The global medical billing outsourcing market size is projected to reach USD 19.7 billion by 2026 expanding at a CAGR of 11.8%, based on a new report by Grand View Research, Inc. Large amount of medical code representation for diagnosis and treatment coupled with the presence of multiple payers renders medical billing an intricate part of any medical practice, posing significant challenges. Currently, the healthcare system is witnessing a subsequent rise in outsourcing of medical billing services by hospitals and physicians due to obligatory implementation of complex ICD-10 coding system, increasing healthcare costs, and 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 medical 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, consolidation of large healthcare practices is also expected to be a one of the factors fueling the market growth.
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Further key findings from the study suggest:
- In-house segment accounted for the largest market share in 2018. However, outsourced medical billing is expected to be the largest and fastest-growing segment in future
- Front-end services led the market in 2018. However, middle-end services segment is expected to register the highest CAGR of 12.4% over the forecast period
- Hospitals accounted for the largest market share of the medical billing outsourcing market in 2018 and is estimated to maintain the dominance even during the forecast years
- North America held the largest share of the global market. It is projected to expand further as U.S. has witnessed a change in healthcare system with the implementation of ICD-10 coding and pressure from the government to incorporate EMR management system
- Some of the key firms in this industry include Accretive Health, Inc.; Allscripts; Cerner Corporation; EClinicalWorks; Experian Information Solutions, Inc.; GE Healthcare; Genpact; HCL; Kareo; McKesson Corporation; Quest Diagnostics; and The SSI Group, LLC