In the twenty-first century, the world’s population is constantly aging. According to the United Nations data, one in 11 people are above 65 years in 2019. Besides, the persons aged 80 or above are anticipated to rise from 143 million in 2019 to 426 million in 2050, experiencing growth by three times. This rising aged population is reflecting in the global healthcare upheaval. Moreover, this demand to provide extended care to the aging population is further impelling the healthcare diagnosis and services, which include medical coding and billing, health education departments, and insurance outsourcing services. As part of extended care, healthcare diagnostics and services are emphasizing on accurate and efficient medical coding and billing services.

With these growth prospects, the medical coding market was experiencing huge demand and reached $14.3 billion in 2018. Furthermore, the market is experiencing lucrative opportunities growing at a CAGR of 10.2% over the forecast period 2019-2025.

Cost-Saving and Skilled Operations of Outsourcing is Gaining Ground in the Medical Coding Market

In recent years, the medical coding market is experiencing a paradigm shift toward outsourcing services. Outsourcing medical coding and billing services save the time of the healthcare providers. Often, it becomes an expensive endeavor and causes turmoil to the healthcare organizations. Also, coding and clinical documentation is a daunting aspect of the revenue cycle in these firms.

Moreover, the companies must remain compliant to the challenging and changing medical standards and coding practices.

Moreover, the outsourcing companies can devote skilled labor to streamline these coding operations along with required advanced software services. With these amenities, codes are highly scrutinized to benefit the quality departments, insurance providers, and other third-party payers. With these aspects, the outsourcing medical coding services are making an inevitable switch in the medical coding industry, thereby boosting the growth of the outsourcing medical coding market.

Digital Trends in the Medical Coding Market

With digital ubiquity in the current scenario, tech-savvy building ecosystems enable competitive-edge to healthcare organizations. Along with that, medical coding and health information services are updating with new technological advancements to ensure accuracy, save time, and increase the efficiency of the transcription. Few of them include:

Blockchain technology – Blockchain technology is nascent in the healthcare industry. Healthcare companies, physicians, insurance providers are grappling with the budding blockchain vision as of now. Subsequently, medical coding is reaping the robust security benefits enabled by the decentralization of blockchain. Besides, data integrity is achieved, which enables accuracy and smooth flow of data in medical coding and electronic health records. These potential benefits of blockchain technology are disrupting in the medical coding market.

Artificial Intelligence and Analytics – AI in medical coding has opened the door to various potential improvements. Machine learning and Natural Language Processing (NLP) through Computer-Assisted Coding (CAC) has immensely improved the speed of coding by automating rigorous tasks. Post-ICD 10 implementation, CAC has substantially minimized production impact. The execution of ICD-10 has spurred cost-relation and administrative burdens to the organizations taking the claims submittal process to the next level. Furthermore, players in the industry are striving to improve the potential benefits of AI in medical coding by enabling analytical tools to increase accuracy and improve service efficacy to the customers. For instance, in 2019, Verisk Analytics, a leader in analytics and Human API, planned to work with Verisk’s new InsurTech tools. With this, the company leverages electronic health record data from human API for insurance portfolio and underwriting tools. Through this, the underwriting process, which is often time-consuming, is handled with high-speed and accuracy. With these unprecedented efforts in AI, the medical coding market demand is surging. 

International Classification of Diseases Acting As a Bedrock for Mortality and Morbidity

(ICD) International Classification of Diseases is a predominant classification system in the global medical coding market and is rising at a CAGR of 5.8% during the forecast period. The rising diseases and death rate are attributable to the dominance of this segment. ICT consists of medical alphanumeric codes to diagnose, identify the symptom, and cause of disease and death. According to the World Health Organization (WHO), in 2016, the adult mortality rate, i.e., the death rate of a person aged 15 years or above, was about 142 per 1000 population. With the rising aged population, the disease burden and mortality rates are rapidly increasing, especially in developing countries. This burden reflects the snapshot of healthcare data. ICT is a bedrock to capture healthcare data related to diseases and mortality. Besides, it allows to map the epidemics and identify areas of investment and R&D. ICT-10 has evolved substantially with the help of NLP.

Furthermore, ICT-11 produced by WHO is under review yet. The organization provides a collaborated and transparent approach in this version adding 55000 codes in ICD-11 which surpasses the older version of ICD-10 which has 144,000 codes. In ICD-11, codes related to neurological disorders and mental health conditions are simplified, which enables the job easy for the medical coders. With these advancements in the ICT-10 and ICT-11 versions, the ICT classification system is experiencing significant growth in the medical coding market.

Robust Healthcare Industry and Fraudulent Activities of North America Triggering Humongous Opportunities in the Medical Coding Market

North America led the global medical coding market and occupied a share of 33% in 2018. Huge investments and expenditure in the healthcare sector is the primary driver of the medical coding market in North America. The U.S healthcare expenditure has attained $3.5 trillion or $10,739 per person in 2017 with a growth rate of 3.9%. Furthermore, the medical records and health information technicians’ jobs, which involve medical coding is observing a significant growth rate of 13% during 2016-2026. This shows that there is a massive demand for medical coding market in the U.S. Along with that, fraudulent activities are triggering strong amendments and ensuring legalization of medical services rendered. One such instance includes Medicare fraud, which incurred more than $30 million loss in the United States as of 2016. Besides, the healthcare industry of Canada is experiencing significant R&D and investments. With all these strong drivers, the medical coding market is propelling in North America.

Key Players in the Global Medical Coding Industry

The core companies operating with a dominant share in the medical coding market are STARTEK Health; Oracle Corporation; Verisk Analytics; Aviacode, Inc.; Parexel International Corporation; Maxim Health Information Services; nThrive, Inc., Medical Record Associates LLC., the 3M Company, and Optum Inc. Acquisitions of cloud-based and analytical services are rising in this industry.

Acquisitions in the Medical Coding Market

· In 2019, 3M acquired M*Modal’s, a clinical documentation company. With M*Modal’s technology business, 3M Health Information Systems business is further expanded in the field of cloud-based and conversational Artificial Intelligence (AI)-powered systems. This deal enriches the company’s product line of speech-recognition technology and cloud-based artificial intelligence services.

· In 2017, Aviacode, a global leader in delivering technology-based medical compliance and coding services, has expanded by acquiring a medical coding company based out of Hyderabad, India. With this acquisition, the company expanded its access to advanced professional, AHIMA and AAPC and certified medical coders in the U.S. and India.


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