U.S. EMS Billing Services Market Size, Share & Trends Analysis Report By Component (In-house, Outsourced), Competitive Landscape, And Segment Forecasts, 2019 - 2026

Published: Dec, 2019 | Pages: 55 | Publisher: Grand View Research
Industry: Medical Devices | Report Format: Electronic (PDF)

The U.S. EMS billing services market size is anticipated to reach USD 2.6 billion by 2026, based on a new report by Grand View Research, Inc., registering a CAGR of 8.9% over the forecast period. Growing demand for error-free electronic accounting processes and faster claim processing is expected to fuel market growth. Outsourcing is a cost-efficient alternative to expensive in-house processes. For instance, in-house solutions need a high initial cost for setup, in addition to staff salaries, training and education, department costs, software and hardware costs, and direct claim processing costs. With the services being outsourced, the administrative cost of the EMS agency can be reduced to maximize the overall revenue.

The cost of administration of the U.S. healthcare system is significantly high, with Billing and Insurance-related (BIR) activities comprising a large share in the total cost. The cost of billing EMS is included under administrative cost, which includes billing of ambulance services provided to physicians and hospitals. Billing and reimbursement are important parts of any EMS operation. The process of verification, accounting, and reimbursement is complex and takes time and resources. EMS billing includes financial support operations that involve complete revenue cycle management of a company with the help of software and additional staffing.

Further key findings from the study suggest:

• Outsourced solutions dominated the market by component in 2018. Outsourcing has become the method of choice for EMS agencies for streamlined workflow and maximized revenue availability of numerous third-parties in the country

• Growing demand for third-party service providers for maximized revenue and more efficient claim filing with a low rate of denial are other major factors fueling market growth. Availability of certified medical coders and skilled staff helps avoid unnecessary delay, thus helping patients to save costs and avail quality offerings

• Key industry participants providing in-house and outsourced EMS billing solutions include EMS Billing Management, LLC; Omni Medical Billing Service, Inc.; EMS Billing Services; Change Healthcare; 911 Billing Services & Consultant, Inc.; EMS Billing & Management Consultant (EMS|MC); The Billing Pros; PCC Ambulance Billing Services; and Pintler Billing Services

• Acquisitions and partnerships are the major strategies being followed by players in this market. For instance, in October 2016, EMS Management & Consultants, Inc. underwent a long-term partnership with regional healthcare system East Texas Medical Center EMS (ETMC EMS) and 911 ambulance transport service provider called Paramedics Plus to offer revenue cycle management services.

 Table of Contents

Chapter 1 Methodology and Scope
                   1.1 Market Segmentation & Scope
                       1.1.1 Component
                           1.1.1.1 In-house
                           1.1.1.2 Outsourced
                       1.1.2 Estimates and forecast timeline
                   1.2 Research Methodology
                   1.3 Information Procurement
                       1.3.1 Purchased database
                       1.3.2 GVR's internal database
                       1.3.3 Secondary sources
                       1.3.4 Primary research
                       1.3.5 Details of primary research
                   1.4 Information or Data Analysis
                       1.4.1 Data analysis models
                   1.5 Market Formulation & Validation
                   1.6 Model Details
                       1.6.1 Commodity flow analysis
                           1.6.1.1 Approach 1: Commodity flow approach
                       1.6.2 Volume price analysis
                           1.6.2.1 Approach 2: Volume price analysis
                   1.7 List of Secondary Sources
                   1.8 List of Abbreviations
                   1.9 Objectives
                       1.9.1 Objective 1
                       1.9.2 Objective 2

Chapter 2 Executive Summary
                   2.1 Market Outlook
                   2.2 Segment Outlook
                       2.2.1 By Component
                       2.2.2 Competitive landscape

Chapter 3 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 Market Dynamics
                       3.3.1 Market driver analysis
                           3.3.1.1 Outsourcing as a cost-effective option
                           3.3.1.2 Technological advancement for improved billing service
                           3.3.1.3 Enhanced accuracy of EMS billing records
                       3.3.2 Market restraint analysis
                           3.3.2.1 High cost associated with standard rate of collection
                           3.3.2.2 Discrepancy in the claim denial statistics hampers providers efficiency
                           3.3.2.3 Cybersecurity threat for EMS billing software
                   3.4 Penetration & Growth Prospect Mapping
                       3.4.1 Penetration & growth prospect mapping analysis
                   3.5 Regulatory & Reimbursement Framework
                       3.5.1 Emergency Medical Billing (EMS) billing service regulations in the U.S.
                   3.6 Business Environment Analysis Tools
                       3.6.1 U.S. Emergency Medical Services (EMS) billing service market: Porter's five forces analysis
                       3.6.2 U.S. Emergency Medical Services (EMS) billing service market: PESTEL analysis
                       3.6.3 Major deals & strategic alliances analysis
                           3.6.3.1 Mergers & acquisitions and joint ventures
                           3.6.3.2 Licensing & partnerships and technology collaborations

Chapter 4 U.S. Emergency Medical Services (EMS) Billing Service Market: Component Analysis
                   4.1 U.S. Emergency Medical Services (EMS) Billing Service Component Market Share Analysis, 2018 & 2026
                   4.2 U.S. Emergency Medical Services (EMS) Billing Service Component Market: Segment Dashboard
                   4.3 U.S. Emergency Medical Services (EMS) Billing Service Component Market: Movement Analysis
                       4.3.1 U.S. Emergency Medical Services (EMS) billing service market, 2015 - 2026 (USD Million)
                   4.4 Market Size & Forecasts and Trend Analyses, 2015 to 2026 for the Component Segment
                       4.4.1 In-house
                           4.4.1.1 In-house market, 2015 - 2026 (USD Million)
                       4.4.2 Outsourced
                           4.4.2.1 Outsourced market, 2015 - 2026 (USD Million)

Chapter 5 Competitive Analysis
                   5.1 Strategic Framework/Competition Categorization (Key Innovators, Market Leaders, Emerging Players)
                   5.2 Vendor Landscape
                       5.2.1 Company market position analysis (Market presence, service portfolio, employee strength, strategic initiatives)
                           5.2.1.1 Analysis
                   5.3 Company Profiles
                       5.3.1 EMS Management & Consultants, Inc. (EMS|MC)
                           5.3.1.1 Company overview
                           5.3.1.2 Financial performance
                           5.3.1.3 Service benchmarking
                           5.3.1.4 Strategic initiatives
                           5.3.1.5 SWOT analysis
                       5.3.2 The Billing Pros
                           5.3.2.1 Company overview
                           5.3.2.2 Financial performance
                           5.3.2.3 Product/Service benchmarking
                           5.3.2.4 SWOT analysis
                       5.3.3 Omni Medical Billing Service, Inc.
                           5.3.3.1 Company overview
                           5.3.3.2 Financial performance
                           5.3.3.3 Product/service benchmarking
                           5.3.3.4 SWOT analysis
                       5.3.4 EMS Billing Services, Inc.
                           5.3.4.1 Company overview
                           5.3.4.2 Financial performance
                           5.3.4.3 Product/service benchmarking
                           5.3.4.4 Strategic initiatives
                           5.3.4.5 SWOT analysis
                       5.3.5 911 Billing Services & Consultant, Inc.
                           5.3.5.1 Company overview
                           5.3.5.2 Financial performance
                           5.3.5.3 Product/service benchmarking
                           5.3.5.4 Strategic initiatives
                           5.3.5.5 SWOT analysis
                       5.3.6 Change Healthcare
                           5.3.6.1 Company overview
                           5.3.6.2 Financial performance
                           5.3.6.3 Product/service benchmarking
                           5.3.6.4 Strategic initiatives
                           5.3.6.5 SWOT analysis
                       5.3.7 PCC Ambulance Billing Services
                           5.3.7.1 Company overview
                           5.3.7.2 Financial performance
                           5.3.7.3 Service benchmarking
                           5.3.7.4 SWOT analysis
                       5.3.8 EMS Billing Management, LLC
                           5.3.8.1 Company overview
                           5.3.8.2 Financial performance
                           5.3.8.3 Service benchmarking
                           5.3.8.4 Strategic initiatives
                           5.3.8.5 SWOT analysis?
                       5.3.9 Pintler Billing Services
                           5.3.9.1 Company overview
                           5.3.9.2 Financial performance
                           5.3.9.3 Product/service benchmarking
                           5.3.9.4 SWOT analysis

List of Tables

TABLE 1 List of secondary sources
TABLE 2 List of abbreviations
TABLE 3 HCPCS codes for ambulance billing service
TABLE 4 Mergers & acquisition and joint ventures
TABLE 5 Licensing & partnerships and technology collaborations
TABLE 6 U.S. Emergency Medical Services (EMS) billing service market, by component 2015 - 2026 (USD million)

List of Figures

Fig. 1 Market research process
Fig. 2 Data triangulation techniques
Fig. 3 Primary research pattern
Fig. 4 Market research approaches
Fig. 5 Value-chain-based sizing & forecasting
Fig. 6 QFD modeling for market share assessment
Fig. 7 Market formulation & validation
Fig. 8 Market outlook. 2018 (USD Million)
Fig. 9 U.S. Emergency Medical Services (EMS) billing services market segmentation
Fig. 10 Market trends & outlook
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 U.S. Emergency Medical Services (EMS) billing service market: Porter's five forces analysis
Fig. 15 U.S. Emergency Medical Services (EMS) billing service market: PESTLE analysis
Fig. 16 U.S. Emergency Medical Services (EMS) billing service component market: Segment dashboard
Fig. 17 U.S. Emergency Medical Services (EMS) billing service component market: Movement analysis
Fig. 18 U.S. Emergency Medical Services (EMS) billing service market, 2015 - 2026 (USD Million)
Fig. 19 In-house market, 2015-2026 (USD Million)
Fig. 20 Outsourced market, 2015 - 2026 (USD Million)
Fig. 21 Strategy framework/Competition categorization
Fig. 22 Company market position analysis (Market presence, service portfolio, employee strength, strategic initiatives)