From claims management to automated coding, we break down the categories of vendors helping healthcare providers maximize revenue and minimize costs.
As threats to bottom lines mount and new revenue models gain ground, revenue cycle management (RCM) is becoming an even bigger priority for healthcare organizations.
In US hospital systems, patient volumes have dropped year-over-year — inpatient volume by 12% and outpatient volume by 5%, according to FinThrive. Additionally, a Kaufman Hall report revealed that expenses in US hospital systems are 21% higher than they were in 2020.
Revenue models are also shifting away from fee-for-service billing to value-based care and alternative payments, where provider revenue is linked to patient outcomes or subscription fees rather than the quantity of services delivered.
New RCM solutions are helping healthcare organizations navigate these challenges. For example, some solutions allow providers to code more accurately and create a smoother billing and payment experience. Others, like robotic process automation (RPA) tools, help free up employees to spend time on more high-value tasks. Meanwhile, capacity management platforms use AI to optimize the usage of scarce resources like imaging suites or operating rooms and, as a result, prevent costly gaps in utilization.
In the market map below, we identify 74 companies across 12 different categories helping healthcare providers manage their revenue cycle.
Note: Our map includes private companies that have received funding in the last 5 years and have a Mosaic score of at least 400. This market map is not exhaustive of the space.
Please click to enlarge.
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