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Ambulatory RCM Services 2017
Finding Consistent Partners

author - Aaron Gleave
Aaron Gleave
author - Jonathan Christensen
Jonathan Christensen
December 14, 2017 | Read Time: 4  minutes

Ambulatory revenue cycle management (RCM) services continue to increase in popularity. Just three years ago in 2014, KLAS’s first look included only five vendors. Today, provider organizations have over a dozen options to choose from. This report covers ten of the most prominent vendors that have proven capable of scaling beyond single-physician practices. With considerable growth, however, often come growing pains. Which vendors have established themselves as consistent, reliable partners? Who scales to best meet the needs of larger clinics? And how much do customers expect from these vendors as they look to value-based care on the horizon? KLAS interviewed 174 clinics to find out.

1. athenahealth, Aprima, NextGen Healthcare Strong, Highly Consistent Performers for Large & Small Clinics

Large growth in the RCM market has caused growing pains for many vendors. athenahealth, Aprima, and NextGen Healthcare have bucked the trend and been able to provide a consistent experience year over year for large and small customers. athenahealth’s industry experience, automated tools, and strong service provide a consistent approach that has proven capable of meeting both large and small customers’ needs. Aprima too has been highly consistent over the past year, with few mentioning significant billing challenges. Aprima relies on very proactive customer service and communication that helps streamline processes and maximize client billables; larger customers report a highly engaged services team. NextGen Healthcare has also proven to consistently and efficiently manage customers’ claims with few hiccups. Their support personnel are highly engaged in resolving requests; customers would like them to more proactively anticipate their needs.

2. Greenway Health Rises to Top of Small Market, Joining CareCloud and athenahealth

Greenway Health customers report vastly improved communication in 2017 (Greenway Health’s first year being fully rated) compared to 2016. Customers regard Greenway Health’s dedicated staff as trusted team members, saying they look for opportunities to improve operations and maximize revenue. Overall, CareCloud has become more consistent since 2016, tightening up the customer experience; 80% now report high satisfaction. CareCloud’s highly engaged staff meets customers’ needs and provides benchmarking reports to improve customer operations. While some smaller athenahealth customers felt overlooked in previous years, small customers did not mention such concerns this year, instead reporting a smooth claims process and better involvement.

ambulatory rcm dashboard

3. CureMD and Pulse Service Stretched Thin amid Growth

Customer satisfaction with CureMD and Pulse—two of last year’s top performers in overall satisfaction—has dropped significantly over the past year. These vendors’ service delivery has failed to keep pace with the growth of their customer bases—customers report a significant decline in overall billing speed and quality and associate this with understaffing or slow or infrequent communication. CureMD customers have experienced this most acutely, at times feeling on their own due to inexperienced staff and lacking communication. However, this has not impacted customers’ denials significantly. Pulse has a smaller contingent of customers with two or more physicians. These customers say the support staff is overwhelmed and unable to adequately respond to requests or proactively handle denials.

4. Inconsistency Leads to Declines for Cerner & Allscripts

Cerner’s delivery has been inconsistent, and Allscripts’ has become increasingly inconsistent over the past year. Some customers (especially larger clinics) report more personalized attention and a smoother collections process. Smaller customers, however, are more likely to report lackluster service. For Allscripts, overextended teams can take too long to get bills out the door—something not reported in 2016. For Cerner, the service quality is dependent on the personnel: some are great, while others lack experience or work in a silo. In both cases, this has contributed to a subpar denials process and a lower perceived value of services.

denials management vs moneys worth
guidance and partnerships

5. Most Looking to RCM _ Vendor for Help with _ Alternative Payment Models; Few Using Today

importance of ability to aid in transition to alternative payment model

To date, few providers have transitioned to alternative payment models with the help of their RCM services vendor. However, market demand is growing for vendor partners who can help with the transition. KLAS will continue to monitor this market to highlight the vendors that go above and beyond. Comments from customers of such vendors include the following:

“CureMD has recently helped us with a transition to alternative payment models. I was trained on PQRS and MIPS. They set up the EMR so that those things come up automatically when I make a note. CureMD was really good about that.” —IT Manager

“I went to a meeting with people in our area where the Comprehensive Primary Care Plus model was introduced. I showed the people there my reporting, and they were so surprised that I was able to get that level of information. I just called athenahealth’s help desk people, and they walked me through things. It only took an hour. . . . I recently found out that our state can apply for this model. I called our athena account manager about it, and that individual told me that athena already knew about it and had people working on it. athena is already on top of things.” —Office Manager

author - Natalie Jamison
Natalie Jamison
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.