查看購物車
  • English
  • Japanese
封面
市場調查報告書
商品編碼
1941498

美國醫療帳單外包市場規模、佔有率和趨勢分析報告：按組件、最終用途、服務和細分市場預測（2026-2033 年）

U.S. Medical Billing Outsourcing Market Size, Share & Trends Analysis Report By Component (In-House, Outsourced), By End-use (Hospitals, Physician Offices), By Service (Front-end, Middle-end, Back-end), And Segment Forecasts, 2026 - 2033
出版日期: | 出版商: Grand View Research | 英文 100 Pages | 商品交期: 2-10個工作天內

價格

美國醫療帳單外包市場概覽

據估計，2025 年美國醫療帳單外包市場規模為 69.5 億美元，預計到 2033 年將達到 176.9 億美元。

預計從 2026 年到 2033 年，該產業將以 12.56% 的複合年成長率成長。醫療服務提供者在管理大量帳單和報銷方面面臨的挑戰日益增加，導致收入大幅下降，這也是美國對醫療帳單外包服務需求不斷成長的一個因素。

此外，患者數量的成長以及醫療專業人員日益繁重的病歷和帳單處理工作也是促成因素。為了應對這些挑戰，醫院正在將醫療帳單處理外包，從而推動市場成長。醫院將醫療帳單處理外包給對《平價醫療法案》(ACA)、醫療補助計劃 (Medicaid) 和其他健康保險項目擁有全面了解的公司。此外，由於強制性的複雜 ICD-10 編碼系統、不斷上漲的醫療成本以及為維持報銷水平而實施電子健康記錄的監管壓力，醫療保健行業也擴大將賬單處理外包。醫療服務在理賠處理和準確結算方面面臨著許多挑戰，預計這將推動對創新收入週期管理 (RCM) 解決方案的需求。利用信譽良好的第三方服務供應商提供的先進創新 RCM 解決方案，醫療機構既可以充分發揮這些 RCM 解決方案的經濟價值和有效性，又能同時專注於改善患者照護。

此外，便捷的理賠結算流程（包括應收帳款和理賠管理）以及精通最新醫療編碼的專家編碼員，是醫療機構選擇外包計費的關鍵原因。然而，與醫療計費相關的資料外洩風險較高，預計將在預測期內阻礙市場成長。例如，根據美國衛生與公眾服務部 (HHS) 民權辦公室 (OCR) 於 2025 年 1 月發布的《2024 年醫療保健資料外洩報告》，預計 2024 年將報告超過 500 起資料外洩事件。

此外，計費服務供應商正擴大採用人工智慧 (AI)、機器人流程自動化和預測分析等先進技術來變革醫療計費流程。人工智慧驅動的編碼引擎能夠自動從臨床文件中提取和分配代碼，從而減少人為錯誤並提高首次理賠核准率。

自動化簡化了重複性任務，例如理賠輸入、保險資格確認和帳單提交，從而加快了計費週期。進階分析功能可即時識別拒付模式、特定付款方問題和收入流失風險。這些功能提高了準確性，縮短了報銷時間，並提升了合規性。例如，2025 年 6 月，Collectly 發布了 Billie，這是第一個用於患者計費和收入管理 (RCM) 的 AI 語音助理。它可透過聊天、電子郵件、簡訊和語音全天候提供服務。 Billie 利用即時電子健康記錄 (EHR) 和保險數據，能夠提供個人化的理賠解釋和結算，無需人工干預即時解決 85% 的諮詢，從而將現金流提高 32%，降低 20-30% 的收款成本，並消除漏接電話。

目錄

第1章調查方法和範圍

第2章執行摘要

第3章 美國醫療帳單外包市場變數、趨勢與範圍

  • 市場譜系展望
    • 母市場展望
    • 相關及附隨市場展望
  • 市場動態
  • 美國醫療帳單外包市場分析工具
    • 產業分析：波特五力模型
    • PESTEL 分析
  • 用例洞察

第4章 美國醫療帳單外包市場：按組成部分分類、估算和趨勢分析

  • 美國醫療帳單外包市場組成部分差異分析
  • 美國醫療帳單外包市場規模及趨勢分析（按組成部分分類，2021-2033年）
  • 內部處理
  • 外包

第5章 美國醫療帳單外包市場：按服務類型分類的估算和趨勢分析

  • 美國醫療帳單外包市場服務波動分析
  • 美國醫療帳單外包市場規模及趨勢分析（按服務類型分類，2021-2033 年）
  • 前端服務
  • 中階服務
  • 後端服務

6. 美國醫療帳單外包市場：按最終用戶分類的估算和趨勢分析

  • 美國醫療帳單外包市場最終用途變化分析
  • 美國醫療帳單外包市場規模及應用趨勢分析（2021-2033年）
  • 醫院
  • 診所
  • 其他

第7章 競爭情勢

  • 公司/競爭對手分類
  • 策略規劃
  • 2025年商業市場分析
  • 公司簡介/列表
    • R1RCM Inc.
    • Veradigm LLC（Allscripts Healthcare, LLC）
    • Oracle（Cerner Corporation）
    • eClinicalWorks
    • Kareo, Inc.
    • McKesson Corporation
    • Quest Diagnostics
    • Promantra Inc.
    • AdvancedMD, Inc.
    • eBilling Inc
Product Code: GVR-2-68038-824-4

U.S. Medical Billing Outsourcing Market Summary

The U.S. medical billing outsourcing market size was estimated at USD 6.95 billion in 2025 and is projected to reach USD 17.69 billion by 2033, growing at a CAGR of 12.56% from 2026 to 2033. Increasing challenges faced by healthcare providers in managing a large volume of claims and reimbursements, resulting in significant revenue losses, are attributed to the rising demand for medical billing outsourcing services in the U.S.

Moreover, amplifying patient load and the need to address the growing records and bills burden medical practitioners. Hospitals are outsourcing the medical billing process to counter such a situation, thus anticipating market growth. Moreover, hospitals outsource medical billing to companies that have end-to-end knowledge of the Affordable Medical Care Act, Medicaid, and other healthcare and insurance programs. In addition, the healthcare industry is observing an increase in the outsourcing of billing activities by physicians and hospitals due to mandatory implementation of the intricate ICD-10 coding structure, growing care costs, and regulatory pressure to implement electronic medical records to sustain compensation levels. Medical services are facing complex challenges in billing and precise payment, which is anticipated to drive the demand for innovative RCM solutions. The availability of advanced innovative RCM solutions offered by renowned third-party service providers can help healthcare organizations leverage the economic value and efficacy of these RCM solutions while simultaneously focusing on improving patient care.

Furthermore, hassle-free claims settlement processes featuring accounts receivable management and claims management and the availability of professional coders acquainted with the latest medical codes are the primary reasons practices outsource their billing services. However, high threats of data breaches associated with medical billing are expected to hinder market growth during the forecast period. For instance, according to the 2024 Healthcare Data Breach Report published in January 2025 by the Department of Health and Human Services (HHS) Office for Civil Rights (OCR), more than 500 data breach records were reported in 2024.

Furthermore, billing service providers are increasingly deploying advanced technologies such as artificial intelligence (AI), robotic process automation, and predictive analytics to transform medical billing operations. AI-driven coding engines automatically extract and assign codes from clinical documentation, reducing human error and improving first-pass claim acceptance rates.

Automation streamlines repetitive tasks, including charge entry, eligibility verification, and claims submission, accelerating billing cycles. Advanced analytics identify denial patterns, payer-specific issues, and revenue leakage risks in real time. These capabilities enhance accuracy, reduce reimbursement timelines, and improve compliance. For instance, in June 2025, Collectly launched Billie, the first AI voice agent for patient billing and RCM, available 24/7 via chat, email, text, and voice. It resolves 85% of inquiries instantly without staff assistance, boosts cash flow by 32%, reduces collection costs by 20-30%, and eliminates missed calls, utilizing real-time EHR/insurance data for personalized bill explanations and payments.

U.S. Medical Billing Outsourcing Market Report Segmentation

This report forecasts revenue growth at the country level and provides an analysis of the latest industry trends in each of the sub-segments from 2021 to 2033. For this study, Grand View Research has segmented the U.S. medical billing outsourcing market report based on component, service, and end-use:

  • Component Outlook (Revenue, USD Million, 2021 - 2033)
  • In-House
  • Outsourced
  • Service Outlook (Revenue, USD Million, 2021 - 2033)
  • Front-end Services
  • Middle-end Services
  • Back-end Services
  • End-use Outlook (Revenue, USD Million, 2021 - 2033)
  • Hospitals
  • Physician Offices
  • Others

Table of Contents

Chapter 1. Methodology and Scope

  • 1.1. Market Segmentation & Scope
  • 1.2. Market Definitions
    • 1.2.1. Component Segment
    • 1.2.2. Service Segment
    • 1.2.3. End Use Segment
  • 1.3. Information analysis
    • 1.3.1. Market formulation & data visualization
  • 1.4. Data validation & publishing
  • 1.5. Information Procurement
    • 1.5.1. Primary Research
  • 1.6. Information or Data Analysis
  • 1.7. Market Formulation & Validation
  • 1.8. Market Model
  • 1.9. Total Market: CAGR Calculation
  • 1.10. Objectives
    • 1.10.1. Objective 1
    • 1.10.2. Objective 2

Chapter 2. Executive Summary

  • 2.1. Market Outlook
  • 2.2. Segment Snapshot
  • 2.3. Competitive Insights Landscape

Chapter 3. U.S. Medical Billing Outsourcing Market Variables, Trends & Scope

  • 3.1. Market Lineage Outlook
    • 3.1.1. Parent market outlook
    • 3.1.2. Related/ancillary market outlook.
  • 3.2. Market Dynamics
    • 3.2.1. Market driver analysis
      • 3.2.1.1. Growing focus on increasing profitability and revenue generation
      • 3.2.1.2. Federal mandate to implement digital record keeping by healthcare providers
      • 3.2.1.3. Rapidly changing healthcare regulations
    • 3.2.2. Market restraint analysis
      • 3.2.2.1. High threat of data breaching
      • 3.2.2.2. Hidden outsourcing costs
  • 3.3. U.S. Medical Billing Outsourcing Market Analysis Tools
    • 3.3.1. Industry Analysis - Porter's
      • 3.3.1.1. Supplier power
      • 3.3.1.2. Buyer power
      • 3.3.1.3. Substitution threat
      • 3.3.1.4. Threat of new entrant
      • 3.3.1.5. Competitive rivalry
    • 3.3.2. PESTEL Analysis
      • 3.3.2.1. Political landscape
      • 3.3.2.2. Technological landscape
      • 3.3.2.3. Economic landscape
      • 3.3.2.4. Environmental Landscape
      • 3.3.2.5. Legal Landscape
      • 3.3.2.6. Social Landscape
  • 3.4. Case Study Insights

Chapter 4. U.S. Medical Billing Outsourcing Market: Component Estimates & Trend Analysis

  • 4.1. Segment Dashboard
  • 4.2. U.S. Medical Billing Outsourcing Market Component Movement Analysis
  • 4.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Component, 2021 to 2033 (USD Million)
  • 4.4. In-house
    • 4.4.1. Market estimates and forecasts 2021 to 2033 (USD Million)
  • 4.5. Outsourced
    • 4.5.1. Market estimates and forecasts 2021 to 2033 (USD Million)

Chapter 5. U.S. Medical Billing Outsourcing Market: Service Estimates & Trend Analysis

  • 5.1. Segment Dashboard
  • 5.2. U.S. Medical Billing Outsourcing Market Service Movement Analysis
  • 5.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by Service, 2021 to 2033 (USD Million)
  • 5.4. Front-end Services
    • 5.4.1. Market estimates and forecasts 2021 to 2033 (USD Million)
  • 5.5. Middle-end Services
    • 5.5.1. Market estimates and forecasts 2021 to 2033 (USD Million)
  • 5.6. Back-end Services
    • 5.6.1. Market estimates and forecasts 2021 to 2033 (USD Million)

Chapter 6. U.S. Medical Billing Outsourcing Market: End Use Estimates & Trend Analysis

  • 6.1. Segment Dashboard
  • 6.2. U.S. Medical Billing Outsourcing Market End Use Movement Analysis
  • 6.3. U.S. Medical Billing Outsourcing Market Size & Trend Analysis, by End Use, 2021 to 2033 (USD Million)
  • 6.4. Hospitals
    • 6.4.1. Market estimates and forecasts 2021 to 2033 (USD Million)
  • 6.5. Physician Offices
    • 6.5.1. Market estimates and forecasts 2021 to 2033 (USD Million)
  • 6.6. Others
    • 6.6.1. Market estimates and forecasts 2021 to 2033 (USD Million)

Chapter 7. Competitive Landscape

  • 7.1. Company/Competition Categorization
  • 7.2. Strategy Mapping
  • 7.3. Company Market Position Analysis, 2025
  • 7.4. Company Profiles/Listing
    • 7.4.1. R1RCM Inc.
      • 7.4.1.1. Company overview
      • 7.4.1.2. Financial performance
      • 7.4.1.3. Product benchmarking
      • 7.4.1.4. Strategic initiatives
    • 7.4.2. Veradigm LLC (Allscripts Healthcare, LLC)
      • 7.4.2.1. Company overview
      • 7.4.2.2. Financial performance
      • 7.4.2.3. Product benchmarking
      • 7.4.2.4. Strategic initiatives
    • 7.4.3. Oracle (Cerner Corporation)
      • 7.4.3.1. Company overview
      • 7.4.3.2. Financial performance
      • 7.4.3.3. Product benchmarking
      • 7.4.3.4. Strategic initiatives
    • 7.4.4. eClinicalWorks
      • 7.4.4.1. Company overview
      • 7.4.4.2. Financial performance
      • 7.4.4.3. Product benchmarking
      • 7.4.4.4. Strategic initiatives
    • 7.4.5. Kareo, Inc.
      • 7.4.5.1. Company overview
      • 7.4.5.2. Financial performance
      • 7.4.5.3. Product benchmarking
      • 7.4.5.4. Strategic initiatives
    • 7.4.6. McKesson Corporation
      • 7.4.6.1. Company overview
      • 7.4.6.2. Financial performance
      • 7.4.6.3. Product benchmarking
      • 7.4.6.4. Strategic initiatives
    • 7.4.7. Quest Diagnostics
      • 7.4.7.1. Company overview
      • 7.4.7.2. Financial performance
      • 7.4.7.3. Product benchmarking
      • 7.4.7.4. Strategic initiatives
    • 7.4.8. Promantra Inc.
      • 7.4.8.1. Company overview
      • 7.4.8.2. Financial performance
      • 7.4.8.3. Product benchmarking
      • 7.4.8.4. Strategic initiatives
    • 7.4.9. AdvancedMD, Inc.
      • 7.4.9.1. Company overview
      • 7.4.9.2. Financial performance
      • 7.4.9.3. Product benchmarking
      • 7.4.9.4. Strategic initiatives
    • 7.4.10. eBilling Inc
      • 7.4.10.1. Company overview
      • 7.4.10.2. Financial performance
      • 7.4.10.3. Product benchmarking
      • 7.4.10.4. Strategic initiatives

List of Tables

  • Table 1 List of abbreviations
  • Table 2 U.S. medical billing outsourcing market, by component, 2021 - 2033 (USD Million)
  • Table 3 U.S. medical billing outsourcing market, by service, 2021 - 2033 (USD Million)
  • Table 4 U.S. medical billing outsourcing market, by end use, 2021 - 2033 (USD Million)

List of Figures

  • Fig. 1 Market research process
  • Fig. 2 Data triangulation techniques
  • Fig. 3 Market formulation & validation
  • Fig. 4 U.S. medical billing outsourcing market: Market outlook
  • Fig. 5 U.S. medical billing outsourcing market: Segment outlook
  • Fig. 6 U.S. medical billing outsourcing market: Competitive landscape outlook
  • Fig. 7 Parent market outlook
  • Fig. 8 U.S. medical billing outsourcing market driver impact
  • Fig. 9 U.S. medical billing outsourcing market restraint impact
  • Fig. 10 U.S. medical billing outsourcing market: Component outlook and key takeaways
  • Fig. 11 U.S. medical billing outsourcing market: Component movement analysis
  • Fig. 12 In-house market estimates and forecasts,2021 - 2033 (USD Million)
  • Fig. 13 Outsourced market estimates and forecasts, 2021 - 2033 (USD Million)
  • Fig. 14 U.S. medical billing outsourcing market: Services outlook and key takeaways
  • Fig. 15 U.S. medical billing outsourcing market: Services movement analysis
  • Fig. 16 Front-end services market estimates and forecasts,2021 - 2033 (USD Million)
  • Fig. 17 Middle-end services market estimates and forecasts, 2021 - 2033 (USD Million)
  • Fig. 18 Back-end services market estimates and forecasts, 2021 - 2033 (USD Million)
  • Fig. 19 U.S. medical billing outsourcing market: End Use outlook and key takeaways
  • Fig. 20 U.S. medical billing outsourcing market: End Use movement analysis
  • Fig. 21 Hospitals market estimates and forecast, 2021 - 2033 (USD Million)
  • Fig. 22 Physician offices market estimates and forecast, 2021 - 2033 (USD Million)
  • Fig. 23 Others market estimates and forecast, 2021 - 2033 (USD Million)