 3.4. Case Study Insights

Chapter 4. U.S. Medical Billing Outsourcing Market: Component Estimates & Trend Analysis

• 4.1. Segment Dashboard
• 4.2. U.S. Medical Billing Outsourcing Market Component Movement Analysis
• 4.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Component, 2021 to 2033 (USD Million)
• 4.4. In-house
  • 4.4.1. Market estimates and forecasts 2021 to 2033 (USD Million)
• 4.5. Outsourced
  • 4.5.1. Market estimates and forecasts 2021 to 2033 (USD Million)

Chapter 5. U.S. Medical Billing Outsourcing Market: Service Estimates & Trend Analysis

• 5.1. Segment Dashboard
• 5.2. U.S. Medical Billing Outsourcing Market Service Movement Analysis
• 5.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Service, 2021 to 2033 (USD Million)
• 5.4. Front-end Services
  • 5.4.1. Market estimates and forecasts 2021 to 2033 (USD Million)
• 5.5. Middle-end Services
  • 5.5.1. Market estimates and forecasts 2021 to 2033 (USD Million)
• 5.6. Back-end Services
  • 5.6.1. Market estimates and forecasts 2021 to 2033 (USD Million)

Chapter 6. U.S. Medical Billing Outsourcing Market: End Use Estimates & Trend Analysis

• 6.1. Segment Dashboard
• 6.2. U.S. Medical Billing Outsourcing Market End Use Movement Analysis
• 6.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by End Use, 2021 to 2033 (USD Million)
• 6.4. Hospitals
  • 6.4.1. Market estimates and forecasts 2021 to 2033 (USD Million)
• 6.5. Physician Offices
  • 6.5.1. Market estimates and forecasts 2021 to 2033 (USD Million)
• 6.6. Others
  • 6.6.1. Market estimates and forecasts 2021 to 2033 (USD Million)

Chapter 7. Competitive Landscape

• 7.1. Company/Competition Categorization
• 7.2. Strategy Mapping
• 7.3. Company Market Position Analysis, 2025
• 7.4. Company Profiles/Listing
  • 7.4.1. R1RCM Inc.
    • 7.4.1.1. Company overview
    • 7.4.1.2. Financial performance
    • 7.4.1.3. Product benchmarking
    • 7.4.1.4. Strategic initiatives
  • 7.4.2. Veradigm LLC (Allscripts Healthcare, LLC)
    • 7.4.2.1. Company overview
    • 7.4.2.2. Financial performance
    • 7.4.2.3. Product benchmarking
    • 7.4.2.4. Strategic initiatives
  • 7.4.3. Oracle (Cerner Corporation)
    • 7.4.3.1. Company overview
    • 7.4.3.2. Financial performance
    • 7.4.3.3. Product benchmarking
    • 7.4.3.4. Strategic initiatives
  • 7.4.4. eClinicalWorks
    • 7.4.4.1. Company overview
    • 7.4.4.2. Financial performance
    • 7.4.4.3. Product benchmarking
    • 7.4.4.4. Strategic initiatives
  • 7.4.5. Kareo, Inc.
    • 7.4.5.1. Company overview
    • 7.4.5.2. Financial performance
    • 7.4.5.3. Product benchmarking
    • 7.4.5.4. Strategic initiatives
  • 7.4.6. McKesson Corporation
    • 7.4.6.1. Company overview
    • 7.4.6.2. Financial performance
    • 7.4.6.3. Product benchmarking
    • 7.4.6.4. Strategic initiatives
  • 7.4.7. Quest Diagnostics
    • 7.4.7.1. Company overview
    • 7.4.7.2. Financial performance
    • 7.4.7.3. Product benchmarking
    • 7.4.7.4. Strategic initiatives
  • 7.4.8. Promantra Inc.
    • 7.4.8.1. Company overview
    • 7.4.8.2. Financial performance
    • 7.4.8.3. Product benchmarking
    • 7.4.8.4. Strategic initiatives
  • 7.4.9. AdvancedMD, Inc.
    • 7.4.9.1. Company overview
    • 7.4.9.2. Financial performance
    • 7.4.9.3. Product benchmarking
    • 7.4.9.4. Strategic initiatives
  • 7.4.10. eBilling Inc
    • 7.4.10.1. Company overview
    • 7.4.10.2. Financial performance
    • 7.4.10.3. Product benchmarking
    • 7.4.10.4. Strategic initiatives

List of Tables

• Table 1 List of abbreviations
• Table 2 U.S. medical billing outsourcing market, by component, 2021 - 2033 (USD Million)
• Table 3 U.S. medical billing outsourcing market, by service, 2021 - 2033 (USD Million)
• Table 4 U.S. medical billing outsourcing market, by end use, 2021 - 2033 (USD Million)

List of Figures

• Fig. 1 Market research process
• Fig. 2 Data triangulation techniques
• Fig. 3 Market formulation & validation
• Fig. 4 U.S. medical billing outsourcing market: Market outlook
• Fig. 5 U.S. medical billing outsourcing market: Segment outlook
• Fig. 6 U.S. medical billing outsourcing market: Competitive landscape outlook
• Fig. 7 Parent market outlook
• Fig. 8 U.S. medical billing outsourcing market driver impact
• Fig. 9 U.S. medical billing outsourcing market restraint impact
• Fig. 10 U.S. medical billing outsourcing market: Component outlook and key takeaways
• Fig. 11 U.S. medical billing outsourcing market: Component movement analysis
• Fig. 12 In-house market estimates and forecasts,2021 - 2033 (USD Million)
• Fig. 13 Outsourced market estimates and forecasts, 2021 - 2033 (USD Million)
• Fig. 14 U.S. medical billing outsourcing market: Services outlook and key takeaways
• Fig. 15 U.S. medical billing outsourcing market: Services movement analysis
• Fig. 16 Front-end services market estimates and forecasts,2021 - 2033 (USD Million)
• Fig. 17 Middle-end services market estimates and forecasts, 2021 - 2033 (USD Million)
• Fig. 18 Back-end services market estimates and forecasts, 2021 - 2033 (USD Million)
• Fig. 19 U.S. medical billing outsourcing market: End Use outlook and key takeaways
• Fig. 20 U.S. medical billing outsourcing market: End Use movement analysis
• Fig. 21 Hospitals market estimates and forecast, 2021 - 2033 (USD Million)
• Fig. 22 Physician offices market estimates and forecast, 2021 - 2033 (USD Million)
• Fig. 23 Others market estimates and forecast, 2021 - 2033 (USD Million)