Medical Billing Outsourcing Market Size, Share & Trends Analysis Report By Component (In-House, Outsourced), By Service (Front End, Middle End, Back End), By End Use, By Region, And Segment Forecasts, 2020 - 2027

Published: Feb, 2020 | Pages: 108 | Publisher: Grand View Research
Industry: ICT | Report Format: Electronic (PDF)

The global medical billing outsourcing market size is projected to reach USD 23.1 billion by 2027, expanding at a CAGR of 12.3%, based on a new report by Grand View Research, Inc. A large amount of clinical code representation for diagnosis and treatment coupled with the presence of multiple payers, renders medical billing an intricate part of any clinical practice, posing significant challenges. Currently, the healthcare system is witnessing a subsequent rise in the outsourcing of clinical billing services by hospitals and physicians due to obligatory implementation of complex ICD-10 coding systems, increasing healthcare costs, and a federal mandate to implement electronic medical records (EMR) to maintain reimbursement levels.

Furthermore, clinics/physician offices are gradually outsourcing their revenue management to cut unnecessary costs and prevent the burden of managing an administrative team to ensure effective handling of in-house billing functions. In addition, multispecialty healthcare groups are implementing consolidation requiring EHR integration and building large healthcare networks. This integration creates a need for revenue cycle management (RCM), which, in turn, demands additional expertise and trained personnel to manage the same. Thus, the consolidation of large healthcare practices is also expected to be one of the factors fueling market growth.

Further key findings from the study suggest:

• The outsourced segment accounted for the largest market share in the component segment in 2019 and is expected to witness a high CAGR attributed to rising preference of hospitals, physician office, and startups opting for outsourced medical billing services for hassle-free claim management at low cost

• Front-end services led the market in 2019. However, the middle-end services segment is expected to register the highest CAGR over the forecast period due to the growing demand for revenue cycle management (RCM) services offering electronic health records (HER) software

• Hospitals, possessing higher claim volumes, accounted for the largest revenue share in the market in 2019 and is estimated to maintain the dominance even during the forecast years

• North America held the largest share of the global medical billing outsourcing market. It is projected to expand further as U.S. has witnessed a change in the healthcare system with the implementation of ICD-10 coding and pressure from the government to incorporate the EMR management system

• Some of the key firms in this industry include R1 RCM, Inc.; Allscripts Healthcare Solutions, Inc.; Cerner Corporation; eClinicalWorks, LLC; Experian Information Solutions, Inc.; GE Healthcare; Genpact; HCL; Kareo, Inc.; McKesson Corporation; Quest Diagnostics; and The SSI Group, LLC.

• Medical billing and revenue cycle management (RCM) companies such as AetnaHealth, are offering successful implementation of EMR at the practice level and are expected to transform the market.

 Table of Contents

Chapter 1 Research Objective
                   1.1 Objective - 1
                   1.2 Objective - 2
                   1.3 Objective - 3
                   1.4 Objective - 4
Chapter 2 Executive Summary
                   2.1 Market Outlook
                   2.2 Segment Outlook
                       2.2.1 Component
                       2.2.2 Service
                       2.2.3 End use
                       2.2.4 Region
                   2.3 Competitive Insights
                   2.4 Medical Billing Outsourcing Market Snapshot
Chapter 3 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 Segmentation
                   3.3 Analysis
                   3.4 Penetration and Growth Prospect Mapping
                       3.4.1 Analysis
                   3.5 Market Dynamics
                       3.5.1 Market driver analysis
                           3.5.1.1 Growing focus on increasing the profitability and revenue generated by the business
                           3.5.1.2 Federal mandate to implement digital record keeping by healthcare providers
                           3.5.1.3 Rapidly changing healthcare regulations
                       3.5.2 Market restraint analysis
                           3.5.2.1 High threat to data breaching
                   3.6 Business Environment Analysis Tools
                       3.6.1 Industry analysis - Porter’s
                           3.6.1.1 Competitive rivalry: High
                           3.6.1.2 Threat of new entrants
                           3.6.1.3 Bargaining power of buyers
                           3.6.1.4 Bargaining power of suppliers
                           3.6.1.5 Threat of substitutes
                       3.6.2 PEST analysis
                           3.6.2.1 Political landscape
                           3.6.2.2 Economic and social landscape
                           3.6.2.3 Technology landscape
                   3.7 Major Deals & Strategic Alliances Analysis
                       3.7.1 Joint ventures & partnerships
                       3.7.2 Mergers & acquisitions
Chapter 4 Medical Billing Outsourcing Market: Component Estimates & Trend Analysis
                   4.1 Segment Dashboard
                   4.2 Medical Billing Outsourcing Market: Component Movement Analysis, USD Million, 2019 & 2027
                       4.2.1 In-house
                           4.2.1.1 In-house market, 2016 - 2027 (USD Million)
                       4.2.2 Outsourced
                           4.2.2.1 Outsourced market, 2016 - 2027 (USD Million)
Chapter 5 Medical Billing Outsourcing Market: Service Estimates & Trend Analysis
                   5.1 Segment Dashboard
                   5.2 Medical Billing Outsourcing Market: Service Movement Analysis, USD Million, 2019 & 2027
                       5.2.1 Front end
                           5.2.1.1 Front end market, 2016 - 2027 (USD Million)
                       5.2.2 Middle end
                           5.2.2.1 Middle end market, 2016 - 2027 (USD Million)
                       5.2.3 Back end
                           5.2.3.1 Back end market, 2016 - 2027 (USD Million)
Chapter 6 Medical Billing Outsourcing Market: End Use Estimates & Trend Analysis
                   6.1 Segment Dashboard
                   6.2 Medical Billing Outsourcing Market: End Use Movement Analysis, USD Million, 2019 & 2027
                       6.2.1 Hospital
                           6.2.1.1 Hospital market, 2016 - 2027 (USD Million)
                       6.2.2 Physician office
                           6.2.2.1 Physician office market, 2016 - 2027 (USD Million)
                       6.2.3 Others
                           6.2.3.1 Others market, 2016 - 2027 (USD Million)
Chapter 7 Medical Billing Outsourcing Market: Regional Estimates & Trend Analysis
                   7.1 Regional Market Share Analysis, 2019 & 2027
                   7.2 Regional Market Dashboard
                   7.3 Regional Market Snapshot (Countries)
                   7.4 Regional Leading Players, 2019
                       7.4.1 North America
                       7.4.2 Europe
                       7.4.3 Asia Pacific
                       7.4.4 Latin America
                       7.4.5 Middle East & Africa
                   7.5 Regional SWOT Analysis
                       7.5.1 North America
                       7.5.2 Europe
                       7.5.3 Asia Pacific
                       7.5.4 Latin America
                       7.5.5 MEA
                   7.6 North America
                       7.6.1 U.S. medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.6.2 Canada medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                   7.7 Europe
                       7.7.1 Germany medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.7.2 U.K. medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.7.3 Spain medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.7.4 France medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.7.5 Italy medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                   7.8 Asia Pacific
                       7.8.1 Japan medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.8.2 China medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.8.3 India medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                   7.9 Latin America
                       7.9.1 Brazil medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.9.2 Mexico medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                   7.10 Middle East & Africa
                       7.10.1 South Africa medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
                       7.10.2 Saudi Arabia medical billing outsourcing market estimates and forecasts, 2016 - 2027 (USD Million)
Chapter 8 Competitive & Vendor Landscape
                   8.1 Recent Development & Impact Analysis, by Key Market Participants
                   8.2 Strategy Mapping
                       8.2.1 Launch of new products
                       8.2.2 Acquisition
                       8.2.3 Expansion
                       8.2.4 Agreements, collaborations, partnerships
                       8.2.5 Marketing
                   8.3 Strategic Framework/Competition Categorization (Key Innovators, Market Leaders, Emerging Players)
                   8.4 Company Market Position Analysis (Revenue, Service Portfolio, Geographic Presence, Employee Strength, Strategic Initiatives)
                       8.4.1 Analysis
                   8.5 Company Profiles
                       8.5.1 R1 RCM, Inc.
                           8.5.1.1 Company overview
                           8.5.1.2 Financial performance
                           8.5.1.3 Service benchmarking
                           8.5.1.4 Strategic initiatives
                           8.5.1.5 SWOT analysis
                       8.5.2 Allscripts; Cerner Corporation
                       8.5.3 eClinicalWorks LLC
                       8.5.4 Experian Information Solutions, Inc.
                       8.5.5 GE Healthcare
                       8.5.6 Genpact
                       8.5.7 Kareo, Inc.;
                       8.5.8 McKesson Corporation
                       8.5.9 Quest Diagnostics
                       8.5.10 Cerner Corporation
Chapter 9 Recommendations
Chapter 10 Research Methodology & Scope
                   10.1 Research Methodology
                       10.1.1 Information procurement
                           10.1.1.1 Purchased database:
                           10.1.1.2 GVR’s internal database
                       10.1.2 Primary Research
                   10.2 Research Scope and Assumptions
                   10.3 List to Data Sources
Chapter 11 Report FAQs
                   11.1 How do I trust your report quality/data accuracy?
                   11.2 My research requirement is very specific; can I customize this report?
                   11.3 I have a pre-defined budget. Can I buy chapters/sections of this report?
                   11.4 How do you arrive at these market numbers?
                   11.5 Who are your clients?
                   11.6 How will I receive this report?
Chapter 12 Appendix
Chapter 13 Compass - Cloud Based Report Delivery Platform
Chapter 14 Related Reports

List of Tables

TABLE 1 List of secondary sources
TABLE 2 List of abbreviation
TABLE 3 North America medical billing outsourcing market, by country, 2016 - 2027 (USD Million)
TABLE 4 North America medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 5 North America medical billing outsourcing market, by service 2016 - 2027 (USD Million)
TABLE 6 North America medical billing outsourcing market, by end use 2016 - 2027 (USD Million)
TABLE 7 U.S. medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 8 U.S. medical billing outsourcing market, by service 2016 - 2027 (USD Million)
TABLE 9 U.S. medical billing outsourcing market, by end use 2016 - 2027 (USD Million)
TABLE 10 Canada medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 11 Canada medical billing outsourcing market, by service 2016 - 2027 (USD Million)
TABLE 12 Canada medical billing outsourcing market, by end use 2016 - 2027 (USD Million)
TABLE 13 Europe medical billing outsourcing market, by country, 2016 - 2027 (USD Million)
TABLE 14 Europe medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 15 Europe medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 16 Europe medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 17 Germany medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 18 Germany medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 19 Germany medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 20 U.K. medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 21 U.K. medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 22 U.K. medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 23 Spain medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 24 Spain medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 25 Spain medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 26 France medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 27 France medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 28 France medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 29 Italy medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 30 Italy medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 31 Italy medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 32 Asia Pacific medical billing outsourcing market, by country, 2016 - 2027 (USD Million)
TABLE 33 Asia Pacific medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 34 Asia Pacific medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 35 Asia Pacific medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 36 Japan medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 37 Japan medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 38 Japan medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 39 China medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 40 China medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 41 China medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 42 India medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 43 India medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 44 India medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 45 Latin America medical billing outsourcing market, by country, 2016 - 2027 (USD Million)
TABLE 46 Latin America medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 47 Latin America medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 48 Latin America medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 49 Brazil medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 50 Brazil medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 51 Brazil medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 52 Mexico medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 53 Mexico medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 54 Mexico medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 55 MEA medical billing outsourcing market, by country, 2016 - 2027 (USD Million)
TABLE 56 MEA medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 57 MEA medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 58 MEA medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 59 South Africa medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 60 South Africa medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 61 South Africa medical billing outsourcing market, by end use, 2016 - 2027 (USD Million)
TABLE 62 Saudi Arabia medical billing outsourcing market, by component, 2016 - 2027 (USD Million)
TABLE 63 Saudi Arabia medical billing outsourcing market, by service, 2016 - 2027 (USD Million)
TABLE 64 Saudi Arabia medical billing outsourcing market, by end use, 2016 - 2027 (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 QFD modelling for market share assessment
Fig. 7 Market formulation & validation
Fig. 8 Medical billing outsourcing market outlook, 2019
Fig. 9 Medical billing outsourcing market segmentation
Fig. 10 Market Dynamics
Fig. 11 Market driver relevance analysis (Current & future impact)
Fig. 12 Market restraint relevance analysis (Current & future impact)
Fig. 13 Penetration & growth prospect mapping
Fig. 14 Medical billing outsourcing market - PESTLE analysis
Fig. 15 Medical billing outsourcing market: Porter’s five forces model
Fig. 16 Market entry strategies
Fig. 17 Company/competition categorization (Key innovators, market leaders, emerging players)
Fig. 18 Strategy framework
Fig. 19 Medical billing outsourcing competitive landscape: Market position analysis (based on services, regional presence, and recent updates (2019))
Fig. 20 Medical billing outsourcing component market share analysis, 2019 & 2027
Fig. 21 Medical billing outsourcing component market: Segment dashboard
Fig. 22 In-house medical billing market, 2016 - 2027 (USD Million)
Fig. 23 Outsourced medical billing market, 2016 - 2027 (USD Million)
Fig. 24 Medical billing outsourcing service market share analysis, 2019 & 2027
Fig. 25 Medical billing outsourcing service market: Segment dashboard
Fig. 26 Front end services market, 2016 - 2027 (USD Million)
Fig. 27 Middle end services market, 2016 - 2027 (USD Million)
Fig. 28 Back end services market, 2016 - 2027 (USD Million)
Fig. 29 Medical billing outsourcing end-use market share analysis, 2019 & 2027
Fig. 30 Medical billing outsourcing end-use market: Segment dashboard
Fig. 31 Hospitals market, 2016 - 2027 (USD Million)
Fig. 32 Physician offices market, 2016 - 2027 (USD Million)
Fig. 33 Others market, 2016 - 2027 (USD Million)
Fig. 34 Regional outlook, 2019 & 2027
Fig. 35 Regional marketplace: Key takeaways
Fig. 36 North America medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 37 U.S. medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 38 Canada medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 39 Europe medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 40 Germany medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 41 U.K. medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 42 Spain medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 43 France medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 44 Italy medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 45 Asia Pacific medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 46 Japan medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 47 China medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 48 India medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 49 Latin America medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 50 Brazil medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 51 Mexico medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 52 MEA medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 53 South Africa medical billing outsourcing market, 2016 - 2027 (USD Million)
Fig. 54 Saudi Arabia medical billing outsourcing market, 2016 - 2027 (USD Million)