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2 COMPUTER ASSISTED CODING MARKET [BY SOFTWARE (NATURAL LANGUAGE PROCESSING, STRUCTURED INPUT, INTEGRATED), BY APPLICATION (AUTOMATED ENCODING, MANAGEMENT REPORTING, CLINICAL CODE AUDITING & ANALYTICS), & BY END USER] GLOBAL FORECAST TO 2019 It s a ll a b o u t m a r k e ts MARKETSANDMARKETS sales@marketsandmarkets.com

3 MarketsandMarkets is a global market research and consulting company based in the U.S. We publish strategically analyzed market research reports and serve as a business intelligence partner to Fortune 500 companies across the world. MarketsandMarkets also provides multi-client reports, company profiles, databases, and custom research services. MarketsandMarkets covers fourteen industry verticals, including aerospace and defence, advanced materials, automotives and transportation, biotechnology, chemicals, consumer goods, energy and power, food and beverages, industrial automation, medical devices, pharmaceuticals, semiconductor and electronics, and telecommunications and IT. Copyright 2015 MarketsandMarkets All Rights Reserved. This document contains highly confidential information and is the sole property of MarketsandMarkets. No part of it may be circulated, copied, quoted, or otherwise reproduced without the approval of MarketsandMarkets. 2

4 1 EXECUTIVE SUMMARY Currently, computer-assisted coding (CAC) solutions are increasingly being adopted among healthcare providers to improve medical coding workflows, increase medical coding accuracy, and manage larger volumes of complex healthcare data in healthcare organizations. This market is expected to reach $XX million by 2019 from $XX million in 2014, at a CAGR of during the forecast period of 2014 to The growing demand for CAC solutions is mainly driven by the transition to ICD-10 coding standards from ICD-9 in North America. The eventual conversion from ICD-9 to ICD-10 is slated to increase the number and complexity of medical codes. This is expected to result in an exponential increase in the volume of structured clinical documentation, thereby increasing the demand for CAC solutions to manage this data. The growing need within the global healthcare system to curtail increasing healthcare costs, improve coding accuracy, and streamline the revenue process are other growth drivers for the computer-assisted coding market. Computer-assisted coding has gained remarkable importance in the healthcare industry over the years, owing to the advantages it offers over traditional documentation handling methods. As healthcare is a paperwork-intensive sector and is seeking new ways to efficiently manage patient information while ensuring security and privacy, the CAC market is expected to witness significant opportunities in coming years. Government emphasis in many developed and developing economies towards building ehealth platforms has also contributed to the growth of computer-assisted coding over the last five years. Factors such as the rise in healthcare reforms, increasing healthcare expenditure, and government initiatives supporting the adoption of healthcare EHR and HIE systems across healthcare organizations are further expected to drive market growth in coming years. However, the reluctance to adopt CAC systems among healthcare organization and physicians, the lack of training and education on ICD-10 standards among coding staff, and the huge implementation and maintenance costs could hinder market growth. Despite these restraints, software vendors in this market are increasingly focusing on maximizing their market shares through partnerships, new product launches, product enhancements, and expansion in high-growth emerging markets. Moreover, increasing consolidation among healthcare providers and the rise of state-of-the-art NLP-enabled CAC systems are expected to provide significant growth opportunities for the market during the forecast period. In this report, the CAC market is segmented by product type, application, mode of delivery, end user, and region. The market, by product type, is categorized into solutions and services. The solutions segment is further divided into standalone and integrated software. The standalone computer-assisted coding software considered is of two types natural language processing (NLP) software and structured input software. Similarly, the services segment is divided into support & maintenance and education & training services. On the basis of application, the market is categorized into three types automated computer-assisted encoding, management reporting and analytics, and clinical code auditing. Based on mode of delivery, the market covers on-premise, web-based, and cloud-based solutions. The major end users of computerassisted coding are hospitals, physicians practices, clinical laboratories, academic medical centers, and other healthcare institutions. The market, by region, is divided into four major regions North America, Europe, Asia-Pacific, and the Rest of the World (RoW) 3

5 FIGURE 1 COMPUTER-ASSISTED CODING SOLUTIONS TO DOMINATE THE MARKET DURING THE FORECAST PERIOD $Million 3, , CAGR (%) 2, , , XX XX Computer-assisted Coding Solutions XX XX Computer-assisted Coding Services Information Management Association (OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis On the basis of product type, the computer-assisted coding solutions segment continues to lead the market, accounting for approximately of the global market in This segment will show significant growth opportunities during the forecast period and is poised to grow at a CAGR of from 2014 to FIGURE 2 INTEGRATED CAC SOFTWARE WILL CONTINUE TO DOMINATE THE SOFTWARE MARKET DURING THE FORECAST PERIOD $Million 1, , CAGR (%) 1, , , XX XX Integrated Computer-assisted Coding Software XX XX Standalone Computer-assisted Coding Software Information Management Association (OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis 4

6 On the basis of solutions, the integrated software segment continues to lead the market, accounting for approximately of the global computer-assisted coding solutions market in This segment shows significant growth opportunities during the forecast period, and is poised to grow at a CAGR of from 2014 to FIGURE 3 AUTOMATED COMPUTER-ASSISTED ENCODING APPLICATION SEGMENT TO REGISTER THE HIGHEST GROWTH DURING THE FORECAST PERIOD $Million 2, , , , , , XX XX XX XX XX XX Automated Computerassisted Encoding Management Reporting and Analytics Clinical Code Auditing CAGR (%) Information Management Association (OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis The market, by application, was dominated by the automated computer-assisted encoding segment in 2014, with the largest share of. This segment is expected to grow at the highest CAGR of from 2014 to

7 2 MARKET OVERVIEW 2.1 MARKET SEGMENTATION The global computer-assisted coding market is segmented on the basis of product, mode of delivery, application, and end user BY PRODUCT FIGURE 4 COMPUTER-ASSISTED CODING MARKET, BY PRODUCT Computer-assisted Coding (CAC) Market, By Product Computer-assisted Coding Solutions Computer-assisted Coding Services Standalone Computer-assisted Coding Software Integrated Computer-assisted Coding Software Support and Maintenance Education and Training NLP Software Structured Input Software Source: Annual Reports, SEC Filings, Press Releases, Investor Presentations, Expert Interviews, and MarketsandMarkets Analysis 6

8 3 GLOBAL COMPUTER-ASSISTED CODING MARKET, BY TYPE 3.1 COMPUTER-ASSISTED CODING SOLUTIONS MARKET TABLE 1 GLOBAL COMPUTER-ASSISTED CODING SOLUTIONS MARKET SIZE, BY TYPE, ($MILLION) Type CAGR ( ) Integrated CAC Software XX XX XX XX Standalone CAC Software XX XX XX XX Total XX XX XX XX Information Management Association(OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis In 2014, the integrated CAC software segment accounted for the largest share of of the global computer-assisted coding solutions market. This segment is poised to reach $XX million by 2019 from $XX million in 2014, at a CAGR of during the forecast period. TABLE 2 GLOBAL COMPUTER-ASSISTED CODING SOLUTIONS MARKET SIZE, BY COUNTRY, ($MILLION) Country/Region CAGR ( ) U.S. XX XX XX XX Canada XX XX XX XX Germany XX XX XX XX France XX XX XX XX U.K. XX XX XX XX Italy XX XX XX XX Spain XX XX XX XX Japan XX XX XX XX China XX XX XX XX India XX XX XX XX Latin America XX XX XX XX Middle East & Africa XX XX XX XX Others XX XX XX XX Total XX XX XX XX Note: Others include RoE (Rest of Europe) and RoAPAC (Rest of APAC). Information Management Association(OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis 7

9 In 2014, the U.S. accounted for the largest share of of the global computer-assisted coding solutions market. This segment is poised to reach $XX million by 2019 from $XX million in 2014, at a CAGR of from 2014 to STANDALONE COMPUTER -ASSISTED CODING SOFTWARE The standalone CAC software market includes different types of software that are used to produce appropriate codes from clinical documents and manage various coding functions. The standalone software segment is sub-segmented into natural language processing (NLP) software and structured input (SI) software. NLP software generates CPT and ICD billing codes by scanning the text of electronic documents. This words, phrases, and sentences are then analyzed by the software and, based upon a set of underlying rules, codes are generated. SI software both creates the text document and generates the CPT and ICD codes. This segment covers different software for each module of computer-assisted coding application, such as coding and reimbursement software, workflow management software, clinical documentation improvement (CDI) software, and billing and management software. Standalone CAC software solutions are primarily adopted by small and midsized healthcare organizations; whereas, large healthcare organizations prefer using integrated solutions. Some of the leading players that offer standalone CAC software include 3M (U.S.) and McKesson Corporation (U.S.). 3M Health Information Systems offers 3M CodeRyte CodeAssist System, which automates the coding process, identifies correct billing codes, and streamlines the coding workflow process. Similarly, 3M s Integrity Plus DQAF auditing suit enables auditors to directly review the original clinical codes assigned by the clinical coder, which helps in identifying coding errors, possible omissions, and identifying sources of error. The global standalone computer-assisted coding software market is estimated to reach $XX million by 2019 from $XX million in 2014, growing at a CAGR of during the forecast period. TABLE 3 GLOBAL STANDALONE COMPUTER-ASSISTED CODING SOFTWARE MARKET SIZE, BY TYPE, ($MILLION) Standalone CAC Software Natural Language Processing Software CAGR ( ) XX XX XX XX Structured Input Software XX XX XX XX Total XX XX XX XX Information Management Association(OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis In 2014, the natural language processing software segment accounted for the largest share of of the global standalone computer-assisted coding software market. This segment is poised to reach $XX million by 2019 from $XX million in 2014, at a CAGR of during the forecast period of 2014 to

10 TABLE 4 GLOBAL STANDALONE COMPUTER-ASSISTED CODING SOFTWARE MARKET SIZE, BY COUNTRY, ($MILLION) Country/Region CAGR ( ) U.S. XX XX XX XX Canada XX XX XX XX Germany XX XX XX XX France XX XX XX XX U.K. XX XX XX XX Italy XX XX XX XX Spain XX XX XX XX Japan XX XX XX XX China XX XX XX XX India XX XX XX XX Latin America XX XX XX XX Middle East & Africa XX XX XX XX Others XX XX XX XX Total XX XX XX XX Note: Others include RoE (Rest of Europe) and RoAPAC (Rest of APAC). Information Management Association(OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis In 2014, the U.S. accounted for the largest share of of the global standalone computer-assisted coding software market. This segment is poised to reach $XX million by 2019 from $XX million in 2014, at a CAGR of from 2014 to

11 4 GLOBAL COMPUTER-ASSISTED CODING MARKET, BY END USER 4.1 INTRODUCTION TABLE 5 GLOBAL COMPUTER-ASSISTED CODING MARKET SIZE, BY END USER, ($MILLION) End User CAGR ( ) Hospitals XX XX XX XX Academic Medical Centers XX XX XX XX Physician Practices XX XX XX XX Clinical Laboratories & Diagnostic Centers XX XX XX XX Other Healthcare Institutions XX XX XX XX Total XX XX XX XX Information Management Association(OHIMA), World Health Organization (WHO),Eurostat, Center for Disease Control and Prevention (CDC), P-MEC News, Eurostat, Expert Interviews, and MarketsandMarkets Analysis In 2014, the hospitals segment accounted for the largest share of of the global computer-assisted coding market. This market is expected to reach $XX million by 2019 from $XX million in 2014, at a CAGR of during the forecast period. 10

12 5 GLOBAL COMPUTER-ASSISTED CODING MARKET, BY REGION 5.1 INTRODUCTION TABLE 6 GLOBAL COMPUTER-ASSISTED CODING MARKET SIZE, BY COUNTRY, ($MILLION) Country/Region CAGR ( ) U.S. XX XX XX XX Canada XX XX XX XX Germany XX XX XX XX France XX XX XX XX U.K. XX XX XX XX Italy XX XX XX XX Spain XX XX XX XX Japan XX XX XX XX China XX XX XX XX India XX XX XX XX Latin America XX XX XX XX Middle East & Africa XX XX XX XX Others XX XX XX XX Total XX XX XX XX Information Management Association (OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Expert Interviews, and MarketsandMarkets Analysis The U.S. accounted for a largest share of of the global computer-assisted coding market in This market is poised to reach $XX million by 2019 from $XX million in 2014, at a CAGR of during the forecast period. 11

13 5.2 NORTH AMERICA TABLE 7 NORTH AMERICA: COMPUTER-ASSISTED CODING SOFTWARE MARKET SIZE, BY TYPE, ($MILLION) Type CAGR ( ) Integrated Software XX XX XX XX Standalone Software XX XX XX XX Total XX XX XX XX Information Management Association (OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Expert Interviews, and MarketsandMarkets Analysis In 2014, the integrated software segment accounted for a share of of the computer-assisted coding market in North America. This market is poised to reach $XX million by 2019 from $XX million in 2014, at a CAGR of during the forecast period. TABLE 8 NORTH AMERICA: STANDALONE COMPUTER-ASSISTED CODING SOFTWARE MARKET SIZE, BY TYPE, ($MILLION) Natural Language Processing Software Type CAGR ( ) XX XX XX XX Structured Input XX XX XX XX Total XX XX XX XX Information Management Association (OHIMA), World Health Organization (WHO), Eurostat, Centers for Disease Control and Prevention (CDC), P-MEC News, Expert Interviews, and MarketsandMarkets Analysis In 2014, the natural language processing software segment accounted for a share of of the computerassisted coding market in North America. This market is poised to reach $XX million by 2019 from $XX million in 2014, at a CAGR of during the forecast period. 12

14 6 COMPETITIVE LANDSCAPE 6.1 OVERVIEW 6.2 MARKET SHARE ANALYSIS The global computer-assisted coding market is consolidated in nature, with the top five players, namely, 3M Health Information Systems (U.S.), Optum, Inc. (U.S.), Nuance Communications, Inc. (U.S.), Cerner Corporation (U.S.), and Artificial Medical Intelligence (U.S.) accounting for ~ of the market share in The other leading players in this market include Dolbey Systems, Inc. (U.S.), Precyse Solutions, LLC (U.S.), Craneware plc (U.K.), McKesson Corporation (U.S.), and TruCode (U.S.), who collectively accounted for a share of ~ of the global computer-assisted coding market in In the computer-assisted coding market, there are numerous smaller players as well operating at both global and regional levels. The leading market players are based across developed countries such as the U.S. and the U.K.; however, in the past few years, a number of smaller players have emerged in other emerging markets, competing with global players on the basis of price and technological innovation. FIGURE 5 COMPUTER-ASSISTED CODING MARKET SHARE ANALYSIS, BY KEY PLAYER, 2014 Leading player in the global computer-assisted coding market 3M HIS (U.S.) launched the 3M CAC System for small hospitals in This system is an easy-touse CAC solution designed for small rural and community-based hospitals 3M HIS (U.S.) acquired CodeRyte, Inc. (U.S.), a provider of NLP technology in M HIS (U.S.) acquired Treo Solutions (U.S.) to expand its real-time data analytics and payment redesign businesses in 2014 Others include Dolbey Systems, Inc. (U.S.), Precyse Solutions, LLC (U.S.), Craneware plc (U.K.), McKesson Corporation (U.S.), and TruCode (U.S.) ABC CDE EFG GHI Top 5 companies accounted for a share of ~ of the global computerassisted coding market IJK MNO Optum, Inc. held the second position in the global computer-assisted coding market Exhaustive product portfolio of computer-assisted coding solutions and services L:aunched the Optum Enterprise CAC and Optum ICD- 10 Core Education in 2012 In 2014, Gwinnett Hospital System (U.S.) collaborated with Optum, Inc. to improve revenue, enhance coder productivity, mitigate audit risks, and ensure ICD-10 compliance with the Optum CAC Source: Annual Reports, Investor Presentations, Expert Interviews, and MarketsandMarkets Analysis 3M Health Information Systems (3M HIS) is the healthcare IT division of 3M Company (U.S.), and this company held the leading position in the global computer-assisted coding market with a share of in 13

15 2014. The company offers integrated software and consulting services for clinical documentation improvement, computer-assisted coding, performance management, compliance, and ICD-10. 3M's healthcare data dictionary and terminology services help promote electronic health record (EHR) accuracy and interoperability. The company also provides products such as coding and reimbursement systems for hospitals and payer organizations, health record management software, financial management applications, risk analysis and resource management software, compliance software, and home healthcare applications; and consulting and training services as well as inpatient and outpatient solutions to accelerate the auto-coding process with accuracy and compliance. The 3M Coding and Reimbursement System software is used by hospitals worldwide. The company has a strong geographical presence in over 38 countries across North America, Asia-Pacific, Europe, and the Middle East and Africa. Its prominent position in the computer-assisted coding industry can be attributed to the increase in revenue contribution by its technology solutions segment over the last few years. The revenue from this segment increased between 2011 and 2013 due to several factors such as new product launches, acquisitions, higher volume of claims processing, and increase in maintenance revenues from new and existing customers. Optum, Inc. is the second-largest player in the global computer-assisted coding market, accounting for a market share of in The company has maintained its leadership position in the market through its strong distribution networks across North America, Europe, Asia-Pacific, and Rest of the World. The company operates through three major segments OptumHealth, OptumInsight, and OptumRx. OptumHealth provides health information and services and integrated care delivery products. OptumInsight is a health information, technology, services, and consulting company. The company provides software and information products, advisory consulting services, and business process outsourcing to hospitals, physicians, commercial health plans, government agencies, life science companies, and other organizations in the healthcare industry. The company s leadership position is attributed to its focus on partnerships, collaborations, and acquisitions with other market players. In this regard, in 2013, Optum, Inc. (U.S.) partnered with HealthEdge to launch a new portfolio of technology-enabled business process outsourcing services to help healthcare payers. Furthermore, in 2014, Gwinnett Hospital System (U.S.) collaborated with Optum, Inc. to improve revenue, enhance coder productivity, mitigate audit risks, and ensure ICD-10 compliance with the Optum CAC. Nuance Communications, Inc. was the third-largest player in the global computer-assisted coding market, with a market share of in The company provides an extensive set of solutions and services that support the clinical documentation process, from capturing data of patient visits to improving clinical documentation, automated coding, revenue cycle management, and other functions. The company s hosted and on-premise solutions provide platforms to generate and distribute clinical documentation using advanced dictation and transcription features that allow it to deliver scalable, highly productive medical transcription solutions. The company s Clintegrity product line offers solutions that leverage captured information with state-of-the-art coding, compliance and record management, and streamline health information management (HIM) processes to assist compliance and reimbursement through professional services and time-based licenses. 14

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