Medical coding market

Medical coding is the process of applying universal alphanumeric codes to healthcare services i.e., medical diagnosis, medical services, medical procedures, and medical equipment provided. Currently, medical coding is being increasingly used to create a proper record of patient care, identify healthcare areas that require focus, streamline billing process, and accelerate payments to physicians. Medical coders are individuals responsible for translating physicians' reports into useful medical codes, which may include a patient’s condition, doctor’s diagnosis, prescription, and procedures performed on the patient, ensuring all vital information is coded appropriately to ensure consistency and accuracy. Medical coding helps to improve efficiency, reduce degree of errors, and simplify the tedious work of administrative staff.

Market Statistics:

The global medical coding market was valued at US$ 16,885.09 Mn in 2021 and is forecast to reach a value of US$ 31,870.82 Mn by 2028 at a CAGR of 9.6% between 2022 and 2028.

North America held dominant position in the global medical coding market in 2020, accounting for 42.5% share in terms of volume, followed by Europe and Asia Pacific, respectively.

Figure 1. Global Medical Coding Market Share (%), by Region, 2021

Recent Developments:

In March 2021, athenahealth, a leading provider of network-enabled software and services for medical groups and health systems nationwide, today announced the general availability of its new athenaOne Medical Coding solution. This solution will relieve providers and staff from coding-related work that slows them down and delays claim submissions.

In November 2020, Nuance and Providence signed strategic collaboration in which Providence will build on the long-term relationship with Nuance by expanding its use of Nuance's cloud solutions across its 51-hospital, seven-state system.

In October 2019, Nuance and Microsoft Corporation partnered to transform the doctor-patient experience. This partnership may help the company in transforming the healthcare delivery.

Market Drivers:

1. Increasing demand for coding services is expected to augment growth of the global medical coding market over the forecast period. For instance, according to the American Academy of Professional Coders (2022 report), there are thousands of services performed by providers and an equal number of injectable drugs and supplies to be tracked, and medical coding categorises these for easier reporting and tracking. Furthermore, medical coding make modern healthcare possible by connecting service providers with insurers to ensure fast processing. Thus, there is an increasing demand for coding services worldwide.
2. Rising need for a universal language in healthcare to reduce frauds and misinterpretations is expected to propel growth of the global medical coding market during the forecast period. For instance, according to the American Academy of Professional Coders, in healthcare, there are many descriptions, names, acronyms, and eponyms for each disease, device and procedure, and medical coding standardizes the language and presentation of all these rudiments, so they can be more easily understood, tracked, and modified.

Figure 2. Global Medical Coding Market Share (%), by Classification System, 2021

Market Restraints:

1. Data security concerns and high implementation and maintenance costs is expected to hinder growth of the global medical coding market. For instance, security issues can pose problems for data security, patient safety, and for regulatory compliance. There is a wide range of security issues that hospitals, healthcare IT departments, care facilities, coders, management and other personnel face on a daily basis. Moreover, due to the nature of medical data, cyber-security in healthcare has become a unique challenge. This in turn is expected hamper market growth.
2. Changing regulations related to medical coding are expected to hamper growth of the global medical coding market. Coding compliance refers to the process of ensuring that the coding of diagnosis, procedures and data complies with all coding rules, laws and guidelines. Therefore, all health care facilities and providers should have a compliance plan. The national medical associations, such as the American Medical Association and the American Dental Association, also put out guidelines, which they publish for the benefit of the healthcare industry.

Market Opportunities:

1. Increasing demand to streamline hospital procedures is expected to offer significant growth opportunities for players in the global medical coding market. For instance, in September 2019, 3M Company Health Information Systems and M Modal announced the launch of the clinical documentation enhancement tool. 3M M*Modal CDI Engage One uses artificial intelligence (AI) and natural language understanding technologies to deliver real-time clinical insight to clinicians, clinical documentation improvement specialists and coding teams.
2. Growing adoption of CAC (computer assisted coding) solutions is expected to offer lucrative growth opportunities for players in the global medical coding market. CAC was promised to increase coder accuracy and improve the quality of medical codes. For instance, Hospitals and health systems are now realizing the benefits of computer-assisted coding solutions, according to the new KLAS Research report. KLAS interviewed users of CAC solutions from 4 vendors; such as 3M, Optum, Dolbey, and ezDI.

Market Trends/Key Takeaways:

1. Growing adoption of digital technologies such as electronic health records (EHR), mHealth, telehealth, etc. is expected to boost growth of the global medical coding market. For instance, Healthcare digitalization is reshaping the way people interacting with healthcare professionals, share medical data, and/or make decisions related to treatment and outcomes. Digital tools give healthcare providers an extensive view of the patient health by significantly increasing access to health data and giving patients greater control over their health. Thus, the rate of adoption of digital technologies in healthcare has increased.
2. Increasing prevalence of chronic diseases across the globe is expected to drive growth of the global medical coding market. Chronic diseases are the leading causes of death and disability worldwide. For instance, according to the World Health Organization (WHO), cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year, representing 32% of all global deaths.

Competitive Landscape:

1. 3M Company
2. Aviacode Inc.
3. Dolbey Systems Inc.
4. Maxim Health Information Services
5. MRA Health Information Services
6. Nuance Communications Inc.
7. Optum Inc.
8. Oracle Corporation
9. Talix
10. nThrive (Precyse Solutions LLC)
11. The Coding Network, L.L.C

Detailed Segmentation:

• Global Medical Coding Market, By Classification System:
  • International Classification of Diseases (ICD)
  • Healthcare Common Procedure Code System (HCPCS)
• Global Medical Coding Market, By Component:
  • In-house
  • Outsourced
• Global Medical Coding Market, By End User:
  • Hospitals
  • Diagnostic Centres
  • Other End Users
• Global Medical Coding Market, By Geography:
  • North America
  • Europe
  • Asia-Pacific
  • South America
  • Middle East and Africa