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From Core Competency to Secondary Solution: What Is the Future of Billing and Claims Healthcare IT Systems?

Posted on: Tuesday, 29 August 2006, 09:01 CDT

PALO ALTO, Calif., Aug. 29 /PRNewswire/ -- While billing and claims solutions have long been considered the focal point of healthcare IT systems, this is rapidly changing with the emergence of new solutions that considerably enhance profitability and reduce operating costs. Today, the healthcare IT industry is an unpredictable, constantly changing arena and the challenge for all IT vendors will be to understand end-user needs as well as the long-term effects of these shifts in order to survive.

New analysis from Frost & Sullivan (http://www.healthcare.frost.com/ ), U.S. Claims Management Systems Markets for Healthcare, reveals that the markets generated revenues of $3.40 billion in 2006 and are likely to reach $4.14 billion in 2011.

If you are interested in a virtual brochure, which provides manufacturers, end users, and other industry participants an overview of the latest analysis of the U.S. Claims Management Systems Markets for Healthcare, then send an e- mail to Melina Trevino, Corporate Communications, at melina.trevino@frost.com with your full name, company name, title, telephone number, e-mail address, city, state, and country. We will send you the information by email upon receipt of the above information.

"The development of solutions such as electronic medical records (EMRs), picture archiving and communications systems (PACS), and care management systems have drastically affected the billing and claims systems markets for the short to medium term," notes Frost & Sullivan Research Analyst Andre Guillemin. "However, the lasting implications of these developments are yet to be fully understood and companies that can correctly forecast the long-term scenario stand to profit greatly."

The shift in billing and claims systems from being a core competency to a secondary solution is critical from an IT vendor's perspective, because it significantly affects product positioning and development as well as partnership and merger and acquisition strategies.

Increasingly, healthcare providers and payers view billing and claims solutions as being 'standard' systems and believe that they no longer provide the level of differentiation they used to. This is leading IT vendors to distinguish themselves through more comprehensive systems that facilitate communication, increase patient compliance, reduce medical errors and track disease progression as well as patient behavior.

Indeed, integration holds the key to the future of the healthcare IT industry and competition will increasingly focus on integrated, rather than stand-alone IT systems. IT vendors that focus solely on billing and claims solutions will find it difficult to compete with those selling comprehensive solutions, which include a billing and claims module.

However, while many IT developers are concentrating on newer modules such as EMRs and care management solutions, it is essential that they continue to maintain a focus on billing and claims solutions, as these systems offer an upfront return on investment (ROI).

Moreover, the ongoing shift in focus from billing and claims to emerging solutions is not likely to be permanent. The functionality of billing and claims solutions is directly related to every new healthcare plan or product entering the market, whether they are consumer-driven health plans (CDHPs) or standard ones. Therefore, understanding the strengths and limitations of these solutions is critical to identifying and exploiting the opportunities associated with such plans.

"Billing and claims solutions still provide quantifiable ROIs with rapid results," says Guillemin. "Therefore, payers and providers must keep their eye on the bottom line and ensure that when purchasing IT systems, they adequately diversify their investments so that their new systems produce both short-and long-term returns while improving the quality of care they deliver."

U.S. Claims Management Systems Markets for Healthcare, part of the Healthcare Information Technologies Group, is an in-depth analysis of the billing and claims IT markets in the United States. The study's analysis of changing market trends helps in identifying major growth opportunities and understanding the future direction of the markets, while its detailed competitive profiling can help vendors develop appropriate strategies for increasing market share. Interviews are available to the press.

Frost & Sullivan, a global growth consulting company, has been partnering with clients to support the development of innovative strategies for more than 40 years. The company's industry expertise integrates growth consulting, growth partnership services, and corporate management training to identify and develop opportunities. Frost & Sullivan serves an extensive clientele that includes Global 1000 companies, emerging companies, and the investment community by providing comprehensive industry coverage that reflects a unique global perspective and combines ongoing analysis of markets, technologies, econometrics, and demographics. For more information, visit http://www.frost.com/ .

U.S. Claims Management Systems Markets for Healthcare F480-48 Contact: Melina Trevino Corporate Communications - North America P: 210.247.2440 F: 210.348.1003 E: melina.trevino@frost.com Radhika Menon Theodore Corporate Communications - Europe P: +91 (044) 52044668 E: rmtheodore@frost.com Jasminder Kaur Corporate Communications - Asia Pacific P: +65.6890.0937 F: +65.6890.0988 E: jkaur@frost.com Surbhi Dedhia Corporate Communications - India P: +91 22 2832 4705 Ext: 131 E: sdedhia@frost.com Sharmin Jassal Corporate Communications - Australia P: +61 2 8247 8900 F: +61 2 9252 8066 E: sharmin.jassal@frost.com http://www.frost.com/

Keywords in this release: Billing and claims healthcare IT systems, core competency, secondary solution, IT vendors, electronic medical records, EMRs, picture archiving and communications systems, PACS, care management systems, healthcare providers, healthcare payers, integration, healthcare plans, consumer-driven healthcare plans, CDHPs, research, information, market, trends, technology, service, forecast, market share.

Frost & Sullivan

CONTACT: Melina Trevino, Corporate Communications - North America,+1-210-247-2440, or fax, +1-210-348-1003, or melina.trevino@frost.com , orRadhika Menon Theodore, Corporate Communications - Europe, +91-044-52044668,or rmtheodore@frost.com , or Jasminder Kaur, Corporate Communications - AsiaPacific, +65-6890-0937, or fax, +65-6890-0988, or jkaur@frost.com , or SurbhiDedhia, Corporate Communications - India, +91-22-2832-4705 Ext: 131, orsdedhia@frost.com , or Sharmin Jassal, Corporate Communications - Australia,+61-2-8247-8900, or fax, +61-2-9252-8066, or sharmin.jassal@frost.com , all ofFrost & Sullivan

Web site: http://www.frost.com/http://www.healthcare.frost.com/

Source: PRNewswire

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