Ambulatory Revenue Cycle Management Services 2024
Organizations’ Increasing Need for Meaningful Partnerships

R1 RCM, athenahealth & CareCloud* Drive Outcomes for Complex Projects; CompuGroup Medical & Access Healthcare* Satisfy Clients despite Offering Fewer Services

R1 RCM offers the most types of services on average, and interviewed clients report wide adoption. Large organizations (>75 physicians) are particularly satisfied with the value, highlighting the firm’s extensive expertise in streamlining revenue cycle workflows and improving collection rates. Additionally, respondents feel the firm partners with organizations to meet important financial metrics, all while clearly communicating progress. athenahealth and CareCloud also offer a range of services while effectively driving outcomes. athenahealth is noted for their industry knowledge. Respondents trust athena to perform well with minimal oversight, saying the firm demonstrates ownership in helping clients meet financial metrics. Satisfied CareCloud* respondents have frequent meetings with leadership to improve processes and review metrics. Some clients say their success has been hindered because the firm hasn’t responded to or given feedback on requests for accurate reporting. Respondents appreciate the firm’s technology, which pulls reports and uses AI to reduce denials.

Since CompuGroup Medical acquired eMDs in 2020, interviewed clients have reported increasing satisfaction, mentioning the knowledgeable client service teams and quick response times. In addition, respondents appreciate having a consistent point of contact who understands the value each claim provides to the organization (i.e., the contact follows up on smaller claims and repeatedly checks denials). Respondents of Access Healthcare*—one of two firms in this report with a validated median organization size of ≥150 physicians—say the firm drives solid results and, as a result, helps organizations save money by reducing FTEs. Quick turnaround on projects and consistent, frequent progress reports are also strengths. The firm is seen as eager to go beyond core RCM work; however, more-complex projects (e.g., claims denials, aged accounts) often require some direction from the client.

*Limited data

athenahealth & CompuGroup Medical Have Greatest Positive Impact on Respondents’ Important Financial Metrics

Regardless of the firm they use, all respondents say communication and their contact person are top contributing factors to a valuable engagement. athenahealth and CompuGroup Medical stand out in these regards; interviewed clients say the firms understand expectations and frequently adapt to new timelines and organizational goals, helping clients meet important metrics. Additionally, respondents appreciate that these two firms not only report on metrics set by the client but also help develop a strategy to hit those metrics. Respondents of IKS Health—the other firm in this report whose validated median organization size is ≥150 physicians—report seeing significant improvement in A/R days, though many wish the firm were more involved in helping them develop a revenue cycle strategy. Greenway Health and National Medical Billing Services have had the least impact on respondents’ metrics. Greenway Health* respondents say the firm doesn’t communicate progress for important financial metrics, citing inconsistent account representatives and the offshore service model as challenges. As a result, some have lost confidence in the firm’s capabilities. Respondents of National Medical Billing Services* cite challenges with staff turnover, unorganized management, and a lack of reporting, leading to untimely filings, higher-than-expected A/R days, and inaccurate reports.

*Limited data

Client Satisfaction with Azalea Health*, NextGen Healthcare & Greenway Health Drops due to Unmet Expectations around Communication

Overall performance scores for Veradigm, Azalea Health, NextGen Healthcare, and Greenway Health have decreased over the past two years, with the latter three decreasing most significantly (see first chart). While Veradigm* respondents acknowledge the product’s stability and helpful upgrades, satisfaction has dropped due to the firm not driving outcomes; respondents report insufficient follow-through and a lack of education on how to drive value and adopt new product features. Azalea Health* respondents are frustrated about not receiving regular updates from the firm and mention that it is difficult to escalate issues. The firm’s push to communicate more via email has increased feelings of disconnect for many. In addition, many respondents report fewer follow-ups on claims, leading to uncertainty about the firm’s partnership. Some NextGen Healthcare respondents would also like more person-to-person communication and more specific updates regarding their ROI. Small organizations (1–10 physicians) tend to score the firm the highest, citing consistent outreach and exceeded expectations. This contrasts with midsize and large organizations (11–75 physicians and >75 physicians, respectively), who say the firm hasn’t lowered A/R days or resolved denials. The satisfaction of interviewed Greenway Health clients has significantly dropped over the last two years, with clients reporting a difficult transition to the new offshore service model. However, a few respondents were recently assigned a consistent account representative, making them more optimistic about the future. Other firms have respondents who are frustrated with having to use an offshore service model. However, similar to Greenway Health, Access Healthcare*, CompuGroup Medical, and R1 RCM have been able to mediate potential problems with offshore resources by assigning consistent, effective account managers to clients. This has helped improve client-firm relationships.

*Limited data

CompuGroup Medical, athenahealth & R1 RCM* Seen as Partners That Educate Clients on Process Improvement

Respondents highlight CompuGroup Medical and athenahealth for educating clients on how to improve internal processes and submit clean claims. CompuGroup Medical organizations appreciate the frequent feedback they receive about how to update processes and help billing managers navigate ICD code updates. athenahealth is seen as staying ahead of the curve with coding and billing practices, and the firm consistently notifies billing personnel about coding changes to help clients reduce denials. Both firms hold frequent meetings with interviewed clients to discuss what parts of the claims processes are causing the most denials and to provide best practices that will reduce submissions errors. R1 RCM* respondents are also satisfied with their firm’s education, mentioning how knowledge distribution feels consistent across employees. R1 frequently educates respondents on payer updates that affect organizational processes. IKS Health* respondents acknowledge the firm’s client education can be reactive; however, those who have strong relationships with their account executives say the firm is making improvements in this area. In general, respondents of National Medical Billing Services* and NextGen Healthcare* would like more consistent communication for staying up-to-date with changing payer requirements. Interviewed Azalea Health* clients want the firm to help improve their claims submission process, expressing frustration about how the firm hasn’t provided client education.

*Limited data

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 18 months using KLAS’ standard quantitative evaluation for healthcare services, which is composed of 9 numeric ratings questions and 3 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into five client experience pillars—loyalty, operations, relationship, services, and value.

To supplement the performance data collected, KLAS also asked interviewed clients the following questions specific to ambulatory RCM services:

1. What kind of work is your firm doing for your organization?
2. Rate your satisfaction with the firm’s willingness to educate you on best practices for clean claims.
3. What impact did your firm have on your organization’s ability to meet important financial metrics?

Sample Sizes

Unless otherwise noted, sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique client organizations interviewed for a given firm or service. However, it should be noted that to allow for the representation of differing perspectives within any one client organization, samples may include surveys from different individuals at the same organization. The table below shows the total number of unique organizations interviewed for each firm or service as well as the total number of individual respondents.

Some respondents choose not to answer particular questions, meaning the sample size for any given firm or solution can change from question to question. When the number of unique organization responses for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Where textual content relies on limited data, the firm name is marked with an asterisk. Note that when a firm has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.