Clinical Documentation Improvement/ Mid-revenue Cycle Management Market is projected to reach USD 4.5 billion by 2023 from USD 3.1 billion in 2018, at a CAGR of 7.9%
Market growth is largely driven by the increasing utilization of mid-revenue cycle management solutions to reduce healthcare costs, check the loss of revenue due to medical billing and coding errors, resolve issues raised by the decline in reimbursement rates, manage ever-increasing amounts of unstructured data, and maintain regulatory compliance.
However, IT infrastructural constraints in developing countries, a scarcity of skilled IT professionals, and the risks associated with HCIT solutions in terms of data security & privacy may restrain the growth of this market to a certain extent.
The solutions segment to hold the largest share of the market in 2018
On the basis of product & service, the Clinical Documentation Improvement/ Mid-revenue Cycle Management Market is segmented into solutions and consulting services.
In 2017, solutions accounted for the largest share of the mid-revenue cycle management solutions market. The large share of the solutions segment can be attributed to the benefits offered by mid-revenue cycle solutions when they are integrated with EHRs/EMRs, encoder systems, voice/text/speech recognition software, CDI, transcription systems, and other hospital information management systems.
Moreover, these solutions also eliminate the duplication of administrative work of entering selected codes into each record. They also decrease the potential for data documentation, charge capture, and coding errors, and improve the overall mid-revenue cycle process.
The clinical coding segment accounted for the largest share of the market in 2017
The mid-revenue cycle management solutions market is further segmented into clinical documentation, clinical coding, charge capture, clinical documentation improvement (CDI), pre-bill review, and disease-related grouping (DRG). The clinical coding segment accounted for the largest market share in 2017.
Clinical coding solutions are increasingly being used as an effective tool to maximize the revenue of organizations by reducing coding errors and minimizing the claims reimbursement cycle. Clinical coding solutions are a highly cost-effective method of improving revenue cycle productivity, as they help in reducing or eliminating coding errors associated with manual coding practices and help streamline the workflow within a healthcare organization.
North America dominated the market in 2017
In 2017, North America accounted for a major share of the market. The market is well-established in North America, with the US dominating the market in this region.
The healthcare insurance industry in the US, with programs such as Medicare and Medicaid, plays a primary role in the country’s healthcare delivery system. More recently, the demand for advanced computer-assisted coding systems in the country has increased due to the implementation of ICD-10 coding standards.
The enhanced data provided by ICD-10 leads to better insights about health conditions and care management, better predictive analytics, and, ultimately, improved health outcomes. Growth in this market is also supported by the trend of decreasing reimbursement rates in the US.
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