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In a post-pandemic scenario, mid-office Revenue Cycle Management (RCM) processes (including but not limited to CDI) are likely to report accelerated adoption due to the growing emphasis on in-depth clinical documentation and coding to personalize treatment, prevent adverse effects (medical reconciliation, HAI, clinical trial mismatches) and optimize clean-claims rate (or first-pass rate) across the care continuum. In addition, as an increasing number of patients check-in virtually through digital platforms, automated and voice-enabled CDI applications that are built into incumbent RCM or EMR workflows for accurate capture of patient interactions, irrespective of their underlying enrollment in various payers’ FFS or VBC payment programs, will see higher traction from physicians and care managers in the United States. As a result, the US CDI market will account for approximately 33% of the total US RCM market by 2024. The Canadian CDI market, which currently holds a negligible share (4.8%) of the total NA CDI market, due to the lack of regulatory impetus, is likely to improve its contribution to 16.7% by 2024. Key growth drivers include local health authorities’ gradual move away from their legacy frameworks of addressing gaps in care through the assessment of clinical documentation post care to the prioritization of proactive clinical documentation that drives population health management pre, during, and post care.

This Frost & Sullivan study presents a comprehensive overview of the North American Clinical Documentation Improvement (CDI) market. CDI is a mid-end process of the broader Revenue Cycle Management (RCM) ecosystem. The study analyzes key end users and product types and examines the leading market participants across the United States and Canada. Revenue is forecast for the study period—from 2020 to 2024 (total market as well as for the US and the Canadian markets, separately). In addition, the research service highlights top growth opportunities pertaining to clinical documentation, health information management (HIM), case management, and quality reporting and monitoring. The revenue contribution of these 4 product types to the total market is also discussed. The study also predicts the use of disruptive technologies (on-premise and cloud) and their potential to drive greater market revenue through higher adoption by hospitals, physician practices, and payers (the 3 key end users of CDI solutions in North America).