The $2.4 billion hospital RCM software and services industry expects double digit increases in 2014 because of business shifts, reimbursement and payment reforms, accountable care participation, ICD-10 coding challenges, physician practice acquisitions, collection issues, and overall declining margins, according to  two reports released Sept. 23 by market research firm Black Book.

The two RCM reports Top Hospital Software Vendors, Revenue Cycle Management: Small/Rural and Community Hospitals under 250 Beds, and Top Hospital Software Vendors, Revenue Cycle Management: Hospitals over 250 Beds, Chains and Networks provide analysis on the replacement RCM market as healthcare systems to upgrade patient billing and collection processes.

More than 1,900 hospital CFOs, CIOs, business office managers, tech and financial staffers contributed their perceptions to Black Book between April 2013 and August 2013. Additionally the business managers of 1,800 physician practices owned by hospital systems also submitted responses, evaluated separately. There were 557 hospital and inpatient organizations represented in the survey.

[See also: Hospitals eager to replace RCM systems.]

“Shifting payment models and regulations are forcing hospital leaders to redirect previously launched budgets, priorities and strategic plans to assess if new RCM solutions can rescue them from imminent hospital layoffs, even bankruptcies," said Doug Brown, managing partner, Black Book Rankings.

“Most hospital CFOs have no choice but to leverage next generation RCM solutions in order to keep their organizations solvent. The reimbursement challenges ahead to get paid may require several new RCM applications, and the frank reality is that a failing RCM could quickly close a marginally performing hospital for good,” Brown said.

HIMSS Analytics found similar market trends earlier this year. In an interview with Healthcare IT News Managing Editor Mike Miliard, HIMSS Analytics Executive Vice President John Hoyt asserted, "There's a new future for reveue cycle." It's time – past time – for replacement, he suggested.

"We're looking at ages 8 to 11 years for these revenue cycle systems" Hoyt said. "Patient billing is different from registration is different from scheduling, but they're generally up there: 8 to 11 years. And that's basically the kind of thing that the auto industry watches. How old are the cars on the road? There's a point at which people just have to start buying new cars."

[See also: RCM tools ill-suited for payment reform.]

In its report Black Book also highlighted the top performing RCM software vendors as ranked by customer satisfaction on 18 client experience-based key performance indicators.