Table of Content

1 INTRODUCTION 14
1.1 OBJECTIVES OF THE STUDY 14
1.2 MARKET DEFINITION 14
1.3 MARKET SCOPE 15
1.3.1 MARKETS COVERED 15
1.3.2 YEARS CONSIDERED FOR THE STUDY 15
1.4 LIMITATIONS 16
1.5 CURRENCY 16
1.6 STAKEHOLDERS 16

2 RESEARCH METHODOLOGY 17
2.1 RESEARCH APPROACH 17
2.1.1 SECONDARY DATA 18
2.1.1.1 KEY DATA FROM SECONDARY SOURCES 18
2.1.2 PRIMARY DATA 18
2.1.2.1 BREAKDOWN OF PRIMARIES 19
2.1.2.2 KEY DATA FROM PRIMARY SOURCES 20
2.1.2.3 KEY INDUSTRY INSIGHTS 20
2.2 MARKET SIZE ESTIMATION 21
2.3 MARKET BREAKDOWN AND DATA TRIANGULATION 22
2.4 ASSUMPTIONS FOR THE STUDY 24

3 EXECUTIVE SUMMARY 25

4 PREMIUM INSIGHTS 32
4.1 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET OVERVIEW 32
4.2 NORTH AMERICAN MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET 33
4.3 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET: MAJOR GEOGRAPHIC REGIONS 34
4.4 GEOGRAPHIC MIX: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET 35

5 MARKET OVERVIEW 36
5.1 INTRODUCTION 36
5.2 MARKET DYNAMICS 36
5.2.1 KEY MARKET DRIVERS 37
5.2.1.1 Increasing healthcare expenditure 37
5.2.1.2 Loss of revenue due to medical billing and coding errors 37
5.2.1.3 Declining reimbursements 38
5.2.1.4 Growing need to manage increasing unstructured healthcare data 38
5.2.2 KEY MARKET RESTRAINTS 39
5.2.2.1 IT infrastructural constraints in developing countries 39
5.2.3 KEY MARKET OPPORTUNITIES 39
5.2.3.1 Rising use of NLP in documentation 39
5.2.4 KEY MARKET CHALLENGES 39
5.2.4.1 Data security concerns 39
5.2.4.2 Reluctance to switch from conventional methods 40
5.2.4.3 Scarcity of skilled IT professionals 40

6 INDUSTRY INSIGHTS 41
6.1 INTRODUCTION 41
6.2 CODING GUIDELINES 41
6.2.1 US 41
6.2.2 EUROPE 41
6.2.3 JAPAN 42
6.2.4 AUSTRALIA 42
6.3 TRENDS IN NLP-ENABLED DOCUMENTATION & CODING 42

7 MID-REVENUE CYCLE MANAGEMENT/CLINICAL DOCUMENTATION IMPROVEMENT MARKET, BY PRODUCT & SERVICE 44
7.1 INTRODUCTION 45
7.2 SOLUTIONS 46
7.2.1 CLINICAL DOCUMENTATION 48
7.2.1.1 Advantages of NLP-enabled documentation over manual processes is driving the adoption of clinical documentation solutions 48
7.2.2 CLINICAL CODING 50
7.2.2.1 NLP Solutions 51
7.2.2.1.1 NLP coding solutions to dominate the mid-revenue cycle management clinical coding solutions market during the forecast period 51
7.2.2.2 Structural Input Solutions 53
7.2.2.2.1 Structured input solutions help to improve the coding process and reduce the coding procedure cost 53
7.2.3 CHARGE CAPTURE 54
7.2.3.1 Rising adoption of smartphones among healthcare professionals to drive the adoption of charge capture solutions 54
7.2.4 CLINICAL DOCUMENTATION IMPROVEMENT 56
7.2.4.1 CDI solutions to witness the highest growth during the forecast period primarily due to a decrease in DNFB and increase in coding accuracy 56
7.2.5 DIAGNOSIS-RELATED GROUPING 57
7.2.5.1 DRG solutions improve pricing and reimbursement accuracy 57
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7.2.6 PRE-BILL REVIEW 58
7.2.6.1 Declining reimbursement rates have triggered awareness of the pre-bill review process 58
7.3 CONSULTING SERVICES 60
7.3.1 CONSULTING SERVICES TO WITNESS THE HIGHEST GROWTH RATE IN THE MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FROM 2018 TO 2023 60

8 MID-REVENUE CYCLE MANAGEMENT/CLINICAL DOCUMENTATION IMPROVEMENT MARKET, BY END USER 61
8.1 INTRODUCTION 62
8.2 HEALTHCARE PROVIDERS 63
8.2.1 INPATIENT SETTINGS 65
8.2.1.1 Mid-RCM solutions play an integral role in inpatient settings, improving quality and growing revenues?a key growth driver 65
8.2.2 OUTPATIENT SETTINGS 66
8.2.2.1 Growing preference for outpatient facilities to reduce the cost of care to drive market growth 66
8.3 HEALTHCARE PAYERS 67
8.3.1.1 Advantages such as the increased productivity and profitability of coding operations are driving the adoption of mid-RCM solutions by healthcare payers 67

9 MID-REVENUE CYCLE MANAGEMENT/CLINICAL DOCUMENTATION IMPROVEMENT MARKET, BY REGION 68
9.1 INTRODUCTION 69
9.2 NORTH AMERICA 70
9.2.1 US 74
9.2.2 CANADA 78
9.3 EUROPE 81
9.4 ASIA PACIFIC 85
9.5 REST OF THE WORLD 90

10 COMPETITIVE LANDSCAPE 94
10.1 OVERVIEW 94
10.2 MARKET LEADERSHIP ANALYSIS 95
10.3 COMPETITIVE SCENARIO 97
10.3.1 AGREEMENTS, COLLABORATIONS, & PARTNERSHIPS 97
10.3.2 PRODUCT LAUNCHES AND ENHANCEMENTS 98
10.3.3 ACQUISITIONS 99
10.3.4 EXPANSIONS 99
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11 COMPANY PROFILES 100
(Business overview, Products and services offered, Recent Developments, SWOT analysis, MNM view)*
11.1 3M COMPANY 100
11.2 OPTUM, INC. (A SUBSIDIARY OF UNITEDHEALTH GROUP, INC.) 104
11.3 NUANCE COMMUNICATIONS, INC. 108
11.4 M*MODAL 111
11.5 DOLBEY SYSTEMS 114
11.6 NTHRIVE, INC. 116
11.7 STREAMLINE HEALTH SOLUTIONS, LLC 118
11.8 VITALWARE, LLC. 120
11.9 CHARTWISE MEDICAL SYSTEMS, INC. 122
11.10 IODINE SOFTWARE 124
*Details on Business overview, Products and services offered, Recent Developments, SWOT analysis, MNM view might not be captured in case of unlisted companies.
11.11 OTHER LEADING PLAYERS 125
11.11.1 CRANEWARE 125
11.11.2 EPIC SYSTEMS CORPORATION 125
11.11.3 CERNER CORPORATION 126
11.11.4 EZDI, INC. 126

12 APPENDIX 127
12.1 INSIGHTS OF INDUSTRY EXPERTS 127
12.2 DISCUSSION GUIDE 128
12.3 KNOWLEDGE STORE: MARKETSANDMARKETS’ SUBSCRIPTION PORTAL 131
12.4 AVAILABLE CUSTOMIZATIONS 133
12.5 RELATED REPORTS 134
12.6 AUTHOR DETAILS 135



List of Figures



FIGURE 1 RESEARCH DESIGN 17
FIGURE 2 BREAKDOWN OF PRIMARY INTERVIEWS: BY COMPANY TYPE, DESIGNATION AND REGION 19
FIGURE 3 BOTTOM-UP APPROACH 21
FIGURE 4 TOP-DOWN APPROACH 22
FIGURE 5 DATA TRIANGULATION METHODOLOGY 23
FIGURE 6 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY PRODUCT & SERVICE, 2018 VS. 2023 (USD MILLION) 26
FIGURE 7 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY TYPE 2018 VS. 2023 (USD MILLION) 27
FIGURE 8 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR CLINICAL CODING, BY TYPE, 2018 VS. 2023 (USD MILLION) 28
FIGURE 9 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY END USER 2018 VS. 2023 (USD MILLION) 29
FIGURE 10 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2018 VS. 2023 (USD MILLION) 30
FIGURE 11 NORTH AMERICA DOMINATED THE MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET IN 2017 31
FIGURE 12 INCREASING UTILIZATION OF MID-RCM SOLUTIONS TO REDUCE HEALTHCARE COSTS?A KEY FACTOR DRIVING MARKET GROWTH 32
FIGURE 13 THE US WILL CONTINUE TO DOMINATE THE MARKET THROUGH 2023 33
FIGURE 14 APAC TO GROW AT THE HIGHEST CAGR DURING THE FORECAST PERIOD 34
FIGURE 15 NORTH AMERICA WILL CONTINUE TO DOMINATE THE MARKET THROUGH 2023 35
FIGURE 16 CONSULTING SERVICES SEGMENT TO WITNESS THE HIGHEST GROWTH DURING THE FORECAST PERIOD 45
FIGURE 17 HEALTHCARE PROVIDERS TO REGISTER THE HIGHEST GROWTH RATE OF
THE MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET DURING
THE FORECAST PERIOD 62
FIGURE 18 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET: GEOGRAPHIC GROWTH OPPORTUNITIES 69
FIGURE 19 NORTH AMERICA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET SNAPSHOT 71
FIGURE 20 EUROPE: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET SNAPSHOT 83
FIGURE 21 APAC: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET SNAPSHOT 87
FIGURE 22 ROW: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET SNAPSHOT 91
FIGURE 23 3M: COMPANY SNAPSHOT (2017) 100
FIGURE 24 OPTUM: COMPANY SNAPSHOT (2017) 104
FIGURE 25 NUANCE: COMPANY SNAPSHOT (2017) 108
FIGURE 26 STREAMLINE HEALTH: COMPANY SNAPSHOT (2017) 118

 

List of Tables



TABLE 1 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET SNAPSHOT 25
TABLE 2 MID-REVENUE CYCLE MANAGEMENT MARKET: DRIVERS, RESTRAINTS, OPPORTUNITIES, AND CHALLENGES 36
TABLE 3 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY PRODUCT & SERVICE, 2016–2023 (USD MILLION) 46
TABLE 4 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY TYPE 2016–2023 (USD MILLION) 47
TABLE 5 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 47
TABLE 6 CLINICAL DOCUMENTATION SOLUTIONS OFFERED BY KEY MARKET PLAYERS 48
TABLE 7 MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL DOCUMENTATION SOLUTIONS, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 49
TABLE 8 MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY TYPE, 2016–2023 (USD MILLION) 50
TABLE 9 MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 51
TABLE 10 NLP CLINICAL CODING SOLUTIONS OFFERED BY KEY MARKET PLAYERS 52
TABLE 11 MID-REVENUE CYCLE MANAGEMENT MARKET FOR NLP SOLUTIONS BY COUNTRY/REGION, 2016–2023 (USD MILLION) 52
TABLE 12 STRUCTURED INPUT CLINICAL CODING SOLUTIONS OFFERED BY KEY MARKET PLAYERS 53
TABLE 13 MID-REVENUE CYCLE MANAGEMENT MARKET FOR STRUCTURAL INPUT SOLUTIONS, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 54
TABLE 14 CHARGE CAPTURE SOLUTIONS OFFERED BY KEY MARKET PLAYERS 55
TABLE 15 MID-REVENUE CYCLE MANAGEMENT MARKET FOR CHARGE CAPTURE SOLUTIONS, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 55
TABLE 16 CDI SOLUTIONS OFFERED BY KEY MARKET PLAYERS 56
TABLE 17 MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL DOCUMENTATION IMPROVEMENT SOLUTIONS, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 57
TABLE 18 DRG SOLUTIONS OFFERED BY KEY MARKET PLAYERS 58
TABLE 19 MID-REVENUE CYCLE MANAGEMENT MARKET FOR DIAGNOSIS-RELATED GROUPING SOLUTIONS, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 58
TABLE 20 PRE-BILL REVIEW SOLUTIONS OFFERED BY KEY MARKET PLAYERS 59
TABLE 21 MID-REVENUE CYCLE MANAGEMENT MARKET FOR PRE-BILL REVIEW SOLUTIONS, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 59
TABLE 22 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR CONSULTING SERVICES, BY COUNTRY/REGION, 2016–2023 (USD MILLION) 60
TABLE 23 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY END USER 2016–2023 (USD MILLION) 62
TABLE 24 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2016–2023 (USD MILLION) 64
TABLE 25 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY REGION, 2016–2023 (USD MILLION) 64
TABLE 26 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR INPATIENT SETTINGS, BY REGION, 2016–2023 (USD MILLION) 65
TABLE 27 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR OUTPATIENT SETTINGS, BY REGION, 2016–2023 (USD MILLION) 66
TABLE 28 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PAYERS, BY REGION, 2016–2023 (USD MILLION) 67
TABLE 29 MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY REGION 2016–2023 (USD MILLION) 70
TABLE 30 NORTH AMERICA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BY COUNTRY, 2016–2023 (USD MILLION) 72
TABLE 31 NORTH AMERICA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BY PRODUCT & SERVICE, 2016–2023 (USD MILLION) 72
TABLE 32 NORTH AMERICA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BY TYPE, 2016–2023 (USD MILLION) 73
TABLE 33 NORTH AMERICA: MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY TYPE, 2016–2023 (USD MILLION) 73
TABLE 34 NORTH AMERICA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BY END USER, 2016–2023 (USD MILLION) 74
TABLE 35 NORTH AMERICA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2016–2023 (USD MILLION) 74
TABLE 36 US: KEY MACROINDICATORS 76
TABLE 37 US: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY PRODUCT & SERVICE, 2016–2023 (USD MILLION) 76
TABLE 38 US: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY TYPE 2016–2023 (USD MILLION) 77
TABLE 39 US: MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY TYPE, 2016–2023 (USD MILLION) 77
TABLE 40 US: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY END USER, 2016–2023 (USD MILLION) 78
TABLE 41 US: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2016–2023 (USD MILLION) 78
TABLE 42 CANADA: KEY MACROINDICATORS 79
TABLE 43 CANADA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY PRODUCT & SERVICE, 2016–2023 (USD MILLION) 79
TABLE 44 CANADA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY TYPE, 2016–2023 (USD MILLION) 80
TABLE 45 CANADA: MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY TYPE, 2016–2023 (USD MILLION) 80
TABLE 46 CANADA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BY END USER, 2016–2023 (USD MILLION) 81
TABLE 47 CANADA: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2016–2023 (USD MILLION) 81
TABLE 48 EUROPE: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BY PRODUCT & SERVICE, 2016–2023 (USD MILLION) 83
TABLE 49 EUROPE: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BY TYPE, 2016–2023 (USD MILLION) 84
TABLE 50 EUROPE: MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY TYPE, 2016–2023 (USD MILLION) 84
TABLE 51 EUROPE: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY END USER, 2016–2023 (USD MILLION) 85
TABLE 52 EUROPE: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2016–2023 (USD MILLION) 85
TABLE 53 APAC: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY PRODUCT & SERVICE, 2016–2023 (USD MILLION) 87
TABLE 54 APAC: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY TYPE 2016–2023 (USD MILLION) 88
TABLE 55 APAC: MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY TYPE, 2016–2023 (USD MILLION) 88
TABLE 56 APAC: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY END USER, 2016–2023 (USD MILLION) 89
TABLE 57 APAC: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2016–2023 (USD MILLION) 89
TABLE 58 ROW: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY PRODUCT & SERVICE, 2016–2023 (USD MILLION) 91
TABLE 59 ROW: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY TYPE 2016–2023 (USD MILLION) 92
TABLE 60 ROW: MID-REVENUE CYCLE MANAGEMENT MARKET FOR CLINICAL CODING SOLUTIONS, BY TYPE, 2016–2023 (USD MILLION) 92
TABLE 61 ROW: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET, BY END USER, 2016–2023 (USD MILLION) 93
TABLE 62 ROW: MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET FOR HEALTHCARE PROVIDERS, BY TYPE, 2016–2023 (USD MILLION) 93
TABLE 63 KEY DEVELOPMENTS IN THE MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET BETWEEN JANUARY 2014 AND NOVEMBER 2018 94
TABLE 64 GROWTH STRATEGY MATRIX (2014–2018) 95
TABLE 65 MARKET POSITION OF LEADING PLAYERS IN MID-REVENUE CYCLE MANAGEMENT SOLUTIONS MARKET 95
TABLE 66 AGREEMENTS, COLLABORATIONS, & PARTNERSHIPS, 2014–2018 97
TABLE 67 PRODUCT LAUNCHES AND ENHANCEMENTS, 2014–2018 98
TABLE 68 ACQUISITIONS, 2014–2018 99
TABLE 69 EXPANSIONS, 2014–2018 99