SANTA CLARA, Calif. (June 15, 2015) – Worldwide revenues for medical electronic data interchange (EDI) is expected to increase to over $2.4 billion in 2019, up from $1.8 billion in 2014, according to IHS Inc. (NYSE: IHS), the leading global source of critical information and insight. Based on data from the IHS Medical Electronic Data Interchange Report, the global medical EDI market is expected to grow at a compound annual growth rate (CAGR) of just under 6 percent, between 2014 to 2019, as healthcare organizations increasingly seek to improve the efficiency of data exchange between providers, consumers and payers.
Medical EDI solutions include software and services that assist with the management, maintenance and optimization of data transmitted between computer systems. For the purposes of the study, medical EDI was segmented across four applications, including traditional EDI (i.e., claims scrubbing, submission, remits, etc.), patient payments, analytics and other optimization services.
EDI solutions streamline revenue cycle processes, resulting in fewer denials and rework requests and faster insurance reimbursements. Further efficiencies are expected as more health-related data become cloud-based, allowing providers and payers to access the same data instantaneously.
“Despite slower adoption when compared to other industries, EDI has played an increasingly valuable role in healthcare, helping to manage the exchange of a variety of data in an efficient, systematic and accessible way,” said Andrew Rebhan, healthcare IT analyst at IHS. “Hospitals and health systems have certainly made progress in terms of moving processes from paper to electronic form and meeting EDI standards, but as care models evolve, they still have trouble getting the correct data to the correct users in a timely manner.”
According to the IHS report, patient payments and analytics have the strongest growth potential among medical EDI applications, particularly in the United States. “The patient is now expected to take on greater responsibility for payments, including co-pays, co-insurance and deductibles,” Rebhan said. “This rise in patient responsibility is reflected in the growth of high-deductible health plans. Providers need to be prepared to collect more money from their patients across a greater number of transactions.”
According to the report, traditional EDI applications have become saturated, with almost every vendor in the market offering some form of traditional EDI functionality. Through 2019, traditional EDI is expected to represent a declining percentage of total U.S. revenues, primarily due to the stronger growth of patient payments and analytic components.
Regulations have also heavily influenced the medical EDI market. Despite its importance, the transition to the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) has been a major undertaking for providers, payers, clearinghouses and healthcare IT vendors. “Healthcare providers have encountered some difficulties, given the heavy amount of regulation they face throughout the claims cycle, and the fact that some practices are still not ready for the anticipated switch to ICD-10 this year,” Rebhan said.
The IHS Medical Electronic Data Interchange Report provides an up-to-date description of the global EDI software and services market and identifies trends that will wield significant influence through 2019. For information about purchasing this report, contact the sales department at IHS in the Americas at (844) 301-7334 or AmericasLeads@ihs.com; in Europe, Middle East and Africa (EMEA) at +44 1344 328 300 or email@example.com; or Asia-Pacific (APAC) at +604 291 3600 or technology_APAC@ihs.com.
About IHS (www.ihs.com)
IHS (NYSE: IHS) is the leading source of insight, analytics and expertise in critical areas that shape today’s business landscape. Businesses and governments in more than 150 countries around the globe rely on the comprehensive content, expert independent analysis and flexible delivery methods of IHS to make high-impact decisions and develop strategies with speed and confidence. IHS has been in business since 1959 and became a publicly traded company on the New York Stock Exchange in 2005. Headquartered in Englewood, Colorado, USA, IHS is committed to sustainable, profitable growth and employs about 8,800 people in 32 countries around the world.
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