United States RCM Market Report 2022: COVID-19 Accelerated the Shift to RCM Outsourcing

In the recent past, the years 2019 through 2021 have been the most challenging for the entire world. Countries are still grappling with health and economic challenges that have emerged as a result of COVID-19.

The pandemic forced (almost) every business to rethink their strategies, budgets and operations. One of the actions many companies took was to outsource their back-end functions to safeguard financial stability—making time instead to focus on revenue generation.

Internal challenges like this, resultant from COVID-19’s impact, accelerated the growth of revenue cycle management (RCM) outsourcing. Healthcare organizations are understandably keen to optimize efficiency, speed-up reimbursements and increase profitability. Other high priorities include reducing billing errors, lowering operations costs and optimizing billing collections. A surge in demand for quality healthcare services—accelerated by COVID-19—has led businesses to strengthen their RCM processes.

Based on a market study by Global Industry Analysts Inc., here are some statistics that indicate a positive shift towards RCM outsourcing:

  • The global healthcare RCM outsourcing market is expected to grow at a CAGR of 9.6% and reach a value of $22.1 billion by 2026
  • The potential difference between the US healthcare RCM outsourcing market in 2021 and 2026 can be $1.67 billion

The need for optimized healthcare administrative processes is seemingly driving growth for the RCM outsourcing market. High administrative costs and expenses associated with managing the regulatory healthcare ecosystem have fueled decisions to outsource. Third-party service providers can not only help control costs, but also improve overall operations and facilitate transparency. All these factors help businesses expand their customer base; increasing demand for outsourced RCM.

To help you make an informed decision for your business, we’ll explore the benefits of RCM outsourcing below.

Building RCM Resilience Post COVID-19 through Outsourcing

Maintain Revenue Integrity

Patient responsibility continues to grow as regulatory compliances in healthcare evolve. Such changes can lead to revenue leakages because of limited subject knowledge or expertise. Your outsourcing partner can help identify and address these leakages and maintain revenue integrity.

Partnering with RCM management companies paves the way for quality service delivery. Outsourcing companies work with staff who have in-depth knowledge of processes, follow compliances and keep themselves updated with the evolving compliances. They consistently map KPIs to manage the rates of claim denials.

Access To Automation

Automation integration is another favorable trend in the RCM market. Healthcare businesses can replace manual processes with automation while maintaining a positive return on investments (ROI). Larger organizations can easily afford access to this technology. However, it might not be the case for small and medium-sized providers.

Outsourcing RCM gives you readily available access to technologies like robotics process automation (RPA), artificial intelligence (AI) and so on. These technologies help you save time by eliminating redundant functions and help you make data-backed decisions for improving claim management and reimbursements.

Automation can also help you improve and increase patient engagement.

Improve Compliance and Reduce Billing Errors

Outsourcing companies work with experts who are well-versed with latest compliance requirements and industry best practices. RCM vendors introduce and manage compliance related administrative workflows for you. These activities account for payer policies and several other regulations which are handled without delay so, you can focus on quality patient care.

Outsourcing RCM also facilitates an error-free and efficient medical billing process which is integral to your healthcare business’ operational success .

In conclusion, healthcare providers must strike a balance between conventional in-house RCM operations and the newer outsourced management. The adoption rates of RCM outsourcing indicate the need for healthcare providers to adjust to previously ignored demands for service optimization.

If you are ready to transition to remote Revenue Cycle Management, we are here to help. HelioNext has spent 15 years developing its leadership as a provider of outsourced RCM management. Our services include comprehensive RCM management focused on reducing costs, increasing efficiency and improving the bottom line for your business.