Friday, 16 May, 2008

Revenue Cycle Management Healthcare


The Indian share of BPO revenues from the offshoring of revenue cycle management (RCM) services is estimated at USD 125 million for the year 2006. This report Research the total revenues from this segment to reach USD 410 million by 2011.
Two of the “core” processes in revenue cycle management (RCM) services are medical coding and billing. In this report, we have discussed billing and coding within the context of RCM services. The emphasis (and estimates) for this report relate to medical coding and billing. Medical transcription, which is another “specialized” service not offered by “generic” BPOs has not been covered in this report, and revenue and manpower estimates exclude medical transcription.
The RCM industry in India is still at a nascent stage. While there are certain large vendors offering end-to-end RCM services such as Perot Systems, Apollo Health Street, Zavata and Ajuba there are few others focused on offering certain specific services such as medical coding, payment posting, accounts receivable, etc.
It has been recognized four vendors as potential winners in this space: Ajuba, Apollo Health Street, Perot Systems and Zavata.
The report provides an overview of the buyer scenario and an in-depth analysis of the Indian vendor space along with profiles of major industry players. The report is designed to help:
US hospitals, physician groups and US based RCM companies looking to outsource/offshorePotential vendors / facilitators to assess opportunitiesOutsourcing consultants to evaluate and compare the offerings of vendorsOutsourcing consultants to evaluate and compare the offerings of vendorsResearchers looking for detailed information on RCM offshoringThis study is based on secondary data as well as extensive interviews with key people at various BPOs (captive as well as third-party) in India.
Source :

Why To Invest In INDIAN Healthcare?

Healthcare delivery is one of the largest service-sector industries in India
Estimated revenue of about US$30 billion (FY 2006)
Industry growth at over 12% p.a. in the past four years
Large domestic market complemented by the inflow of medical tourists
Medical tourists have increased almost twenty-fold from 10,000 in 2000 to about 1,80,000–2,00,000 in 2006

The industry is fragmented with a large number of independent, privately-run hospital and healthcare centres
Private healthcare providers account for almost 70%-80% of the total spend
Government sector and corporate employers account for the rest
Private sector corporate entities like Apollo Hospitals, Wockhardt Hospitals and Fortis Healthcare have aggressive expansion plans
Indian hospitals are gaining reputation globally as ‘quality’ service providers
Many Indian hospitals have secured accreditation from the British Standards Institute and Joint Commission on Accreditation of Healthcare Organisations
NHS, UK has indicated India as a preferred destination for surgery.

100% FDI is permitted for all health related services under the automatic route
Infrastructure status accorded to hospitals:
Lower tariffs and higher depreciation on medical equipment
Income-tax exemption for five years to hospitals in rural areas.

Top Private Healthcare Providers in India

Player Revenues (US$ million) Number of Hospitals Beds
Apollo Hospitals 212 (2007) 45 4,148
Wockhardt Hospitals 37 (2006) 8 1,390
Fortis Healthcare 30 (2007) 13 1,790
Manipal Group NA 16 5,659
Source: Company websites, Capitaline Database

The industry is expected to grow at 15% p.a. to US$60 billion by 2010
Medical tourism is expected to become a US$2 billion industry by 2010
Significant growth in healthcare BPO: Expected to become a US$4.5 billion industry by 2008

High growth domestic market arising from:
Increasing health awareness: Share in total private consumption expenditure has increased from 3.5% (1993-94) to 5.3% (2000-01).
Expected to increase further
Increasing penetration of Health insurance
Rapid growth in private sector companies owning and managing hospitals
High growth in medical tourism
Cost of comparable treatment is on average 1/8th to 1/5th of those in western countries
Opportunities exist in multiple segments along the value chain
Service Providers: Curative and preventive in primary, secondary and tertiary care
Diagnostics Services: Imaging and pathology labs
Infrastructure: Hospitals, Diagnostic centres
Health Insurance: Less than 10% of population is covered by health insurance. Medical Insurance premium income is expected to grow to US$3.8 billion by 2012
*44% growth in Health Insurance during 2006-2007
Healthcare BPO: Medical billing, disease coding, forms processing and claims adjudication
Training: Large opportunity for training doctors, managers, nurses and technicians
Investment opportunity of over US$25 billion by 2010

Source: IBEF, Indian Healthcare Foundation, India Country Commercial Guide 2002

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