Medical Billing Outsourcing Market Analysis

Global Medical Billing Outsourcing Market Overview

The Medical Billing Outsourcing Market Size was valued at USD 13.9 billion in 2023 and is projected to grow from USD 15.48 Billion in 2024 to USD 32.7 billion by 2032, exhibiting a compound annual growth rate (CAGR) of 9.79% during the forecast period (2024 - 2032). Increased demand in the medical sector to focus on core competencies and outsource non-core tasks are the key market drivers enhancing market growth.

Source Secondary Research, Primary Research, MRFR Database, and Analyst Review

Market expansion is projected to be favorable during the next time due to rising patient visits, the advantages of EHR systems in storing and maintaining patient health information, and the assistance in invoicing. The increasing need for patient-generated hospital medical data has been shown to increase the use of outsourced medical billing services.  A significant move toward digital billing was seen during this time, which is projected to continue fueling industry expansion. Since the beginning of the pandemic, there has been a rise in the popularity of paying bills online, which has raised the need for medical billing outsourcing, despite the fact that this is a non-essential function for most hospitals and clinics.

The market for medical billing outsourcing is expanding rapidly as a result of rising demand, increased use of IT resources, and consistent government backing in the healthcare sector. Rising healthcare expenses, especially in developed countries, have spurred innovation and accelerated the widespread use of medical technology, including RCM software. Doctors and hospitals are under increasing pressure to care for more patients while also keeping up with a larger volume of records and invoices. As a result, these elements fuel the growth of the medical billing outsourcing industry.

In February 2023, CPa Medical Billing was acquired by GeBBS Healthcare Solutions, Inc., a company providing revenue cycle management services to FQHCs as well as other multi-specialty physician groups. This purchase had been strategically made to ensure that the firm’s customer base expands by penetrating new geographical areas and extending its market and service capabilities so they can support corporate growth.

In August 2023: Keystone Medical Billing Services (Keystone) is a dedicated revenue cycle management team comprised of best-in-industry talent under the leadership of industry veterans, and Wakefield is pleased to announce that it has entered into a strategic development agreement with Keystone as of August 2023. By working together, we want to develop a novel approach to automating and prioritizing the detection of claims requiring further effort or attention, therefore mitigating the problem of unexpected billing. In accordance with the terms of the agreement, the two firms will pool their expertise, resources, and technological infrastructures to develop an effective system that employs cutting-edge algorithms and artificial intelligence to automate the identification and prioritization of surprise billing claims.

Medical Billing Outsourcing Market Trends

• Hospital outsourced medical billing is driving the market growth

A hospital, also called a medical center, provides patient treatment with specialized treatment procedures. Hospitals are expected to hold a significant share of the medical billing outsourcing market, as most patients prefer hospitals for disease diagnosis and treatment. Increasing patient visits, the benefits of EHR systems in storing and managing patient health records, and the aid in billing likely favor segmental growth over the upcoming period. The ease of handling emergencies during critical care or post-treatment complications can be better manageable in hospitals. Thus most of the disease's treatment and surgeries are performed in hospitals.​ Billing systems used in hospital settings are designed to store data accurately and capture a patient's state across time. As per the American Hospital Association 2020, the number of surgeries performed in registered hospitals in the United States was around 8 million for 500 beds. As per the data published by the Centers for Diseases Control and Prevention, around 130 million emergency department visits were recorded in the United States in 2018. Also, as per the data published by Eurostat in 2020, Europe had a high rate of cesarean section births for which hospital admission is mandatory. These statistics show the rising need to maintain the medical records of patient-generated in hospitals, boosting the adoption of outsourced medical billing in hospital settings.

Hence, adopting outsourced medical billing in hospitals is expected to record a substantial market CAGR growth over the forecast period.

Additionally, with the rising use of IT resources in the healthcare business and steady government support, the medical billing outsourcing market is growing substantially. Increased medical costs, particularly in industrialized nations, have resulted in continuous advancements in the field, allowing for greater adoption of modern technology devices and equipment, such as RCM software. The rising patient load and the need to address the ever-growing record and bills burden health practitioners. Thus, these factors drive the medical billing outsourcing market revenue.

Medical Billing Outsourcing Market Segment Insights

Medical Billing Outsourcing ComponentInsights

Based on components, the medical billing outsourcing market segmentation includes In house and outsourced. The outsourced segment dominated the market because It significantly reduces costs and proves a good fit for small and medium practices. Physician practices (acute care hospitals and clinics/physicians) face challenging times as reimbursements have declined, costs are rising, and the newly introduced regulations have made business more complex. Approximately 20% of physicians' income is estimated to be lost due to health billing errors. Healthcare providers or businesses spend 30 to 40% of their revenue on billing. This is boosting the segment’s growth.

Figure 1 Medical Billing Outsourcing Market, by Component, 2023 & 2032 (USD billion)

Source Secondary Research, Primary Research, MRFR Database, and Analyst Review

Medical Billing Outsourcing Services Insights

Based on Services, the Medical Billing Outsourcing market segmentation includes front end, middle, and back end. The front end segment dominated the market because front-end services consist of scheduling, preregistration, registration, eligibility, insurance verification, and pre-authorization. It comprises the main function of medical billing outsourcing.Managing front-end services well is key to reducing repetitive work and improving the patient experience with faster service.

Medical Billing Outsourcing End User Insights

The Medical Billing Outsourcing market segmentation, based on end-user, includes hospitals. The hospitals segment dominated the market, mainly due to the high demand for financing services in hospitals. In addition, hospital consolidation adds to the complexity of the reimbursement and billing process. This drives the demand for medical billing outsourcing services in the hospital sector.

September 2022, a new alliance between MatrixCare, a pioneer in software solutions for ambulatory care, and Quality Healthcare Resources, a dependable provider of RCM and financial services for skilled nursing facilities, will pave the way. By combining the strength of its technology with QHCR's technical and operational skills in revenue cycle management, MatrixCare is helping its clients boost their cash flow and efficiency. Clients of MatrixCare are more likely to get paid in a timely manner and for the full amount of their services thanks to the partnership between MatrixCare and Quality Healthcare Resources.

June 2023, Office Ally and OnPoint Healthcare Partners, a trusted partner in healthcare management, announced a strategic partnership to increase the availability of their respective products and services to the healthcare industry. As a result of this partnership, OnPoint will be able to give Office Ally's cutting-edge Revenue Cycle Management (RCM) solutions to the healthcare industry's providers, health systems, hospitals, and FQHCs. To meet the challenges of modern healthcare, providers require more resources and assistance. OnPoint Healthcare Partners and Office Ally are dedicated to helping them succeed in their jobs.

Medical Billing Outsourcing Regional Insights

By region, the study provides market insights into North America, Europe, Asia-Pacific, and the Rest of the World. The North American medical billing outsourcing market will dominate this market; due to the increased awareness about the benefits offered by outsourcing firms, providers are relying on the companies to maximize operating margins and manage high-volume transactions, which will boost the market growth in this Region.

Further, the major countries studied in the market report are The U.S., Canada, German, France, the UK, Italy, Spain, China, Japan, India, Australia, South Korea, and Brazil.

Figure 2 MEDICAL BILLING OUTSOURCING MARKET SHARE BY REGION 2023 (%)

Source Secondary Research, Primary Research, MRFR Database, and Analyst Review

Europe's Medical Billing Outsourcing market accounts for the second-largest market share due to the increasing need to reduce the healthcare delivery cost favoring the growth of the market in this Region. Further, the German Medical Billing Outsourcing market held the largest market share, and the UK Medical Billing Outsourcing market was the fastest-growing market in the European Region.

The Asia-Pacific Medical Billing Outsourcing Market is expected to grow at the fastest CAGR from 2024 - 2032. This is due toincreasing awareness about clinical billing software, and the rising adoption of the latest technology is expected to boost the market. Moreover, China’s Medical Billing Outsourcing market held the largest market share, and the Indian Medical Billing Outsourcing market was the fastest-growing market in the Asia-Pacific region.

Medical billing outsourcing Key Market Players & Competitive Insights.

Leading market players are investing heavily in research and development to expand their product lines, which will help the Medical Billing Outsourcing market grow even more. Market participants are also undertaking various strategic activities to expand their footprint, with important market developments including new product launches, contractual agreements, mergers and acquisitions, higher investments, and collaboration with other organizations. The medical billing outsourcing industry must offer cost-effective items to expand and survive in a more competitive and rising market climate.

Manufacturing locally to minimize operational costs is one of the key business tactics manufacturers use in the Medical Billing Outsourcing industry to benefit clients and increase the market sector. In recent years, the Medical Billing Outsourcing industry has offered some of the most significant advantages to medicine. Major players in the Medical Billing Outsourcing market, including R1 RCM Inc., Allscripts, Cerner Corporation, EClinical Works, Experian Information Solutions Inc., GENERAL ELECTRIC COMPANY, Genpact, HCL Technologies Limited, Kareo, Inc., McKesson Corporation, Quest Diagnostics Incorporated, The SSI Groups Inc., and others, are attempting to increase market demand by investing in research and development operations.

Conduent Inc. is an American business services provider headquartered in Florham Park, New Jersey. It was formed in 2017 as a divestiture from Xerox. The company offers digital platforms for businesses and governments. As of 2021, it had over 31,000 employees working across 22 countries. Conduent Incorporated announced a commercial agreement with Experian Health, a leading revenue cycle management product provider that includes patient engagement, patient access, and patient collections. The agreement allows Conduent’s digital IntelliHealth platform to connect with Experian’s consumer data and electronic income verification tool to speed prescription drug assistance approvals and shorten prescription fulfillment and time to therapy.

R1 RCM Inc. is an American revenue cycle management company servicing hospitals, health systems, and physician groups across the United States.R1 RCM Inc. announced acquiring Cerner's RefWorks services business and commercial, non-federal client relationships. RefWorks was involved in the revenue cycle management and billing business.

Key Companies in the medical billing outsourcing market include

• R1 RCM Inc.


• Allscripts


• Cerner Corporation


• EClinical Works


• Experian Information Solutions Inc.


• GENERAL ELECTRIC COMPANY


• Genpact


• HCL Technologies Limited


• Physician's Office


• Kareo Inc.


• McKesson Corporation

Medical billing outsourcing Industry Developments

December 2023, R1 RCM inc acquired Acclara (US), a leading technology-driven revenue cycle management company, to provide comprehensive revenue cycle management services. To generate long-term value for healthcare providers, clients, and investors, this partnership lays the foundation for R1 to continue automating revenue management while broadening its scope and variety

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