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U.S. Hospital Revenue Cycle Management





NEW YORK, April 11, 2013 /PRNewswire/ -- Reportlinker.com announces that a new market research report is available in its catalogue:

U.S. Hospital Revenue Cycle Management

http://www.reportlinker.com/p01158732/US-Hospital-Revenue-Cycle-Management.html#utm_source=prnewswire&utm_medium=pr&utm_campaign=Medical_Facility

Overview and Outlook, 2012-2017

Revenue cycle management (RCM) solutions are used to help healthcare providers to maximize the collection of payments from insurance companies and/or patients by rationalizing a number of complex processes that occur across the entire patient accounts pathway. A large number and variety of vendors serve the hospital RCM market. Many vendors offer both software applications and services, while others specialize in one or the other. Some vendors only address the hospital market and some sell products and/or services to hospitals as well as ambulatory providers.

Executive Summary

• Revenue cycle management (RCM) solutions are used to help healthcare providers maximize the collection of payments from insurance companies and/or patients by rationalizing a number of complex processes and steps that occur across the entire patient-accounts pathway.• A number of different software applications are utilized to address specific tasks involved with managing the revenue cycle. RCM software applications are usually characterized in two segments—core, or platform, solutions, and point solutions, or "bolt-ons," which provide added functionalities to core applications. In addition to information technology, a number of RCM services such as consulting and outsourcing are used by healthcare providers to provide additional capabilities across the RCM process.• A large number and variety of vendors serve the hospital RCM market. Many vendors offer both software applications and services, while others specialize in one or the other. Some vendors only address the hospital market and some sell products and/or services to hospitals as well as ambulatory providers including physicians and other providers.• Today, there are well over Xvendors serving the hospital RCM market in some capacity, and that number is expected to grow, particularly among vendors of point solutions and services, as hospitals increasingly focus on re-engineering RCM to meet growing challenges associated with healthcare reform.• In recent years, RCM solutions have taken a backseat to clinical systems because of providers' focus on adopting clinical solutions like electronic health records (EHRs) needed to meet Meaningful Use (MU). As the MU program matures, hospitals are expected to shift their focus to RCM in order to prepare for changes in reimbursement and patient demographics.• Today, revenue cycle processes and workflows are receiving unprecedented attention in the market as hospitals realize they must take every measure to maximize revenue and address inefficiencies and shortfalls in getting paid fully and on a timely basis. Many hospitals will need to significantly re-engineer their entire RCM function, and most seek solutions that offer robust integration between clinical and financial systems.• The current penetration of RCM solutions for the inpatient (hospital) environment varies by type of application. Software applications needed for the core functions of patient registration, scheduling, billing, coding, and claims processing are almost universally adopted in hospitals today (> X percent), while other RCM applications are less penetrated or significantly vary in penetration across various types of hospitals.• In terms of services, estimates on the rate of utilization of managed services across the hospital market vary significantly, ranging from X percent to X percent. Very few hospitals outsource their entire RCM function (>X percent), but some do.• Total revenue for the U.S. hospital RCM market is estimated at $X million for the base year, 2012. This figure includes revenue derived from application software and selected services. Computer hardware is excluded from this calculation.• Total market revenue is expected to increase steadily year over year, reaching $X million in 2017, representing a X percent increase from 2012. The total market revenue CAGR for the 2012 to 2017 forecast period is Xpercent.• The majority of the revenue for hospital RCM will come from replacements and/or updates of legacy systems, including the addition of new modules to enable more advanced capabilities required by healthcare reform. In addition, hospitals will increase their use of managed services and consultants to address internal staffing and skill shortages, provide niche services, and lower costs for some routine administrative functions.

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