The global patient access solutions market is expected to register a CAGR of 7.5% during the forecast period, 2018 to 2023. Patient Access Solutions involves Denials management, Payment estimation, Streamline pre-registration, and Improve patient collections. The point-of-service (POS) collections is increasingly seen in developing countries where patients are uninsured and pay out-of-pocket. Training and educating the front end staff is important as they are accountable for payment collection and this effects the revenue of the hospital.
Rising Importance of Denials Management
Denials Management has a vital role in hospital revenue generation. Most hospitals are now dependent on third party providers for Denials Management service as they lack the expert knowledge, time to manage the reimbursement process. These providers with dedicated and skilled professionals are able to handle the denied claim and resubmit them. With their expertise these providers are able to increase the cash flow of their clients which were otherwise neglected by the hospitals to resubmit the denied claims. It is estimated that over 90% of the claim denials can be prevented with support from providers who have systems and knowledge experts in this field. Thus the rising need to eradicate claim denials is expected to contribute for the growth of patient access solutions market in the forecast period. The other factors such as Need to maintain regulatory compliance, Increasing Insured patient volume and growing need to reduce healthcare costs are driving the Patient Access Solutions Market.
Data Privacy and Confidentiality
Healthcare being the most personal services provided in our society, for safer and appropriate delivery of care to patients and management of patient access solutions activities most providers collect various data points on patient personal information: medication history, disease history and surgical procedures undergone etc. There is an increasing concern over how healthcare providers use the patient’s information and protect his confidentiality. The hospitals healthcare databases are at risk of unauthorized use or access. Many organizations that obtain patient acknowledgement of the Notice of Privacy Practices are still in nascent stage to assist in the free flow of information between providers involved in a patient's care. In developing countries where the IT systems, technological advancements in medical record databases are not well developed, and lack of proper regulations to combat privacy issues there is a high chance of confidentiality. The above is a major factor that has restrained the growth of the Patient Access Solutions Market.
US Lead the Market in North America Region
As of 2017, the US Patient Access Solutions Market holds the largest market share in North America region due to the presence of high quality healthcare system and modern medical technology in the country. Most hospitals in United States serving patients who are covered under Medicare or any privates insurances are facing difficulty in processing and submitting claims. Hospitals face challenge in accurately billing patients for a procedure or surgery done. This has created a huge opportunity for companies that provide patient access solutions to bridge the gap. With proper management of services such as patient registration, medical claim submission, automation in payment estimates etc, patient access solutions companies are streamlining the process and helping in generating extra revenue by decreasing the denial rate of claims.
Additionally, most hospitals in United States having recognized that automating the payment estimation with help of IT tools is helping both hospitals and patients to understand the costs in real time and collect payments by reducing the accounts receivable turnaround time. This is likely to contribute towards the growth of the Patient Access Solutions Market.
Key Developments in the Market
• Mar 2017: Mosaic Life Care, based in Missouri, has selected AccuReg to help standardize and automate the patient registration process across its network of 58 clinics
Major Players: ACCUREG SOFTWARE, CERNER CORPORATION, CIRIUS GROUP, INC, COGNIZANT, CONIFER, EPIC SYSTEMS CORPORATION, EXPERIAN PLC, MCKESSON CORPORATION, OPTUM, INC., AND ZIRMED among others.
Reasons to Purchase this Report
• Current and future Patient Access Solutions Market outlook in the developed and emerging markets
• Analyzing various perspectives of the market with the help of Porter’s five forces analysis
• The segment that is expected to dominate the market
• Regions that are expected to witness fastest growth during the forecast period
• Identify the latest developments, market shares and strategies employed by the major market players.
• 3-month analyst support along with the Market Estimate sheet (in Excel)
Customization of the Report
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1.1 Market Definition
2. Research Methodology
3. Executive Summary
4. Key Inferences
5. Market Overview
5.1 Current Market Scenario
5.2 Porter's Five Forces Analysis
5.2.1 Bargaining Power of Suppliers
5.2.2 Bargaining Power of Consumers
5.2.3 Threat of New Entrants
5.2.4 Threat of Substitute Product and Services
5.2.5 Degree of Competition
6. Market Dynamics
6.1 Market Drivers
6.1.1 Need to Maintain Regulatory Compliance
6.1.2 Rising Importance of Denials Management
6.1.3 Increasing Insured Patient Volume
6.1.4 Growing Need to Reduce Healthcare Costs
6.2 Market Restraints
6.2.1 Data Privacy and Confidentiality
7. Market Segmentation
7.1 By Product and Services
7.1.1 Support & Maintenance Services
7.1.2 Training & Education Services
7.1.3 Claims Denial & Appeal Management
7.1.4 Claims Payment Estimation
7.2 By Delivery Mode
7.2.1 Web & Cloud-Based Solutions
7.2.2 On-Premise Solutions
7.3 By End User
7.3.1 Healthcare Providers
7.3.2 HCIT Outsourcing Companies
7.4 By Geography
7.4.1 North America
220.127.116.11 United states
18.104.22.168 United Kingdom
22.214.171.124 Rest of Europe
126.96.36.199 South Korea
188.8.131.52 Rest of Asia-Pacific
7.4.4 Middle East & Africa
184.108.40.206 South Africa
220.127.116.11 Rest of Middle East & Africa
7.4.5 South America
18.104.22.168 Rest of South America
8. Company Profiles & Competitive Landscape
8.1 AccuReg Software
8.2 Cerner Corporation
8.3 Cirius Group, Inc
8.6 Epic Systems Corporation
8.7 Experian plc
8.8 McKesson Corporation
8.9 Optum, Inc.
8.10 ZirMed, Inc
*List Not Exhaustive
9. Future of the Market
Secondary Research Information is collected from a number of publicly available as well as paid databases. Public sources involve publications by different associations and governments, annual reports and statements of companies, white papers and research publications by recognized industry experts and renowned academia etc. Paid data sources include third party authentic industry databases.
Once data collection is done through secondary research, primary interviews are conducted with different stakeholders across the value chain like manufacturers, distributors, ingredient/input suppliers, end customers and other key opinion leaders of the industry. Primary research is used both to validate the data points obtained from secondary research and to fill in the data gaps after secondary research.
The market engineering phase involves analyzing the data collected, market breakdown and forecasting. Macroeconomic indicators and bottom-up and top-down approaches are used to arrive at a complete set of data points that give way to valuable qualitative and quantitative insights. Each data point is verified by the process of data triangulation to validate the numbers and arrive at close estimates.
The market engineered data is verified and validated by a number of experts, both in-house and external.
REPORT WRITING/ PRESENTATION
After the data is curated by the mentioned highly sophisticated process, the analysts begin to write the report. Garnering insights from data and forecasts, insights are drawn to visualize the entire ecosystem in a single report.