Key Takeaways

• The global medical billing outsourcing market size was valued at $10.2 billion in 2020 and is projected to reach $25.3 billion by 2028, growing at a CAGR of 12.3% from 2021 to 2028.
• High-impact drivers in the market include the "growing emphasis on compliance and risk management, the need to make processes efficient, and healthcare organizations’ stress on achieving their desired business goals.
• The COVID-19 pandemic has affected the market negatively, putting a substantial burden on healthcare organizations and providers to become accustomed to the changes.

Introduction

Market Outlook

• The global medical billing outsourcing market size was valued at $10.2 billion in 2020.
• The market size is projected to reach $25.3 billion by 2028.
• The market is expected to grow "at a CAGR of 12.3% from 2021 to 2028."
• Medical billing outsourcing helps by increasing cash flow, saves on the cost of software and equipment, as well as reducing staff size and employee expenses. The current systems in practice "for managing revenue are gradually becoming obsolete, due to the lack of expertise in tackling new payment models and revenue management tools."
• In 2019, North America led the global market due to the shifting focus of numerous healthcare service providers in the United States towards "end-to-end outsourcing firms for effectively managing their billing processes, as well as the advent of novel technologies.
• The global medical billing outsourcing market is moderately competitive due to the presence of a significant number of players in the market. Major players in the market include Mckesson Corporation, EClinicalWorks, Allscripts Healthcare Solutions, Cerner Corporation Inc, R1 RCM Inc, Kareo Inc, and Quest Diagnostics among others.

• The introduction of new tech solutions, changing government requirements, bad debts, and uncollectible accounts "have sparked a new trend leading to an increased preference for medical billing outsourcing by several healthcare providers."

Market Disruption

• The COVID-19 pandemic has affected the market negatively, putting a substantial burden on healthcare organizations and providers to become accustomed to the changes. Restrictive containment measures such as social distancing, closures of commercial activities, and remote working had resulted in operational challenges.
• The ongoing pandemic is putting "healthcare systems under strain worldwide and forcing hospitals and other medical facilities to scramble to make sure that their billing data can be processed and stored effectively." It has also adversely affected the medical billing outsourcing sector "by reducing patient or service volumes and payment ability."
• Recovery from the financial impact of the pandemic could take a long time.

Market Growth/Drivers

• On the flip side, the COVID-19 pandemic situation has also led to some positives on the market. The pandemic situation has "firmly established the need for active action and the establishment of a robust, collaborative, scalable, and agile digital healthcare infrastructure."
• As a result of the pandemic, many companies "are now building up a new road map such as adopting digitization and outsourcing non-core aspects of their businesses, like billing and accounts, which is expected to augment the market growth."
• In addition, "consumer interest has also increased significantly towards online bill payments since the pandemic began, leading to greater demand for medical billing outsourcing as it forms a non-core business operation for most healthcare institutes."
• High-impact drivers in the market include the "growing emphasis on compliance and risk management, the need to make processes efficient, efforts to decrease in-house processing costs, and healthcare organizations’ stress on achieving their desired business goals.
• Complexities in managing reimbursements and claims and the consequent need for simplifying the process is also another key factor that's driving the market growth.