US Medical Billing Outsourcing Market Introduction and Overview
According to SPER Market Research, the US Medical Billing Outsourcing Market is estimated to reach USD 14.04 Billion by 2033 with a CAGR of 12.5%.
The report includes an in-depth analysis of the US Medical Billing Outsourcing Market, including market size and trends, product mix, applications, and supplier analysis. Medical billing outsourcing is the process of handing off the duty of medical coding and invoicing from healthcare practitioners to qualified outside service providers. These service providers are skilled in managing the revenue cycle, coding, reimbursement, and filing of claims, among other facets of medical billing. Healthcare providers can improve revenue collection, streamline operations, and lessen administrative responsibilities by outsourcing these tasks.
- February 2023: AI Advantage, a software created specifically to address the rising problem of healthcare insurance claim denials, was introduced by Experian Health. This innovative system offers a seamless and all-inclusive solution for claims administration in the healthcare sector by utilising artificial intelligence and Experian's big data solutions experience.
- January 2022: A final agreement was signed by R1RCM Inc. to acquire Cloudmed. The transaction, which was valued at USD 4.1 billion, is anticipated to go into an 18-month lockup.
Market Opportunities and Challenges
Opportunities:
- Future opportunities to lead the market are being created by creative and novel ways: The field of research and development is expanding quickly as a result of rising funding, new technologies, and sophisticated resources made available to the healthcare system. The rising cost of healthcare in underdeveloped nations has prompted technological innovations like medical bill outsourcing. In addition to visiting hospitals, patients in the US are referred to insurance companies for help with paying their medical bills. With the use of electronic health record (EHR) systems, medical representatives can effortlessly manage patient records and assist with billing, which is expected to propel the market during the forecast period.
Challenges:
- The market's expansion is hampered by the shortage of qualified healthcare professionals: Throughout the projection period, the lack of qualified personnel will operate as a barrier and impede the expansion of the medical billing outsourcing market. Unless a physician practices or clinic hires a seasoned billing company.
Market Competitive Landscape
The major key players in the US Medical Billing Outsourcing Market are: Advanced MD, Inc., Allscripts Healthcare, LLC, Care Cloud, Cerner Corporation, eClinicalWorks, Kareo Inc., McKesson Corporation, Promantra Inc., Quest Diagnostics Incorporated, R1RCM Inc., Others. Businesses in the sector are concentrated on finding opportunities to reduce costs and simplifying their products and services. Because of this, more healthcare professionals will choose to outsource their revenue management procedures in order to maximise profits. Moreover, important businesses use partnerships and acquisitions as important business strategy to broaden their service offerings and geographic reach.
Scope of the Report:
| Report Metric | Details |
| Market size available for years | 2019-2033 |
| Base year considered | 2022 |
| Forecast period | 2023-2033 |
| Segments covered | By Component, By Service, By End Use
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| Regions covered | Eastern Region, Western Region, Southern Region, Northern Region
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| Companies Covered | Advanced MD, Inc., Allscripts Healthcare, LLC, Care Cloud, Cerner Corporation, eClinicalWorks, Kareo Inc., McKesson Corporation, Promantra Inc., Quest Diagnostics Incorporated, R1RCM Inc., Others
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COVID-19 Impact on US Medical Billing Outsourcing Market
The growing impact of technology in healthcare during the Covid-19 pandemic contributed to the industry's good rise in medical billing outsourcing. Historically dependent on regional systems, the pandemic spurred the industry's digital development and helped to expand the market as a whole. The crisis made clear how important it is to have a strong digital health infrastructure, which led several healthcare sectors to develop new plans of action. It is projected that the market would develop as a result of the adoption of digitization and the outsourcing of non-core operations, especially accounting and billing. The need for medical billing outsourcing services is rising due in part to the surge in digital invoicing during the pandemic and growing consumer interest in online bill payments.
Key Target Audience:
- Healthcare Consultants
- Healthcare IT Companies
- Healthcare Payers
- Healthcare Providers
- Medical Billing Service Providers
- Medical Coding Professionals
- Pharmaceutical Companies
- Others
Our in-depth analysis of the US Medical Billing Outsourcing Market includes the following segments:
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By Component:
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In-house
Outsourced
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By Service:
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Front-end Services
Middle-end Services
Back-end Services
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By End Use:
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Hospitals
Physician Offices
Others
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Key Topics Covered in the Report:
- US Medical Billing Outsourcing Market Size (FY’2023-FY’2033)
- Overview of US Medical Billing Outsourcing Market
- Segmentation of US Medical Billing Outsourcing Market By Component (-house, Outsourced)
- Segmentation of US Medical Billing Outsourcing Market By Service (Front-end Services, Middle-end Services, Back-end Services)
- Segmentation of US Medical Billing Outsourcing Market By End Use (Hospitals, Physician Offices, Others)
- Statistical Snap of US Medical Billing Outsourcing Market
- Expansion Analysis of US Medical Billing Outsourcing Market
- Problems and Obstacles in US Medical Billing Outsourcing Market
- Competitive Landscape in the US Medical Billing Outsourcing Market
- Impact of COVID-19 and Demonetization on US Medical Billing Outsourcing Market
- Details on Current Investment in US Medical Billing Outsourcing Market
- Competitive Analysis of US Medical Billing Outsourcing Market
- Prominent Players in the US Medical Billing Outsourcing Market
- SWOT Analysis of US Medical Billing Outsourcing Market
- US Medical Billing Outsourcing Market Future Outlook and Projections (FY’2023-FY’2033)
- Recommendations from Analyst
1. Introduction
1.1. Scope of the report
1.2. Market segment analysis
2. Research Methodology
2.1. Research data source
2.1.1. Secondary Data
2.1.2. Primary Data
2.1.3. SPER’s internal database
2.1.4. Premium insight from KOL’s
2.2. Market size estimation
2.2.1. Top-down and Bottom-up approach
2.3. Data triangulation
3. Executive Summary
4. Market Dynamics
4.1. Driver, Restraint, Opportunity and Challenges analysis
4.1.1. Drivers
4.1.2. Restraints
4.1.3. Opportunities
4.1.4. Challenges
4.2. COVID-19 Impacts of the US Medical Billing Outsourcing Market
5. Market variable and outlook
5.1. SWOT Analysis
5.1.1. Strengths
5.1.2. Weaknesses
5.1.3. Opportunities
5.1.4. Threats
5.2. PESTEL Analysis
5.2.1. Political Landscape
5.2.2. Economic Landscape
5.2.3. Social Landscape
5.2.4. Technological Landscape
5.2.5. Environmental Landscape
5.2.6. Legal Landscape
5.3. PORTER’s Five Forces
5.3.1. Bargaining power of suppliers
5.3.2. Bargaining power of buyers
5.3.3. Threat of Substitute
5.3.4. Threat of new entrant
5.3.5. Competitive rivalry
5.4. Heat Map Analysis
6. Competitive Landscape
6.1. US Medical Billing Outsourcing Market Manufacturing Base Distribution, Sales Area, Product Type
6.2. Mergers & Acquisitions, Partnerships, Product Launch, and Collaboration in US Medical Billing Outsourcing Market
7. US Medical Billing Outsourcing Market, By Component (USD Million)
7.1. US Medical Billing Outsourcing Market Value Share and Forecast, By Component, 2023-2033
7.2. In-house
7.3. Outsourced
8. US Medical Billing Outsourcing Market, By Service (USD Million)
8.1. US Medical Billing Outsourcing Market Value Share and Forecast, By Service, 2023-2033
8.2. Front-end Services
8.3. Middle-end Services
8.4. Back-end Services
9. US Medical Billing Outsourcing Market, By End Use (USD Million)
9.1. US Medical Billing Outsourcing Market Value Share and Forecast, By End Use, 2023-2033
9.2. Hospitals
9.3. Physician Offices
9.4. Others
10. US Medical Billing Outsourcing Market Forecast, 2019-2033 (USD Million)
10.1. US Medical Billing Outsourcing Market Size and Market Share
11. US Medical Billing Outsourcing Market, By Component, 2019-2033 (USD Million)
11.1. US Medical Billing Outsourcing Market Size and Market Share By Component (2019-2026)
11.2. US Medical Billing Outsourcing Market Size and Market Share By Component (2027-2033)
12. US Medical Billing Outsourcing Market, By Service, 2019-2033 (USD Million)
12.1. US Medical Billing Outsourcing Market Size and Market Share By Service (2019-2026)
12.2. US Medical Billing Outsourcing Market Size and Market Share By Service (2027-2033)
13. US Medical Billing Outsourcing Market, By End Use, 2019-2033 (USD Million)
13.1. US Medical Billing Outsourcing Market Size and Market Share By End Use (2019-2026)
13.2. US Medical Billing Outsourcing Market Size and Market Share By End Use (2027-2033)
14. US Medical Billing Outsourcing Market, By Region, 2019-2033 (USD Million)
14.1. US Medical Billing Outsourcing Market Size and Market Share By Region (2019-2026)
14.2. US Medical Billing Outsourcing Market Size and Market Share By Region (2027-2033)
14.3. California
14.4. Florida
14.5. Illinois
14.6. New York
14.7. Texas
14.8. Others
15. Company Profile
15.1. Advanced MD, Inc.
15.1.1. Company details
15.1.2. Financial outlook
15.1.3. Product summary
15.1.4. Recent developments
15.2. Allscripts Healthcare, LLC
15.2.1. Company details
15.2.2. Financial outlook
15.2.3. Product summary
15.2.4. Recent developments
15.3. Care Cloud
15.3.1. Company details
15.3.2. Financial outlook
15.3.3. Product summary
15.3.4. Recent developments
15.4. Cerner Corporation
15.4.1. Company details
15.4.2. Financial outlook
15.4.3. Product summary
15.4.4. Recent developments
15.5. eClinicalWorks
15.5.1. Company details
15.5.2. Financial outlook
15.5.3. Product summary
15.5.4. Recent developments
15.6. Kareo Inc.
15.6.1. Company details
15.6.2. Financial outlook
15.6.3. Product summary
15.6.4. Recent developments
15.7. McKesson Corporation
15.7.1. Company details
15.7.2. Financial outlook
15.7.3. Product summary
15.7.4. Recent developments
15.8. Promantra Inc.
15.8.1. Company details
15.8.2. Financial outlook
15.8.3. Product summary
15.8.4. Recent developments
15.9. Quest Diagnostics Incorporated
15.9.1. Company details
15.9.2. Financial outlook
15.9.3. Product summary
15.9.4. Recent developments
15.10. R1RCM Inc.
15.10.1. Company details
15.10.2. Financial outlook
15.10.3. Product summary
15.10.4. Recent developments
15.11. Others
16. List of Abbreviations
17. Reference Links
18. Conclusion
19. Research Scope
SPER Market Research’s methodology uses great emphasis on primary research to ensure that the market intelligence insights are up to date, reliable and accurate. Primary interviews are done with players involved in each phase of a supply chain to analyze the market forecasting. The secondary research method is used to help you fully understand how the future markets and the spending patterns look likes.
The report is based on in-depth qualitative and quantitative analysis of the Product Market. The quantitative analysis involves the application of various projection and sampling techniques. The qualitative analysis involves primary interviews, surveys, and vendor briefings. The data gathered as a result of these processes are validated through experts opinion. Our research methodology entails an ideal mixture of primary and secondary initiatives.
