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市場調查報告書
商品編碼
1679393

美國醫療帳單外包市場規模、佔有率、趨勢分析報告：按組件、最終用途、服務和細分市場預測，2025 年至 2030 年

U.S. Medical Billing Outsourcing Market Size, Share & Trends Analysis Report By Component (In-house, Outsourced), By End-use (Hospitals, Physician Offices), By Service (Front-end, Middle-end, Back-end), And Segment Forecasts, 2025 - 2030
出版日期: | 出版商: Grand View Research | 英文 120 Pages | 商品交期: 2-10個工作天內

價格

美國醫療帳單外包市場的成長和趨勢

根據Grand View Research, Inc.的最新報告，美國醫療帳單外包市場規模預計到2030年將達到122.6億美元，2025年至2030年期間的複合年成長率為12.0%。

醫療報銷日益複雜以及索賠被拒的可能性較高預計將推動市場成長。疫情期間和疫情之後，患者群、病患資料和帳單量的負擔不斷增加，迫使醫院產業外包服務。預計這將在預測期內推動市場成長。

疫情期間內部計費服務面臨的挑戰增加了對外包服務等替代服務的需求。在遵守 ICD-11 規範和應對報銷額下降以及醫療成本上升方面，挑戰重重。急診醫院和診所等醫療保健提供者更願意將其計費流程外包，以抑制和消除這些挑戰。

醫療保健公司正在擴大其產品範圍，以減輕計費和報銷流程的負擔。例如，2023 年 4 月，南佛羅裡達州的行動診斷影像公司 Concierge Diagnostics Inc. 在其 100 多家宣布合作夥伴的組合中增加了醫療帳單和諮詢服務。目的是減少醫生的執業成本，同時增加收益並盡量減少索賠拒絕。

不同醫療機構對收益週期管理 (RCM) 的接受程度因應用而異。在美國，調度、編碼、計費、患者登記和索賠處理比任何其他 RCM 應用程式更為普遍。外包醫療帳單服務的好處包括由於錯誤減少而改善帳單流程、縮短週轉時間以及使醫院和其他醫療機構的管理更加順暢。

COVID-19 疫情對市場產生了重大影響。醫院收入和患者數量的下降減緩了市場成長。疫情期間引入了新的計費代碼和遠端醫療代碼。患者負擔的增加和醫務人員工作量的增加不僅對適應新規範提出了挑戰，而且對在實踐中實施新規範也提出了挑戰。醫療帳單提供者在資源和技術上花費了大量資金，醫療保健提供者在外包帳單流程後可以利用這些資金。

美國醫療帳單外包市場報告重點

  • 從組成部分來看，外包部分預計成長最快，到 2024 年將佔據最大收入佔有率，超過 58.90%。
  • 從服務來看，前端服務佔據市場主導地位，2024 年的營收佔有率將超過 38.6%。
  • 預計中階​​服務領域在預測期內將實現最快的複合年成長率。這是因為醫療保健專業人員對計費外包的認知不斷提高，並且中階服務的採用率不斷提高。
  • 根據最終用途，由於索賠數量眾多且患者共同支付費用增加，醫院部門在 2024 年佔據最大收入佔有率，超過 46.95%。此外，醫療帳單外包由於其無錯誤流程和最大限度減少付款造成的損失等優勢，擴大被綜合醫院採用。

目錄

第1章調查方法與範圍

第2章執行摘要

第3章美國醫療帳單外包市場變數、趨勢與範圍

  • 市場體系展望
    • 母市場展望
    • 相關/輔助市場展望
  • 市場動態
    • 市場促進因素分析
    • 市場限制因素分析
  • 美國醫療帳單外包市場分析工具
    • 產業分析—波特五力分析
    • PESTEL分析
  • 使用案例
  • 技術進步

第4章美國醫療帳單外包市場：組成部分、估算與趨勢分析

  • 細分儀表板
  • 美國醫療帳單外包市場成分變化分析
  • 美國醫療帳單外包市場規模和趨勢分析（按組成部分），2018 年至 2030 年
  • 內部
  • 外包

第5章美國醫療帳單外包市場：按服務、估計和趨勢分析

  • 細分儀表板
  • 美國醫療帳單外包市場服務變化分析
  • 美國醫療帳單外包市場規模與趨勢分析（按服務分類），2018 年至 2030 年
  • 前端服務
  • 中階服務
  • 後端服務

第6章美國醫療帳單外包市場：按最終用途的估計和趨勢分析

  • 細分儀表板
  • 美國醫療帳單外包市場的最終用途趨勢分析
  • 2018 年至 2030 年美國醫療帳單外包市場規模及趨勢分析（依最終用途）
  • 醫院
  • 醫生辦公室
  • 其他

第7章競爭格局

  • 公司/競爭對手分類
  • 戰略地圖
  • 2024年企業市場分析
  • 公司簡介/上市公司
    • R1RCM Inc.
    • Veradigm LLC（Allscripts Healthcare, LLC）
    • Oracle（Cerner Corporation）
    • eClinicalWorks
    • Kareo, Inc.
    • McKesson Corporation
    • Quest Diagnostics
    • Promantra Inc.
    • AdvancedMD, Inc.
Product Code: GVR-2-68038-824-4

U.S. Medical Billing Outsourcing Market Growth & Trends:

The U.S. medical billing outsourcing market size is expected to reach USD 12.26 billion by 2030, registering a CAGR of 12.0% from 2025 to 2030, according to a new report by Grand View Research, Inc. Increasing complexity in health reimbursement and high chances of claim denials are expected to drive market growth. The growing burden of the patient pool, patient data, and claims volumes during and after the pandemic forced the hospital industry to outsource services. This is expected to propel market growth during the forecast period.

The challenges faced by in-house billing services during the pandemic increased the need for an alternative, such as outsourcing services. The challenge mounts when the billing process necessitates adherence to the ICD-11 code and dealing with declining reimbursements and rising healthcare costs. Several healthcare providers such as acute care hospitals and clinics/physician offices prefer outsourcing their billing processes to curb or eliminate these challenges.

The healthcare companies are expanding their product offerings to relieve the burden of claims and reimbursement processes. For instance, in April 2023, Concierge Diagnostics Inc., a mobile diagnostic imaging company in South Florida, added medical billing and consulting services to its portfolio of over 100 referral partners. The aim is to enhance revenue and minimize claim denial while reducing costs for physician practices.

Acceptance of revenue cycle management (RCM) in various healthcare facilities varies with application. Scheduling, coding, billing, patient registration, and claims processing are adopted more than other RCM applications in the U.S. Advantages associated with outsourcing medical billing services include improvement in billing process by decreasing errors, swift turnaround time, and smooth administrations for hospitals and other medical institutes.

The COVID-19 pandemic drastically impacted the market. Reduction in hospital revenue and patient volumes slowed down market growth. New billing and telehealth codes were introduced during the pandemic. Growing patient burden and increased workload on healthcare staff posed a challenge to adapt new codes as well as implement them into the setting. Medical billing providers have spent significant amounts on resources and technology, which can be utilized by healthcare providers after outsourcing the billing process.

U.S. Medical Billing Outsourcing Market Report Highlights:

  • Based on component, the outsourced segment held the largest revenue share of over 58.90% in 2024 and is expected to register the fastest growth, owing to a growing focus on minimizing the cost of healthcare delivery and improving the patient and physician relationship
  • Based on service, the front-end services segment dominated the market with a revenue share of over 38.6% in 2024, as these services increase downstream cash flow and decrease rework and cost to collect
  • The middle-end services segment is expected to register the fastest CAGR during the forecast period. This is attributed to growing awareness about billing outsourcing among healthcare practitioners and rising adoption of middle-end services among them
  • Based on end-use, the hospital segment accounted for the largest revenue share of over 46.95% in 2024 owing to high claim volumes and rising patient burden. In addition, errorless procedures and minimization of loss due to denial of payments are benefits associated with medical billing outsourcing, which leads to rising adoption in multispecialty hospitals

Table of Contents

Chapter 1. Methodology and Scope

  • 1.1. Market Segmentation & Scope
  • 1.2. Market Definitions
    • 1.2.1. Component Segment
    • 1.2.2. Service Segment
    • 1.2.3. End Use Segment
  • 1.3. Information analysis
    • 1.3.1. Market formulation & data visualization
  • 1.4. Data validation & publishing
  • 1.5. Information Procurement
    • 1.5.1. Primary Research
  • 1.6. Information or Data Analysis
  • 1.7. Market Formulation & Validation
  • 1.8. Market Model
  • 1.9. Total Market: CAGR Calculation
  • 1.10. Objectives
    • 1.10.1. Objective 1
    • 1.10.2. Objective 2

Chapter 2. Executive Summary

  • 2.1. Market Outlook
  • 2.2. Segment Snapshot
  • 2.3. Competitive Insights Landscape

Chapter 3. U.S. Medical Billing Outsourcing Market Variables, Trends & Scope

  • 3.1. Market Lineage Outlook
    • 3.1.1. Parent market outlook
    • 3.1.2. Related/ancillary market outlook.
  • 3.2. Market Dynamics
    • 3.2.1. Market driver analysis
      • 3.2.1.1. Increasing complexity of claims and reimbursement processes
      • 3.2.1.2. Increasing focus on patient engagement and reduce operational costs
      • 3.2.1.3. Technological advancements
    • 3.2.2. Market restraint analysis
      • 3.2.2.1. Ethical concerns related to data privacy
      • 3.2.2.2. Lack of Professionals to handle RCM processes
  • 3.3. U.S. Medical Billing Outsourcing Market Analysis Tools
    • 3.3.1. Industry Analysis - Porter's
      • 3.3.1.1. Supplier power
      • 3.3.1.2. Buyer power
      • 3.3.1.3. Substitution threat
      • 3.3.1.4. Threat of new entrant
      • 3.3.1.5. Competitive rivalry
    • 3.3.2. PESTEL Analysis
      • 3.3.2.1. Political landscape
      • 3.3.2.2. Technological landscape
      • 3.3.2.3. Economic landscape
      • 3.3.2.4. Environmental Landscape
      • 3.3.2.5. Legal Landscape
      • 3.3.2.6. Social Landscape
  • 3.4. Case Study
  • 3.5. Technological Advancement

Chapter 4. U.S. Medical Billing Outsourcing Market: Component Estimates & Trend Analysis

  • 4.1. Segment Dashboard
  • 4.2. U.S. Medical Billing Outsourcing Market Component Movement Analysis
  • 4.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Component, 2018 to 2030 (USD Million)
  • 4.4. In-house
    • 4.4.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 4.5. Outsourced
    • 4.5.1. Market estimates and forecasts 2018 to 2030 (USD Million)

Chapter 5. U.S. Medical Billing Outsourcing Market: Service Estimates & Trend Analysis

  • 5.1. Segment Dashboard
  • 5.2. U.S. Medical Billing Outsourcing Market Service Movement Analysis
  • 5.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Service, 2018 to 2030 (USD Million)
  • 5.4. Front-end Services
    • 5.4.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 5.5. Middle-end Services
    • 5.5.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 5.6. Back-end Services
    • 5.6.1. Market estimates and forecasts 2018 to 2030 (USD Million)

Chapter 6. U.S. Medical Billing Outsourcing Market: End Use Estimates & Trend Analysis

  • 6.1. Segment Dashboard
  • 6.2. U.S. Medical Billing Outsourcing Market End Use Movement Analysis
  • 6.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by End Use, 2018 to 2030 (USD Million)
  • 6.4. Hospitals
    • 6.4.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 6.5. Physician Offices
    • 6.5.1. Market estimates and forecasts 2018 to 2030 (USD Million)
  • 6.6. Others
    • 6.6.1. Market estimates and forecasts 2018 to 2030 (USD Million)

Chapter 7. Competitive Landscape

  • 7.1. Company/Competition Categorization
  • 7.2. Strategy Mapping
  • 7.3. Company Market Position Analysis, 2024
  • 7.4. Company Profiles/Listing
    • 7.4.1. R1RCM Inc.
      • 7.4.1.1. Company overview
      • 7.4.1.2. Financial performance
      • 7.4.1.3. Product benchmarking
      • 7.4.1.4. Strategic initiatives
    • 7.4.2. Veradigm LLC (Allscripts Healthcare, LLC)
      • 7.4.2.1. Company overview
      • 7.4.2.2. Financial performance
      • 7.4.2.3. Product benchmarking
      • 7.4.2.4. Strategic initiatives
    • 7.4.3. Oracle (Cerner Corporation)
      • 7.4.3.1. Company overview
      • 7.4.3.2. Financial performance
      • 7.4.3.3. Product benchmarking
      • 7.4.3.4. Strategic initiatives
    • 7.4.4. eClinicalWorks
      • 7.4.4.1. Company overview
      • 7.4.4.2. Financial performance
      • 7.4.4.3. Product benchmarking
      • 7.4.4.4. Strategic initiatives
    • 7.4.5. Kareo, Inc.
      • 7.4.5.1. Company overview
      • 7.4.5.2. Financial performance
      • 7.4.5.3. Product benchmarking
      • 7.4.5.4. Strategic initiatives
    • 7.4.6. McKesson Corporation
      • 7.4.6.1. Company overview
      • 7.4.6.2. Financial performance
      • 7.4.6.3. Product benchmarking
      • 7.4.6.4. Strategic initiatives
    • 7.4.7. Quest Diagnostics
      • 7.4.7.1. Company overview
      • 7.4.7.2. Financial performance
      • 7.4.7.3. Product benchmarking
      • 7.4.7.4. Strategic initiatives
    • 7.4.8. Promantra Inc.
      • 7.4.8.1. Company overview
      • 7.4.8.2. Financial performance
      • 7.4.8.3. Product benchmarking
      • 7.4.8.4. Strategic initiatives
    • 7.4.9. AdvancedMD, Inc.
      • 7.4.9.1. Company overview
      • 7.4.9.2. Financial performance
      • 7.4.9.3. Product benchmarking
      • 7.4.9.4. Strategic initiatives

List of Tables

  • Table 1 List of abbreviations
  • Table 2 U.S. medical billing outsourcing market, by component, 2018 - 2030 (USD Million)
  • Table 3 U.S. medical billing outsourcing market, by service, 2018 - 2030 (USD Million)
  • Table 4 U.S. medical billing outsourcing market, by end use, 2018 - 2030 (USD Million)

List of Figures

  • Fig. 1 Market research process
  • Fig. 2 Data triangulation techniques
  • Fig. 3 Market formulation & validation
  • Fig. 4 U.S. medical billing outsourcing market: Market outlook
  • Fig. 5 U.S. medical billing outsourcing market: Segment outlook
  • Fig. 6 U.S. medical billing outsourcing market: Competitive landscape outlook
  • Fig. 7 Parent market outlook
  • Fig. 8 U.S. medical billing outsourcing market driver impact
  • Fig. 9 U.S. medical billing outsourcing market restraint impact
  • Fig. 10 U.S. medical billing outsourcing market: Component outlook and key takeaways
  • Fig. 11 U.S. medical billing outsourcing market: Component movement analysis
  • Fig. 12 In-house market estimates and forecasts,2018 - 2030 (USD Million)
  • Fig. 13 Outsourced market estimates and forecasts, 2018 - 2030 (USD Million)
  • Fig. 14 U.S. medical billing outsourcing market: Services outlook and key takeaways
  • Fig. 15 U.S. medical billing outsourcing market: Services movement analysis
  • Fig. 16 Front-end services market estimates and forecasts,2018 - 2030 (USD Million)
  • Fig. 17 Middle-end services market estimates and forecasts, 2018 - 2030 (USD Million)
  • Fig. 18 Back-end services market estimates and forecasts, 2018 - 2030 (USD Million)
  • Fig. 19 U.S. medical billing outsourcing market: End Use outlook and key takeaways
  • Fig. 20 U.S. medical billing outsourcing market: End Use movement analysis
  • Fig. 21 Hospitals market estimates and forecast, 2018 - 2030 (USD Million)
  • Fig. 22 Physician offices market estimates and forecast, 2018 - 2030 (USD Million)
  • Fig. 23 Others market estimates and forecast, 2018 - 2030 (USD Million)