Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

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Revenue Cycle Management Outsourcing is Set to Expand

By Ryan Mcaskill

According to reports, investment is revenue cycle management outsourcing could expand at a CAGR of 7.2 percent through 2019.

- The start of the new year brings with a fresh start and a fresh set of predictions. Another year of data and trends to analyze, means research firms are able to take a longer look into the future. If current reports are to be believed, the revenue cycle management (RCM) process and outsourcing strategies are going to experience a boom.

Revenue Cycle Management Outsourcing

According to a recent report from MicroMarket Monitor, a global market research firm, the North American RCM system market is projected to growth at a compounded annual growth rate of 7.2 percent through the year 2019.

“RCM has become one of the most popular functions for healthcare providers to outsource, due to its critical importance and significant challenges associated with managing internal functionalities of hospitals and clinics, in an efficient and cost-effective manner,” the report reads. “The transformation of the U.S. healthcare facility is anticipated to ensure widespread adoption of these outsourced services.”

The report adds that the growing complexity of healthcare reform is laying emphasis on the need to have an optimized RCM solution that functions with accountable care organizations, physician practices, ambulatory clinics and hospitals. These systems are critical because they are central to operations as a whole. They help clinical staff manage claims, payments, reimbursement and revenue. In many cases, this process is being automated and upgrades to technology and processes is critical  to streamlining transactions and eliminating human errors.

This goes along with previous reports, that show the RCM marketplace is growing. According to a study from Black Book Research, the RCM outsourcing industry currently sits at $7.7 billion and could grow to $9.9 billion by mid-2016. The study also found that 45 percent of struggling hospitals plan to take a long look at outsourcing their complete RCM system.

“After carefully identifying and assessing their organizations’ core competencies, hundreds of hospitals have moved to outsourced RCM services over the last two years,” said Doug Brown, Managing Partner of Black Book Market Research. “It has been no surprise that many overwhelmed hospital leaders have realized that RCM isn’t their organization’s core competency, and have turned to large end-to-end outsourcing firms for RCM to refocus on patient care and clinical service delivery.”

Outsourcing Healthcare IT

While the MicroMarket study touches on outsourcing RCM solutions, a different report from TechNavio examined the global healthcare and life sciences sectors and found that a larger number of companies are outsourcing their IT management  solutions. Furthermore, through 2019, outsourcing will grow at a CAGR of 8.6 percent.

“Healthcare providers have begun subscribing to IT outsourcing services to deliver improved patient care services and to maximize staff efficiency,” the report reads. “IT outsourcing also reduces operational and maintenance costs and enables healthcare providers to focus on core business areas and deal with the complexities of patient care more efficiently.”

The report states that the usual applications and services that are outsources include operational, financial, database management and infrastructure-related services.

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