Market Size and Overview:

The 2023 valuation of the worldwide autonomous medical coding market amounted to USD 39.8 billion, with a projected increase to a comprehensive market assessment of USD 88 billion by 2030. A compound annual growth rate (CAGR) of 12% is anticipated for the market's expansion throughout the analysis period spanning from 2024 to 2030.

Industry Overview

The intricacies of medical coding pose significant challenges within revenue cycle management, necessitating the expertise of highly trained professionals. In recent years, the incidence of revenue leakage due to coding errors has surged. The evolving landscape, marked by the transition to ICD-10, alterations in regulatory frameworks, and heightened clinical documentation requirements, has contributed to the growing complexity of medical coding. Frequent modifications in coding requirements have impeded coder efficiency, leading to increased denial rates, a shortage of certified coders, and persistent pressure to stay abreast of changing payer and industry regulations while enhancing both efficiency and quality.

Healthcare providers seek automation solutions capable of interpreting medical charts, understanding medical language, and selecting appropriate codes to optimize reimbursement, coding efficiency, and compliance. While various autonomous coding systems are available, their scope is often limited to specific specialties and demands within inpatient, outpatient, and emergency department settings. Additionally, the success of these systems is frequently contingent upon the types of input utilized.

Impact of Covid-19 on the Industry

The COVID-19 pandemic has ushered in economic repercussions across diverse industries, including healthcare IT. Notably, the global computer-assisted coding market has experienced a positive impact, driven by the increased adoption of innovative solutions to reduce operating costs and a heightened emphasis on patient care management. The utilization of computer-assisted coding (CAC) has gained traction worldwide, reflecting the influence of COVID-19 on the adoption of such systems. During the pandemic, code providers utilized an ICD-10-CM emergency code introduced by the World Health Organization in March 2020 for confirmed COVID-19 cases.

Market Drivers

The adoption of Artificial Intelligence across various industries is poised to propel market growth.

Anticipated advancements in medical coding technology are closely tied to the accelerated integration of Artificial Intelligence (AI) and Machine Learning (ML) capabilities, along with advancements in natural language processing. Organizations are exploring large-scale implementation of Autonomous Medical Coding (AMC) to leverage these technologies, aiming for a coding method capable of translating clinical data into coded information for secure insurance payment without human intervention. Additionally, AMC technologies contribute to transparency by providing an audit trail of autonomous codes, reducing the likelihood of errors during complex patient interactions and enhancing model accuracy through machine learning techniques.

The high accessibility of urgent care centers has fueled demand during the pandemic.

The rapid evolution of medical coding technology is spurred by businesses investigating widespread AMC implementation. With advancements in AI/ML and natural language processing capabilities, organizations aspire to develop a comprehensive coding solution that can seamlessly translate clinical data into coded information for insurance claims, eliminating the need for human involvement. AMC technologies not only offer transparency through audit trails but also enhance accuracy by employing machine learning techniques to refine the model during intricate patient interactions.

Market Restraints

A lack of expertise in the field is poised to serve as a constraint on market growth.

Attaining eligibility for medical and billing training programs necessitates a high school diploma or a General Educational Development (GED) degree, a crucial requirement due to the specialized nature of medical terminology involved. Proficiency in language and mathematics acquired during high school forms the foundation for success in medical billing and coding training programs. Failure to meet these educational qualifications precludes individuals from enrolling in such training programs.

To embark on a career as a medical biller and coder, completion of an accredited training program is mandatory. Various options, including certificate, diploma, or associate degree programs, are available through community colleges, vocational schools, universities, hospitals, and other healthcare education providers. Depending on the chosen curriculum, the duration of the required training program may range from 7 to 24 months.

Global Autonomous Medical Coding Market - By Mode of Delivery

• Web & Cloud-based
• On-Premises

The Autonomous Medical Coding market is currently experiencing notable transformations driven by technological advancements and the demand for efficient healthcare coding processes. The Web & Cloud-based segment has secured a predominant position, holding the highest market revenue. This dominance is attributed to the provision of scalable and accessible coding solutions by healthcare organizations through cloud platforms. The convenience of remote access and real-time updates positions Web & Cloud-based coding as the preferred mode of delivery for many healthcare providers. On-Premises emerges as the fastest-growing segment. Despite the increasing popularity of cloud-based solutions, some healthcare organizations opt for On-Premises deployment to maintain complete control over their coding systems and data. The flexibility to customize and tailor the coding infrastructure to specific needs makes On-Premises coding an attractive choice for certain end-users, contributing to its rapid growth in the market.

Global Autonomous Medical Coding Market - By End User

• Hospitals
• Clinical Laboratories and Diagnostics Centre
• Other

Hospitals have established dominance as the leading end-user, holding the highest market share revenue. The utilization of autonomous coding solutions in hospitals has enabled efficient management of a diverse range of patient data and streamlined coding workflows. The adoption of autonomous coding technologies in hospitals contributes to streamlined processes, heightened accuracy, and optimized revenue cycle management, signifying the major factor for the segment's dominance. Clinical Laboratories and Diagnostics Centre represent the fastest-growing segment, driven by the ability of autonomous coding technology to process a substantial volume of diagnostic tests and patient data, leading to enhanced efficiency and improved patient outcomes. The swift growth of coding technologies in diagnostics centers reflects the industry's commitment to advancing healthcare management, and as the significance of diagnostics centers in healthcare grows, the demand for efficient and accurate coding solutions in this segment is anticipated to boost 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 dominant region for Autonomous Medical Coding solutions, acquiring the highest revenue market share. This is propelled by a well-established healthcare infrastructure, substantial investments in healthcare IT, and a strong focus on technological innovation. The proactive approach in adopting advanced coding technologies in North America has resulted in improved accuracy in medical coding, optimized revenue cycle management, and enhanced overall patient care. As the region continues to prioritize healthcare digitization and automation, the demand for autonomous medical coding solutions is expected to remain robust. The Asia-Pacific region emerges as the fastest-growing market during the forecast period, driven by a burgeoning population, increasing healthcare expenditure, and a growing focus on healthcare modernization. The adoption of autonomous coding solutions in Asia-Pacific is fueled by the need to manage large volumes of healthcare data, optimize coding workflows, and minimize coding errors. The market growth in the Asia-Pacific region is further propelled by the increasing emphasis on telemedicine and remote healthcare services.

Global Autonomous Medical Coding Market - By Companies

• 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

Notable Happenings in the Global Autonomous Medical Coding Market in the Recent Past:

• Product Launch: In April 2021, 3M Company introduced a new technology platform, 3M SDoH, allowing healthcare professionals and payers to prioritize treatment and resources for high-risk individuals and patient populations by integrating clinical, social, and community health data.
• Merger & Acquisition: In April 2021, Cerner Corporation completed the USD 375 million cash acquisition of Kantar Health, a Kantar Group company, subject to adjustment.