With rising technological advancements and the adoption of the value-based care model, providers are focusing on implementing advanced patient-centric RCM solutions to enhance cash collections and reduce reliance on manual processes. They are developing unified payment gateways with digital payment options, cumulative patient billing, and data transparency to boost patient satisfaction. In 2023–2024, providers saw improved operating margins due to increased revenues. However, rising costs driven by inflation, labor shortages, and escalating drug prices remained a concern. Nevertheless, they continue to invest in technologies such as Gen AI-assisted coding, self-service scheduling, and Gen AI-powered denials recovery solutions to streamline operations and enhance efficiency.
Both demand-side and supply-side trends are covered in our Revenue Cycle Management (RCM) Business Process Transformation 2024 Market Insights™ and Revenue Cycle Management (RCM) Business Process Transformation 2024 RadarView™, respectively.
These reports present a comprehensive study of RCM service providers and closely examine market leaders, innovators, disruptors, and challengers.
Avasant evaluated 42 service providers across three dimensions: practice maturity, domain ecosystem, and investments and innovation. Of the 42 providers, we recognized 22 that brought the most value to the market during the past 12 months.
The RadarView recognizes service providers in four categories:
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- Leaders: Access Healthcare, GeBBS Healthcare Solutions, Omega Healthcare, Optum, Cognizant, and R1 RCM
- Innovators: AGS Health, Conifer Health, Firstsource, and Genpact
- Disruptors: Exela Technologies, NextGen Healthcare, Sagility, Sutherland, Teleperformance, and WNS
- Challengers: Atos, Datavant, FinThrive, Innova Solutions, Savista RCM, and Shearwater Health
Figure 1 below from the full report illustrates these categories:
“Healthcare providers are developing integrated online payment gateways to enhance transparency and boost patient collections,“ said Avasant Partner Avinash Baliga. “They are transitioning to digital billing systems with e-statements, automated texts, and a single payment source to streamline the patient payment experience and improve RCM.”
“ The reports provide several findings, including the following:
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- In 2024, operating margins improved, indicating a trend toward financial stabilization despite rising administration costs.
- With improved margins, healthcare providers are investing in delivering exceptional patient experiences,
- Healthcare providers are adopting the latest technologies to enhance operational efficiency, including AI/ML-powered suggestive tools, Gen AI-assisted coding, omnichannel patient payment and engagement platforms, and AI-driven denial recovery solutions.
- To support value-based care, providers are continually innovating by developing new automation tools using Gen AI and delivering personalized services to better meet patient needs.
“Increased administrative costs and low collections strain healthcare providers despite better margins,” said Aditya Jain, principal analyst at Avasant. “Challenges like inflation, delayed claims, drug shortages, and rising labor costs persist. Providers are turning to technology and workforce optimization to ease financial pressures.”
The RadarView also features detailed profiles of 22 service providers, along with their solutions, offerings, and experience in assisting enterprises in their RCM services journeys.
This Research Byte is a brief overview of Avasant’s Revenue Cycle Management (RCM) Business Process Transformation 2024 Market Insights™ and Revenue Cycle Management (RCM) Business Process Transformation 2024 RadarView™ (click for pricing).