Medical Billing Market Trends

Medical Billing Market Trends

Growing online billing platforms and government support to drive market growth

Increasing government funds and rising government schemes drive the growth of medical billing. Increased use of billing and medical coding procedures in revenue cycle management is further expected to propel medical billing market revenue. With the current increase in patient load, hospitals are experiencing a problem with the billing process, which is also causing challenges with point-of-care delivery. Thus, outsourcing the medical billing process will help medical practitioners manage patients and the billing process. The government is providing funds and advanced billing systems to hospitals to make the billing process more accessible, and the market is growing. In 2021, Epic Systems was a software company based in the United States that provided cloud-based healthcare software that can be utilized in various practices and sizes. The platform offers complete revenue cycle management (RCM) capabilities, including integrated electronic medical records, billing and coding, patient management capabilities, and more.

Innovative and novel techniques are creating future opportunities to increase market. As more money is invested in R&D, new technology and advanced resources are becoming available in the healthcare system. Medical costs are rising in developing countries, prompting advances in new technology such as medical bill outsourcing. Patients in the United States are referred to insurance methods for paying their medical bills; additionally, they visit healthcare facilities, and through electronic health record (EHR) systems, the medical delegate easily maintains data and easily Assis the billing drives the market CAGR during the forecast period.

Medical Billing Market Segment Insights

Medical Billing Type Insights

The market segmentation of medical billing, based on type, includes professional billing and institutional billing. The institutional billing segment held the majority share in 2022, contributing to approximately 61–64% market revenue of medical billing. Institutional billing is submitting invoices for hospital or healthcare facility claims for in-patient and out-patient services. At the same time, institutional billing is a common term used for hospital billing for the same reason. Moreover, professional nursing services are covered by institutional claims. Besides, it bills medical claims for services like radiology, health products, and laboratory testing. The responsibilities of institutional billers occasionally diverge from those of professional billers. Many institutional billers oversee billing entirely or take care of all billing and collections. Collecting, assessing, and billing are the fundamental duties of institutional billers. They are employed for outpatient and inpatient services and hospital services like laboratory, equipment, supply, and radiology.

Latest Industry Developments in Medical Billing Type Segment

June 2024: Accenture has launched an analytics platform utilizing AI and machine learning to optimize medical billing processes, predict errors, streamline claim submissions, and improve revenue cycle management, thereby reducing claim denials.

May 2024: Tata Consultancy Services has introduced a blockchain-based billing system to improve transparency and reduce medical billing fraud, creating an immutable ledger for claim verification and payment tracking across healthcare stakeholders.

July 2024: Genpact has rolled out an AI-powered billing automation solution for institutional billing, utilizing natural language processing and machine learning algorithms to handle complex scenarios, reduce manual intervention, and improve accuracy and efficiency in handling large claims and invoices.

Medical Billing Application Insights

The medical billing market segmentation based on application includes database management, financial, infrastructure, and Operational Database Management. Financial dominated the market in 2022 and is expected to be the fastest-growing segment over the forecast period, 2024-2032, owing to the increasing need for hospital finance services. This is mainly driven by the substantial demand for financing services in hospitals worldwide. Moreover, hospital consolidation complicates the billing and reimbursement process. Digital order management addresses this issue by offering healthcare professionals automated remote medical billing and financial data input linked to a single, easily accessible medical claims management system. This fuels the hospital industry's demand for financial outsourcing services for medical billing.

Figure 1:  Medical Billing Market, by Application, 2022 & 2030 (USD billion)

Source: Primary Research, Secondary Research, MRFR Database, and Analyst Review

Medical Billing Process Insights

Based on the process, the medical billing market data has been segmented into electronic billing, payment, and medical billing services. Medical billing services held the most prominent segment share in 2022. Medical billing is a term for revenue cycle management. It is the most complex and vital aspect of the healthcare industry. Medical billing has numerous advantages, including increased cash flow, lower software and equipment costs, and lower personnel costs due to fewer employees. Successful medical billing and coding management is a strategic advantage for medical practitioners in the complex and dynamic healthcare market. Medical practices with internal billing staff are more vulnerable than practices that outsource medical billing services. These companies provide the specialists required to complete the medical billing procedures thoroughly. The demands for medical billing outsourcing services are growing as healthcare providers strive to reduce errors and internal procurement costs. The emergence of new technological solutions, rising and shifting governmental regulations, and bad debt and uncollectible accounts have sparked a new trend that has increased the preference for medical billing services among many healthcare providers.

Medical Billing Regional Insights

By Region, the study provides market insights into Europe, North America, Asia-Pacific, and the Rest of the World. The North American medical billing market, which is expected to reach USD 6.5 billion in 2022, is anticipated to grow at a significant CAGR due to evolving medical systems, the use of medical coding that is currently in use, improvements in IT medical technology, the incorporation of electronic medical records, and the presence of significant players. The further existence of several healthcare providers in the United States and their shift in focus to end-to-end outsourcing firms for billing process management is increasing the market share in North America. Regional healthcare providers primarily rely on companies to maximize operating margins and manage high-volume transactions due to the increased awareness of the advantages offered by outsourcing firms.

Moreover, the significant countries studied in the market report are the United States, Canada, Germany, France, the United Kingdom, Italy, Spain, India, China, Australia, Japan, South Korea, and Brazil.

Figure 2:  Medical Billing Market Share By Region 2022 (%)

Source: Primary Research, Secondary Research, MRFR Database, and Analyst Review

The European medical billing market is the second largest in the world, owing to rising demand for cost-cutting measures in the healthcare sector. Reimbursement procedures and price changes may result in substantial growth for the region. In this region, there is growing pressure on medical providers to create a sustainable healthcare system, which is one of the key factors driving medical billing market growth. Further, the German market of medical billing held the largest market share, and the UK market of medical billing was the fastest-growing market in the European region.

The Asia-Pacific Medical Billing Market is expected to grow at the fastest CAGR from 2024 to 2032, owing to increased awareness of medical billing software, improved healthcare facilities, and supportive government initiatives. Expanding patient populations and enhanced healthcare infrastructure make emerging regional nations like Australia, India, Singapore, and China the most profitable markets. The growing need to reduce healthcare delivery costs drives the Asia Pacific market of medical billing share. Moreover, China’s market of medical billing held the largest market share, and the Indian market of medical billing was the fastest-growing market in the Asia-Pacific region.

Medical Billing Key Market Players & Competitive Insights

The medical billing industry is fiercely competitive, with numerous large, medium, and small businesses competing. Partnerships, mergers, acquisitions, and technological advancements are some crucial business development strategies used by major companies to strengthen their market position in the medical billing industry. The market players concentrate on streamlining their product offerings and identifying opportunities for cost reduction. As a result, more healthcare practitioners will outsource their revenue management process to maximize their returns. Major industry players are further increasing their R&D investments to expand their solution and service offerings, which will help the medical billing industry grow.

Manufacturing locally to cut operational costs is one of the main business tactics used by the medical billing industry to serve customers and increase the market sector. The medical billing industry has recently given medicine some of the most important advantages. The major players include Accenture (US), TCS (India), AGS Health (India), Cognizant Technology Solutions (US), GeBBS Healthcare (US), Genpact (US), HCL Technologies (India), INFINIT Healthcare and Medusind (India).

eClinicalWorks is a privately held healthcare IT leader that provides comprehensive Practice Management (PM) and Electronic Health Record (EHR) solutions to over 850,000 medical professionals in over 20 countries. In March 2021, eClinicalWorks officially confirmed that Soma Medical Center P.A., which provides a wide range of medical services to communities in Palm Beach County, Florida, had implemented its integrated cloud service and platform for its 50+ providers. The patient engagement and automation solutions from eClinicalWorks help to guarantee that therapy is provided consistently and give Soma Medical Center's clinicians more effective ways to communicate with patients and their family members. The cloud-based nature of eClinicalWorks EMR allows Soma Medical Center to always maintain the security and accessibility of practice and patient data.

R1 RCM Inc is a revenue cycle management company based in the United States that serves hospitals, health systems, and physician groups. In July 2021, R1 RCM Inc, a provider of technology-driven solutions that improve healthcare providers' patient experiences and financial results, announced the successful completion of its acquisition of VisitPay, a digital payment solution provider. The acquisition combines VisitPay's client payments infrastructure with R1's renowned patient access technology, enabling providers to provide a smooth financial journey to their patients.

Key Companies in the medical billing market include

• Accenture (US)


• TCS (India)


• AGS Health (India)


• Cognizant Technology Solutions (US)


• GeBBS Healthcare (US)


• Genpact (US)


• HCL Technologies (India)


• INFINIT Healthcare


• Medusind (India)

Medical Billing Industry Developments

March 2022: Omega Healthcare, a well-known supplier of medical billing services and solutions, has acquired Reventics, a development company of revenue cycle management systems that improve physician reimbursement and compliance.

February 2022: National Billing Partners, a supplier of RCM services to surgical practices and ASCs, was acquired by National Medical Billing Services, a well-developed RCM business in the healthcare industry.

June 2020: R1 RCM Inc acquired Cerner RevWorks, allowing the company's revenue to grow.

February 2019: Veritas Capital acquired Athenahealth Inc, giving them access to their network-enabled services for hospitals.

Medical Billing Market Segmentation

Medical Billing Type Outlook

• Professional Billing


• Institutional Billing

Medical Billing Application Outlook

• Database Management


• Financial


• Infrastructure


• Operational

Medical Billing Process Outlook

• Electronic Billing


• Payment


• Medical Billing Services

Medical Billing Regional Outlook

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  North America

  
  
  
  
  • US
  
  
  • Canada
  
  
  
  


• 
  

  Europe

  
  
  
  
  • Germany
  
  
  • France
  
  
  • UK
  
  
  • Italy
  
  
  • Spain
  
  
  • Rest of Europe
  
  
  
  


• 
  

  Asia-Pacific

  
  
  
  
  • China
  
  
  • Japan
  
  
  • India
  
  
  • Australia
  
  
  • South Korea
  
  
  • Australia
  
  
  • Rest of Asia-Pacific
  
  
  
  


• 
  

  Rest of the World

  
  
  
  
  • 
    

    Middle East

    
    
  
  
  • 
    

    Africa

    
    
  
  
  • 
    

    Latin America