The U.S. Revenue Cycle Management (RCM) Market was valued at USD 141.61 billion in 2024 and is projected to reach USD 272.78 billion by 2030, growing at a compound annual growth rate (CAGR) of 11.55% during the forecast period.
The U.S. revenue cycle management market report includes exclusive data on 55 vendors. This market is dynamic and highly competitive, driven by the increasing demand for technology-based solutions, consolidation among key players, and the emergence of new entrants leveraging advanced technologies such as artificial intelligence (AI) and automation.
Leading companies in the RCM market include Change Healthcare, Epic Systems Corporation, Experian, McKesson Corporation, Oracle, R1 RCM, Veradigm, and SSI Group. These organizations dominate the industry by offering comprehensive solutions for billing, claims management, and regulatory compliance. With strong, long-standing relationships with large healthcare providers, these companies continue to expand their service portfolios through strategic acquisitions and partnerships to maintain a competitive edge in the market.
MARKET TRENDS & DRIVERS
Transition from Computer-Assisted Coding (CAC) to Autonomous Coding
The healthcare industry is undergoing a shift from Computer-Assisted Coding (CAC) to Autonomous Coding, fueled by advancements in AI and machine learning technologies. Unlike CAC, which supports coders by suggesting codes using natural language processing (NLP), autonomous coding fully automates the process, reducing the need for human intervention. This transformation aims to enhance efficiency, accuracy, and cost-effectiveness in medical coding and billing, addressing common challenges such as human error, coder fatigue, and rapidly changing coding standards.
According to a 2023 report by Frost & Sullivan, more than 30% of healthcare organizations are either piloting or planning to implement autonomous coding solutions. Additionally, a TruCode report indicates that autonomous coding systems can cut coding time by up to 50% while simultaneously improving accuracy. As AI technologies continue to evolve, autonomous coding is expected to revolutionize revenue cycle management by boosting operational efficiency, ensuring regulatory compliance, and maximizing revenue collection through smarter, more adaptable systems.
Rising Adoption of Third-Party Managed RCM Solutions
The growing adoption of third-party managed Revenue Cycle Management (RCM) solutions is significantly transforming the U.S. healthcare landscape. Healthcare providers are increasingly turning to outsourced RCM services to address financial pressures, navigate complex regulatory requirements, and adapt to the shift towards value-based care. Outsourcing RCM functions enables healthcare organizations to streamline operations, enhance cash flow, and reduce costs, allowing them to focus more on delivering quality patient care.
A 2023 survey by Healthcare IT News revealed that 40% of healthcare providers currently outsource RCM functions, primarily to cut down on operational expenses associated with maintaining in-house teams. Third-party vendors offer specialized expertise in billing, coding, and collections, alongside advanced technologies such as automation and AI, which improve operational efficiency and minimize errors. Furthermore, a KPMG report highlights that 56% of healthcare providers are outsourcing non-core functions, including RCM, to concentrate on achieving clinical excellence. This trend underscores the growing demand for cost-effective, expert-driven solutions that optimize revenue cycles while enabling healthcare organizations to allocate internal resources toward high-quality patient care.
