Revenue cycle management (RCM) is the financial process with a number of steps right from utilizing medical billing software that healthcare facilities use to track patient care episodes from registration and appointment scheduling to the final payment of a balance. Revenue Cycle Management (RCM) in simpler words refers to the process of recognizing, collecting and managing the monetary funds or revenue obtained from the services provided to the payers. A successful RCM process is essential for a healthcare practice to earn profits, maintain financial viability and continue to provide quality treatment for their patients. Intensification of healthcare services and more holistic patient care approach on a large scale has pushed healthcare service providers to assess and upgrade their revenue cycle management. RCM works at the functional core of a healthcare organization and is a backbone in ensuring profitability whether it is a small practice or a large hospital. Poor billing practices can result in financial losses and potentially put at risk the ability to deliver quality care. Without healthcare revenue cycle management, that is a key financial process, healthcare organizations would find it difficult to sustain and at the same time keep their doors open to treat patients. It is the strategy that healthcare organizations use to earn revenue for their offered services.
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COVID – 19 scenario analysis:
- The COVID-19 pandemic has emerged as a humanitarian as well as economic crisis, creating strain on the society and affecting millions of people and businesses
- Industry closures and people are asked to stay in their homes which has cause taken a huge toll in terms of money and economic growth
- Over 4 million people affected globally, with 300 thousand losing their lives due to novel coronavirus
- Healthcare organizations are already working in battle mode, preparing new plans to respond growing COVID-19 patients, right from sourcing rapid diagnosing kits to sufficient PPE kits for workers, and now they have to face another set of challenges i.e. to maintain their revenue cycles
- Various governments have brought down the treatment costs for COVID-19, as the hospitals and diagnostic centers are flooding with huge in flow of patients
Healthcare providers currently, are facing drastic challenges due to increasing number of patients, need for well-equipped hospitals, increasing complexity and rising treatment costs. These factors are causing enormous strain on the healthcare authorities. Healthcare revenue cycle management (HRCM) comes in handy in such situations. Presence of upgraded software reduces humanitarian errors, duplication of work and minimizes confusion while handling tons of data. Major players are trying to focus on developing innovative HRCM software that would serve as one of the most important components in healthcare system, enhancing patient engagement along with simplifying the workflow. HRCM software is gaining popularity even in diagnostic laboratories.
The prime factors driving the Healthcare revenue cycle management market growth are rising regulatory mandates for the adoption of system like HRCM in healthcare sector and ineffectiveness of the conventional billing systems in administration of on-going billing operations. Parallely, there has been a notable rise in the adoption of cloud-backed revenue cycle management solutions, as they are attributed with flexiblility, security and cost-effectivity. These factors are expected to drive the market growth over the period of time. The government reforms also play an active role in boosting the adoption of the revenue cycle management system. For example, the Affordable Care Act (ACA) introduced in the U.S., focuses on expanding health insurance services to people with low income. This extended insurance can be managed effectively only through revenue cycle management solutions.
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Advanced HRCM models have revolutionized the workflow in hospitals
Hospitals are major end users of HRCM systems owing to increasing cash flows in hospitals, number of patients are increasing due to rising prevalence of diseases that forces healthcare providers to implement efficient and quick revenue cycle management system for patient data collection and administration. Hospitals try to optimize revenue by integrating advanced HRCM software developed by companies that ensures effective management of patient’s clinical data and financial data. Factors mentioned above are expected to escalate the segmental growth. Furthermore, it also offers greater control on data management that proves beneficial for the segmental growth. In addition, increasing emphasis of major players on providing best-in-class pricing and billing management system will increase its acceptance thereby, ensuring the segmental growth.
Key segments covered:
Product
- Integrated
- Standalone
Presence
- On-premises
- On-cloud
- Web-based services
Application
- Collection and storing of clinical data
- Medical coding and billing
- Claims and denial management
- Others
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