Revenue Cycle Management

The U.S. healthcare industry remains a consumer-focused market segment in which, in theory, prospective patients search for medical providers that best serve their needs at a given price point. This consumer-centric approach to healthcare caused this industry to evolve and morph drastically over the past few decades. Firms developed advanced technology systems which were subsequently adopted by providers, governments created new regulations that shifted markets and increased administrative and operational requirements, and changing demographics and consumer preferences forced providers to adapt to modern trends. To combat the added complexity in the healthcare industry and manage everything in a cost-effective manner, medical providers are increasingly more reliant on outsourcing responsibilities to third-party specialists, such as revenue cycle management (RCM) professionals.

The RCM industry may have been initially comprised of specialists responsible for efficiently collecting patient delinquencies on behalf of healthcare providers; however, with the healthcare industry’s transformation, RCM responsibilities have expanded to include complete management of a receivables entire lifecycle, from pre-intervention to post-intervention. Expectations have heightened and costs have increased. Healthcare providers now trust RCM specialists to maintain premier technology platforms and manage other responsibilities, such as employing an effective electronic medical record (EMR) system. Additionally, RCM specialists must also adequately consider and enhance the patient’s experience because consumerism is so important in the healthcare industry. Simply providing a modern online platform, through which patients could complete all medical history or related forms and electronically settle their copayments, may make all the difference for a healthcare provider remaining in business.

The growing healthcare market and increased outsourcing reliance have led to robust growth for the RCM industry. Kaulkin Ginsberg Company (Kaulkin Ginsberg) estimate the RCM industry to total $30.3 billion in aggregate revenue as of year’s end 2017 – the most up-to-date available data – up 7.8% year-over-year compared to 2016. Kaulkin Ginsberg estimated the average annual growth rate of RCM industry revenue at 14.6% since 2010, attributed to robust EMR adoption, growing healthcare expenditures, and case studies of public companies that revealed robust financial prosperity. As the remaining Baby Boomers begin retiring and healthcare expenditures start rising even faster, the RCM industry should see its size and competition requirements increase accordingly. Specifically, Kaulkin Ginsberg anticipate the RCM industry to grow between 6.4% to 13.2% annually, on average, over the next few years, with a conservative revenue estimate of about $38.1 billion by 2022.

While the healthcare industry grows, morphs, and evolves, Kaulkin Ginsberg continues serving RCM companies as both a strategic and transaction advisor to board-level executives. Furthermore, the importance of consumerism and baseline stability of the healthcare industry consistently draws interest from financial and strategic buyers of RCM specialists. After nearly 30 years, Kaulkin Ginsberg serves as a strategic consultant and transaction advisory to current and prospective industry executives, providing premier market intelligence and strategic insight to its clients.

Kaulkin Ginsberg understands the history of the RCM industry, continues to garner expertise within it, and has the foresight to know where it’s trending. Kaulkin Ginsberg is excited about the potential within the RCM industry and look forward to collaborating with owners and executives who are committed to achieving their growth and exit objectives.

If you are interested in purchasing a copy of the entire Revenue Cycle Management Industry: 2018 Outlook, or would like to confidentially discuss your interests in the RCM industry, please contact a member of our strategic advisory team at hq@kaulkin.com. Additionally, if you would like to receive a copy of Kaulkin Ginsberg's Revenue Cycle Management whitepaper, simply fill out the request form to the right.

© 2019 by Kaulkin Ginsberg Company

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