Global Autonomous Medical Coding Market Research Report Segmentation By Mode of Delivery (Web & Cloud-based, and On-Premises); End-User (Hospitals, Clinical Laboratories, and Diagnostics Centre and Other); Region Size, Share, Growth Analysis | Forecast (2024 2030)

Market Size and Overview:

The global autonomous medical coding market was valued at USD 39.8 billion in 2023 and is estimated to reach a total market valuation of USD 88 billion by 2030. The market is projected to grow with a CAGR of 12% per annum during the period of analysis (2024 - 2030).

Industry Overview

In the realm of revenue cycle management, medical coding stands out as a particularly challenging component, demanding a workforce of highly trained and qualified professionals. The prevalence of revenue leakage due to coding errors has experienced a significant surge in recent times. The landscape of medical coding has grown increasingly intricate with the shift to ICD-10, alterations in regulatory frameworks, and evolving clinical documentation prerequisites. The efficiency of coders has faced hindrances owing to frequent adjustments in medical coding requirements, resulting in elevated denial rates, a scarcity of certified coders, and persistent pressure to stay abreast of evolving payer and industry guidelines, all contributing to a demanding operating environment.

As healthcare providers strive for optimal reimbursement, heightened coding efficiency, and compliance adherence, there is a growing inclination towards automation systems. These systems are sought after for their ability to interpret medical charts, comprehend medical language, and accurately select codes for processing. Despite the availability of various autonomous coding systems, their scope is often confined to specific specialties and does not fully cater to the demands of inpatient, outpatient, and emergency departments. Moreover, the success of such projects is frequently contingent upon input types.

Impact of Covid-19 on the Industry

The COVID-19 pandemic has ushered in potential economic ramifications across diverse industries, including healthcare IT. Within this context, the global computer-assisted coding market has experienced a positive impact due to increased utilization of innovative solutions to reduce operational costs and a heightened focus on patient care management. The adoption of computer-assisted coding (CAC) in numerous healthcare institutions worldwide is a testament to the influence of COVID-19 on the uptake of these systems. During the pandemic, code providers resorted to an ICD-10-CM emergency code, endorsed by the World Health Organization in March 2020, specifically designed for confirmed COVID-19 cases.

Global Autonomous Medical Coding Market Drivers:

The acceleration of Artificial Intelligence (AI) adoption across various sectors is poised to propel market growth for medical coding technology.

Anticipated advancements in AI and machine learning (ML), along with natural language processing capabilities, are fueling significant evolution in medical coding technology. Organizations are exploring large-scale implementation of Automated Medical Coding (AMC) to achieve a transformative goal: the ability to translate clinical data into coded information, ensuring seamless payment processing from insurance carriers without human intervention. Furthermore, AMC technologies contribute to transparency by providing an audit trail of autonomous code, reducing the likelihood of errors during complex patient interactions and enhancing model accuracy through machine learning techniques. The increased accessibility of urgent care centers has further stimulated demand during the ongoing pandemic.

Global Autonomous Medical Coding Market Challenges:

A notable market restraint arises from a deficiency in expertise within the field. Eligibility for medical and billing training programs mandates a high school diploma or a General Educational Development (GED) degree. This prerequisite is fundamental due to the specialized nature of medical terminology involved. Proficiency in language and mathematics, cultivated during high school, ensures readiness for success in a medical billing and coding training program. Individuals who have not completed high school or obtained a GED do not meet the qualifications for enrollment in such programs.

To pursue a career as a medical biller and coder, completion of an accredited training program is imperative. Various options, including certificate, diploma, or associate degree programs, are available. Community colleges, vocational schools, universities, hospitals, and healthcare-focused organizations offer diverse training programs. Depending on the chosen curriculum, the duration of the required training program for becoming a medical biller and coder may range from 7 to 24 months.

Global Autonomous Medical Coding Market Segmentation:

Global Autonomous Medical Coding Market - By Mode of Delivery

• Web & Cloud-based
• On-Premises

The Autonomous Medical Coding market is currently witnessing substantial transformations, spurred by technological advancements and the imperative for streamlined healthcare coding procedures. The Web & Cloud-based segment has positioned itself as the leader, securing the highest market revenue. This preeminence is attributed to the provision of scalable and accessible coding solutions to healthcare organizations through cloud platforms. The appeal of Web & Cloud-based coding lies in the convenience of remote access and real-time updates, making it the favored mode of delivery for numerous healthcare providers. On-Premises emerges as the fastest-growing segment. Despite the increasing popularity of cloud-based solutions, certain healthcare organizations opt for On-Premises deployment to retain complete control over their coding systems and data. The adaptability to customize and tailor the coding infrastructure to specific requirements renders On-Premises coding an appealing choice for specific end-users, propelling its rapid ascent in the market.

Global Autonomous Medical Coding Market - By End User

• Hospitals
• Clinical Laboratories and Diagnostics Centre
• Other

Hospitals have asserted dominance in the end-user segment by securing the highest market share revenue, leveraging autonomous coding solutions to effectively manage extensive patient data and streamline coding workflows. The integration of autonomous coding technologies in hospitals streamlines processes, heightens accuracy, and optimizes revenue cycle management, constituting the primary driver for the segment's preeminence. Clinical Laboratories and Diagnostics Centre represent the fastest-growing segment, propelled by the ability of autonomous coding technology to process a substantial volume of diagnostic tests and patient data, leading to heightened efficiency and improved patient outcomes. The swift adoption of coding technologies in diagnostics centers mirrors the industry's commitment to superior healthcare management. As the significance of diagnostics centers in healthcare continues to rise, the demand for efficient and precise coding solutions in this segment is anticipated to bolster market growth.

Global Autonomous Medical Coding Market - By Region

• North America
• Europe
• Asia-Pacific
• Latin America
• The Middle East and Africa

North America stands out as the predominant region for Autonomous Medical Coding solutions, commanding the highest revenue market share. This is propelled by a well-established healthcare infrastructure, substantial investments in healthcare IT, and a robust focus on technological innovation. The region's proactive adoption of advanced coding technologies has resulted in improved accuracy in medical coding, optimized revenue cycle management, and overall enhanced patient care. As North America persists in prioritizing healthcare digitization and automation, the demand for autonomous medical coding solutions is poised to remain robust.

The Asia-Pacific region emerges as the swiftest-growing market during the forecast period. Characterized by a burgeoning population, escalating healthcare expenditure, and a heightened focus on healthcare modernization, the region witnesses a surge in the adoption of autonomous coding solutions. This growth is fueled by the imperative to manage large volumes of healthcare data, optimize coding workflows, and minimize coding errors. Additionally, the market expansion in the Asia-Pacific region is propelled by the increasing emphasis on telemedicine and remote healthcare services.

Key Players:

• 3M Company
• Optum Inc.
• Nuance Communications Inc.
• Cerner Corporation
• TruCode LLC
• Artificial Medical Intelligence Inc.
• Athenahealth Inc.
• Streamline Health Solutions Inc.
• Epic Systems Corporation
• ZyDoc Corporation
• Alpha II LLC

Recent Significant Events in the Global Autonomous Medical Coding Market:

Product Introduction: In April 2021, healthcare professionals and payers witnessed the unveiling of a novel technological platform crafted by 3M. This platform aims to prioritize treatment and allocate resources effectively for individuals and patient populations at high risk. Termed 3M SDoH, the platform seamlessly integrates clinical, social, and community health data to provide a comprehensive overview of a patient's health.

Merger & Acquisition: During the same month, Cerner Corporation successfully concluded a significant cash acquisition amounting to USD 375 million. The acquisition involved Kantar Health, a distinguished company within the Kantar Group, with the final transaction value subject to adjustment.