As ICD-10 takes hold and meaningful use fades, revenue cycle opportunities are heating up

Looking into its crystal ball – or perhaps digital spreadsheets – PiperJaffray analysts see big plays in the RCM market. That potential is so large, in fact, that Cerner alone has a $40 billion opportunity, and it ranks fifth in market share.
By Bernie Monegain
12:36 PM

Now that ICD-10 has arrived and hospitals are focusing less on EHR implementations to earn meaningful use incentives, “revenue cycle opportunities are heating up,” according to PiperJaffray.

PiperJaffray analysts Sean Wieland and Nina Deka wrote in a March 31 brief that “66 percent of hospitals plan to focus on improving revenue cycle operations,” citing a recent study by the clearinghouse Navicure.

That translates to what Deka and Wieland called “a very real multi-billion dollar opportunity,” for hospitals and technology vendors alike.

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[Also: Cerner's point man on revenue cycle talks outsourcing options in a risk-based world]

PiperJaffray considers that potential so real, in fact, that it estimated Cerner alone could pull in a whopping $40 billion during the next decade from RCM tools, notably its RevWorks software, “if Cerner fully penetrated its existing base.”

And while PiperJaffray’s brief focused on Cerner, which is one of its clients, there are other RCM companies no doubt looking to cash in on the opportunity as well.

Cerner is only the fifth largest RCM vendor as measured by number of beds. The four ahead of Cerner: Epic, Meditech, McKesson and Siemens – though of those five Epic and Cerner are the only ones currently growing their market share, PiperJaffray said in a February 23, 2016 report.

“Revenue cycle is a front-burner issue once again,” Deka and Wieland wrote in the March 31 brief. “Recent channel checks indicate an increase in the number of revenue cycle system selections are either underway or at the early stages. The complexity of the revenue cycle is expected to increase due to at-risk payment models such as bundled payments and fee-for-value.”

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