The global Medical Billing Outsourcing Market is estimated to be valued at US$ 18.02 Bn in 2024 and is expected to exhibit a CAGR of 20% over the forecast period 2024 to 2031, as highlighted in a new report published by Coherent Market Insights. Medical billing outsourcing refers to the process of contracting specialized companies to handle various back-office operations such as managing claims, coding, billing, and associated administrative tasks on behalf of healthcare providers. Growing focus on improving margins and recovering unpaid claims has boosted adoption among hospitals, physicians, and other healthcare providers.
Major companies operating in the medical billing outsourcing market include GE Healthcare, R1 RCM, Inc. (Accretive Health), Allscripts Healthcare Solutions, Inc., Kareo, Inc., Cerner Corporation, Quest Diagnostics, and Experian Information Solutions, Inc., among others. These companies focus on enhancing their service offerings and leveraging technology to consolidate their market position. For instance, R1 RCM acquired Accretive Health in January 2017 to expand its scale and strengthen its position as a leading provider of technology-enabled revenue cycle management services.
Opportunity
The rising cost of complex medical billing processes is encouraging healthcare providers to outsource their medical billing activities to third-party companies. This presents lucrative opportunities for medical billing outsourcing providers to leverage their expertise and manage billing and claims processing activities more efficiently and at lower costs. With medical billing outsourcing providers reducing turnaround times and denials rates, many providers are able to free up substantial internal resources that can be utilized for critical functions like direct patient care. Furthermore, outsourcing partners with technologies and methodologies to improve key billing metrics are well-positioned to capture a significant share of the growing outsourcing market.
Drivers
Facility-based providers: Many facility-based healthcare providers such as hospitals, clinics, and physician practice groups are turning to outsourcing partners to streamline their billing workflows and optimize revenue cycle management.
Increase in healthcare costs: The substantial rise in healthcare costs is compelling providers to seek ways to maximize revenue and cash collection through reliable outsourcing of their entire billing processes.
Compliance requirements: Medical coding and billing involves a high degree of complexity due to stringent compliance norms. Outsourcing to compliant specialists helps providers avoid non-compliance penalties.
Key Takeaways
Growing demand - The medical billing outsourcing market is growing significantly due to the rising costs of in-house billing and growing demand to alleviate revenue leakages. Several mid-sized and large healthcare providers are outsourcing their billing processes to specialized outsourcing companies.
Global expansion - Key players in this market are expanding globally by partnering with local providers to leverage their market knowledge and customized solutions. This is helping them strengthen their foothold and capture the outsourcing opportunities in international healthcare domains.
Technological advancements - Outsourcing companies are investing heavily in AI, ML and analytics capabilities to streamline their billing workflows and enhance their offerings. Technologies help automate repetitive tasks, reduce errors, optimize coding practices and enable value-based reimbursements. This is improving billing efficiencies and the overall customer experience.
