5 Market Factors Driving Next-Gen Revenue Cycle Management Growth

Medical history questionnaire clipboardHospitals are actively evaluating and buying new Revenue Cycle Management (RCM) applications to supplement core RCM functions, such as patient registration, billing and collections, according to a newly released report from HIMSS Analytics.

These newer solutions are designed to improve collection rates, business office workflows, productivity, patient satisfaction and patient convenience, according to the 2013 Annual Report of the U.S. Hospital IT Market, which looks at retrospective IT purchase data from HIMSS members.

“The next generation RCM market is still in its infancy, but these applications are expected to become critical solutions for all hospitals within the next few years,” says the report.

Much of the growth is in consumer-focused applications, such as web pre-registration, web scheduling and web self-pay, the latter of which showed the highest growth rate from 2010 to 2012 among all of the next generation solutions tracked by HIMSS.

Other popular “next-gen” applications provide rules engines that facilitate billing and payment, billing dashboards, and EFT (electronic funds transfer) software.

The report also identified five market drivers that will affect the purchase and adoption of these new solutions through 2015:

  • Capital constraints and the intense competition of IT capital funds, which will drive many hospitals to acquire bolt-on next generation RCM applications to enhance their existing, legacy RCM environments, extending their useful life.
  • Possible major upgrades or outright replacements of RCM solutions due to the ICD-10 mandate.
  • Consolidation of RCM vendors and enhancement of legacy RCM systems to include “next-gen” functionality in the new versions of their products.
  • Acquisition, especially at small- and mid-sized facilities, of comprehensive EMR/application suites, including replacement of legacy RCM applications with versions that incorporate these features.
  • Stage 2 Meaningful Use as a driver for adoption of web self-service capabilities for patients.

In contrast to the robust market for new RCM products, the market for most core solutions, such as scheduling and registration, is highly saturated. The majority of purchasing plans for core RCM applications in 2012 were replacement purchases, says the report.