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市場調查報告書
商品編碼
1404738

美國醫療申請外包市場規模、佔有率和趨勢分析報告：2024-2030 年按構成、最終用途、服務和細分市場進行的預測

U.S. Medical Billing Outsourcing Market Size, Share & Trends Analysis Report By Component (In-House, Outsourced), By End-use (Hospitals, Physician Offices), By Service (Front-end, Back-end), And Segment Forecasts, 2024 - 2030
出版日期: | 出版商: Grand View Research | 英文 90 Pages | 商品交期: 2-10個工作天內

價格

美國醫療申請外包市場的成長與趨勢：

Grand View Research, Inc.最新報告顯示，到2030年，美國醫療申請外包市場規模預計將達到123億美元，2024年至2030年複合年成長率為11.78%。

醫療保險報銷的日益複雜性和索賠申請的高機率預計將推動市場成長。在大流行期間和之後，患者群、病患資料和申請量的壓力增加，迫使醫院產業外包服務。預計這將在預測期內推動市場成長。

疫情期間內部申請服務面臨的挑戰增加了對外包服務等替代服務的需求。在遵守 ICD-11 準則以及應對報銷下降和醫療費用上升方面，挑戰比比皆是。一些醫療保健提供者，包括急診醫院和診所，更喜歡外包其申請流程，以限制或消除這些挑戰。

醫療保健公司正在擴大其產品範圍，以減輕申請和報銷流程的負擔。例如，2023 年 4 月，南佛羅裡達州行動影像公司 Concierge Diagnostics Inc. 在其 100 多個推薦合作夥伴的投資組合中增加了醫療申請和諮詢服務。目的是降低醫生執業成本，同時增加收益並最大限度地減少申請拒絕。

各種醫療機構對收益週期管理 (RCM) 的接受程度因應用而異。在美國，與任何其他 RCM 應用程式相比，它更多地用於調度、編碼、申請、患者登記和申請處理。與外包醫療申請服務相關的好處包括改進的申請流程、更少的錯誤、更快的周轉時間以及更順暢的醫院和其他醫療機構的管理。

COVID-19大流行對市場產生了重大影響。醫院收益和患者數量的下降減緩了市場成長。大流行期間引入了新的申請和遠端醫療代碼。病患負擔的增加和醫護人員工作量的增加不僅給適應新規範帶來了挑戰，而且在現場實施也帶來了挑戰。醫療申請提供者在資源和技術上花費了大量資金，在外包申請流程後，醫療保健提供者可以利用這一點。

美國醫療申請外包市場報告亮點

  • 從組成來看，預計到2023年外包產業將佔最大收入佔有率，超過57%，成長最快。
  • 從服務來看，前端服務領域佔據市場主導地位，2023年收益佔有率將超過38%。
  • 預計中端​​服務業在預測期內複合年成長率最快。這是由於醫療保健專業人員對申請外包的認知不斷增強以及中間端服務的採用不斷增加。
  • 按最終用途分類，由於申請數量高和患者成本增加，2023 年醫院部門的收入佔有率最大，超過 46%。此外，無錯誤處理和因付款拒絕而造成的損失最小化是與醫療申請外包相關的好處，這導致多學科醫院擴大採用。

目錄

第1章調查方法和範圍

第 2 章執行摘要

第3章市場變數、趨勢和範圍

  • 市場區隔和範圍
  • 市場體系展望
    • 母市場展望
    • 相關/附隨市場展望
  • 市場趨勢及展望
  • 市場促進因素分析
  • 市場抑制因素分析
  • 營商環境分析
    • PESTLE分析
    • 波特五力分析
  • COVID-19感染疾病的影響分析

第4章美國醫療申請外包市場：構成預估及趨勢分析

  • 美國醫療申請外包市場：構成變化分析及市場佔有率
  • 美國醫療申請外包市場：細分儀表板
  • 公司內部
    • 內部市場，2018-2030
  • 外包
    • 外包市場，2018-2030

第5章美國醫療申請外包市場：服務估算與趨勢分析

  • 美國醫療申請外包市場：服務差異分析與市場佔有率
  • 美國醫療申請外包市場：細分儀表板
  • 前端服務
    • 前端服務市場，2018-2030
  • 中階服務
    • 中階服務市場，2018-2030
  • 後端服務
    • 後端服務市場，2018-2030

第6章美國醫療申請外包市場：最終用途估算與趨勢分析

  • 美國醫療申請外包市場：最終用途變化分析和市場佔有率
  • 美國醫療申請外包市場：細分儀表板
  • 醫院
    • 醫院市場，2018-2030
  • 檢查室
    • 2018-2030年檢查室市場
  • 其他
    • 其他市場，2018-2030

第7章競爭形勢

  • 參與企業概況
  • 財務績效
  • 公司市場分析
  • 策略規劃
    • 擴張
    • 獲得
    • 合作
    • 新產品發布
    • 合夥
    • 其他
  • 參與企業概況
    • R1 RCM, Inc.
    • Veradigm LLC（Allscripts Healthcare, LLC）
    • Oracle（Cerner Corporation）
    • McKesson Corporation
    • eClinicalWorks
    • Kareo, Inc.
    • Promantra Inc.
    • AdvancedMD, Inc.
    • Quest Diagnostics
Product Code: GVR-2-68038-824-4

U.S. Medical Billing Outsourcing Market Growth & Trends:

The U.S. medical billing outsourcing market size is expected to reach USD 12.3 billion by 2030, registering a CAGR of 11.78% from 2024 to 2030, according to a new report by Grand View Research, Inc. Increasing complexity in health reimbursement and high chances of claim denials are expected to drive market growth. The growing burden of the patient pool, patient data, and claims volumes during and after the pandemic forced the hospital industry to outsource services. This is expected to propel market growth during the forecast period.

The challenges faced by in-house billing services during the pandemic increased the need for an alternative, such as outsourcing services. The challenge mounts when the billing process necessitates adherence to the ICD-11 code and dealing with declining reimbursements and rising healthcare costs. Several healthcare providers such as acute care hospitals and clinics/physician offices prefer outsourcing their billing processes to curb or eliminate these challenges.

The healthcare companies are expanding their product offerings to relieve the burden of claims and reimbursement processes. For instance, in April 2023, Concierge Diagnostics Inc., a mobile diagnostic imaging company in South Florida, added medical billing and consulting services to its portfolio of over 100 referral partners. The aim is to enhance revenue and minimize claim denial while reducing costs for physician practices.

Acceptance of revenue cycle management (RCM) in various healthcare facilities varies with application. Scheduling, coding, billing, patient registration, and claims processing are adopted more than other RCM applications in the U.S. Advantages associated with outsourcing medical billing services include improvement in billing process by decreasing errors, swift turnaround time, and smooth administrations for hospitals and other medical institutes.

The COVID-19 pandemic drastically impacted the market. Reduction in hospital revenue and patient volumes slowed down market growth. New billing and telehealth codes were introduced during the pandemic. Growing patient burden and increased workload on healthcare staff posed a challenge to adapt new codes as well as implement them into the setting. Medical billing providers have spent significant amounts on resources and technology, which can be utilized by healthcare providers after outsourcing the billing process.

U.S. Medical Billing Outsourcing Market Report Highlights:

  • Based on component, the outsourced segment held the largest revenue share of over 57% in 2023 and is expected to register the fastest growth, owing to a growing focus on minimizing the cost of healthcare delivery and improving the patient and physician relationship
  • Based on service, the front-end services segment dominated the market with a revenue share of over 38% in 2023, as these services increase downstream cash flow and decrease rework and cost to collect
  • The middle-end services segment is expected to register the fastest CAGR during the forecast period. This is attributed to growing awareness about billing outsourcing among healthcare practitioners and rising adoption of middle-end services among them
  • Based on end-use, the hospital segment accounted for the largest revenue share of over 46% in 2023 owing to high claim volumes and rising patient burden. In addition, errorless procedures and minimization of loss due to denial of payments are benefits associated with medical billing outsourcing, which leads to rising adoption in multispecialty hospitals

Table of Contents

Chapter 1. Methodology and Scope

  • 1.1. Market Segmentation & Scope
  • 1.2. Research Methodology
  • 1.3. Information or Data Analysis
  • 1.4. Market Formulation & Validation
  • 1.5. Model Details
  • 1.6. List of Secondary Sources
  • 1.7. List of Abbreviations
  • 1.8. Objectives

Chapter 2. Executive Summary

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

Chapter 3. Market Variables, Trends, & Scope

  • 3.1. Market Segmentation and Scope
  • 3.2. Market Lineage Outlook
    • 3.2.1. Parent Market Outlook
    • 3.2.2. Related/Ancillary Market Outlook
  • 3.3. Market Trends and Outlook
  • 3.4. Market Driver Analysis
  • 3.5. Market Restraint Analysis
  • 3.6. Business Environment Analysis
    • 3.6.1. PESTLE Analysis
    • 3.6.2. Porter's Five Forces Analysis
  • 3.7. COVID-19 Impact Analysis

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

  • 4.1. U.S. Medical Billing Outsourcing Market: Component Movement Analysis and Market Share
  • 4.2. U.S. Medical Billing Outsourcing Market: Segment Dashboard
  • 4.3. In-house
    • 4.3.1. In-house market, 2018 - 2030 (USD Million)
  • 4.4. Outsourced
    • 4.4.1. Outsourced market, 2018 - 2030 (USD Million)

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

  • 5.1. U.S. Medical Billing Outsourcing Market: Services Movement Analysis and Market Share
  • 5.2. U.S. Medical Billing Outsourcing Market: Segment Dashboard
  • 5.3. Front-end Services
    • 5.3.1. Front-end services market, 2018 - 2030 (USD Million)
  • 5.4. Middle-end Services
    • 5.4.1. Middle-end services market, 2018 - 2030 (USD Million)
  • 5.5. Back-end Services
    • 5.5.1. Back-end services market, 2018 - 2030 (USD Million)

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

  • 6.1. U.S. Medical Billing Outsourcing Market: End-use Movement Analysis and Market Share
  • 6.2. U.S. Medical Billing Outsourcing Market: Segment Dashboard
  • 6.3. Hospitals
    • 6.3.1. Hospitals market, 2018 - 2030 (USD Million)
  • 6.4. Physician Offices
    • 6.4.1. Physician offices market, 2018 - 2030 (USD Million)
  • 6.5. Others
    • 6.5.1. Others market, 2018 - 2030 (USD Million)

Chapter 7. Competitive Landscape

  • 7.1. Participant's Overview
  • 7.2. Financial Performance
  • 7.3. Company Market Position Analysis
  • 7.4. Strategy Mapping
    • 7.4.1. Expansion
    • 7.4.2. Acquisition
    • 7.4.3. Collaborations
    • 7.4.4. New Product Launches
    • 7.4.5. Partnerships
    • 7.4.6. Others
  • 7.5. Participant's overview
    • 7.5.1. R1 RCM, Inc.
      • 7.5.1.1. Overview
      • 7.5.1.2. Financial Performance
      • 7.5.1.3. Product Benchmarking
      • 7.5.1.4. Strategic Initiatives
    • 7.5.2. Veradigm LLC (Allscripts Healthcare, LLC)
      • 7.5.2.1. Overview
      • 7.5.2.2. Financial Performance
      • 7.5.2.3. Product Benchmarking
      • 7.5.2.4. Strategic Initiatives
    • 7.5.3. Oracle (Cerner Corporation)
      • 7.5.3.1. Overview
      • 7.5.3.2. Financial Performance
      • 7.5.3.3. Product Benchmarking
      • 7.5.3.4. Strategic Initiatives
    • 7.5.4. McKesson Corporation
      • 7.5.4.1. Overview
      • 7.5.4.2. Financial Performance
      • 7.5.4.3. Product Benchmarking
      • 7.5.4.4. Strategic Initiatives
    • 7.5.5. eClinicalWorks
      • 7.5.5.1. Overview
      • 7.5.5.2. Financial Performance
      • 7.5.5.3. Product Benchmarking
      • 7.5.5.4. Strategic Initiatives
    • 7.5.6. Kareo, Inc.
      • 7.5.6.1. Overview
      • 7.5.6.2. Financial Performance
      • 7.5.6.3. Product Benchmarking
      • 7.5.6.4. Strategic Initiatives
    • 7.5.7. Promantra Inc.
      • 7.5.7.1. Overview
      • 7.5.7.2. Financial Performance
      • 7.5.7.3. Product Benchmarking
      • 7.5.7.4. Strategic Initiatives
    • 7.5.8. AdvancedMD, Inc.
      • 7.5.8.1. Overview
      • 7.5.8.2. Financial Performance
      • 7.5.8.3. Product Benchmarking
      • 7.5.8.4. Strategic Initiatives
    • 7.5.9. Quest Diagnostics
      • 7.5.9.1. Overview
      • 7.5.9.2. Financial Performance
      • 7.5.9.3. Product Benchmarking
      • 7.5.9.4. Strategic Initiatives

List of Tables

  • Table 1 List of secondary sources
  • Table 2 List of abbreviations
  • Table 3 U.S. medical billing outsourcing market, by component, 2018 - 2030 (USD Million)
  • Table 4 U.S. medical billing outsourcing market, by service 2018 - 2030 (USD Million)
  • Table 5 U.S. medical billing outsourcing market, by end-use 2018 - 2030 (USD Million)

List of Figures

  • Fig. 1 Market research process
  • Fig. 2 Information procurement
  • Fig. 3 Primary research pattern
  • Fig. 4 Market research approaches
  • Fig. 5 Value chain-based sizing & forecasting
  • Fig. 6 Market formulation & validation
  • Fig. 7 Medical billing outsourcing market segmentation
  • Fig. 8 Market Snapshot, 2023
  • Fig. 9 Market trends & outlook
  • Fig. 10 Market driver relevance analysis (current & future impact)
  • Fig. 11 Market restraint relevance analysis (current & future impact)
  • Fig. 12 PESTLE analysis
  • Fig. 13 Porter's Five Forces analysis
  • Fig. 14 U.S. medical billing outsourcing market: component movement and market share analysis
  • Fig. 15 U.S. medical billing outsourcing market component outlook: Segment Dashboard
  • Fig. 16 In-house market, 2018 - 2030 (USD Million)
  • Fig. 17 Outsourced market, 2018 - 2030 (USD Million)
  • Fig. 18 U.S. medical billing outsourcing market: service movement and market share analysis
  • Fig. 19 U.S. medical billing outsourcing market service outlook: Segment Dashboard
  • Fig. 20 Front-end services market, 2018 - 2030 (USD Million)
  • Fig. 21 Middle-end services market, 2018 - 2030 (USD Million)
  • Fig. 22 Back-end services market, 2018 - 2030 (USD Million)
  • Fig. 23 U.S. medical billing outsourcing market: end-use movement and market share analysis
  • Fig. 24 U.S. medical billing outsourcing market end-use outlook: Segment Dashboard
  • Fig. 25 Physician back offices market, 2018 - 2030 (USD Million)
  • Fig. 26 Hospitals market, 2018 - 2030 (USD Million)
  • Fig. 27 Others market, 2018 - 2030 (USD Million)
  • Fig. 28 Strategy mapping
  • Fig. 29 Company market position analysis