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Enterprise Revenue Cycle 2020—Advanced User Insights Enterprise Revenue Cycle 2020—Advanced User Insights
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Enterprise Revenue Cycle 2020—Advanced User Insights
The Value of Consolidation

author - Boyd Stewart
Boyd Stewart
author - Alex McIntosh
Alex McIntosh
September 8, 2020 | Read Time: 8  minutes

While enterprise strategies for clinical technology are common, the complexity of the revenue cycle has, to date, precluded such an approach on the financial side, as no one vendor provides all the revenue cycle functionality organizations need. However, Change Healthcare, Experian, nThrive, and Waystar now claim to have expansive portfolios that fill the gaps left by the EMR and to have customers who have adopted a broad range of their revenue cycle technology. The goal of this report is to validate the veracity of these claims and gain insight into how this early market is shaping up—is enterprise revenue cycle adoption real? Do organizations who have broadly adopted one vendor see valuable benefits?


Advanced User Insights reports are designed to help readers understand what is possible at the cutting edge of a given technology. Most of the data in these reports is based on feedback from a small sample of vendors’ most advanced users and should therefore not be interpreted as a comprehensive view of customer satisfaction or adoption.

What constitutes an “advanced user” varies somewhat from market to market and may include organizations who have deeply adopted a vendor’s technology, organizations who have adopted a broad range of functionality from a single vendor, or organizations who are in some other way using a technology beyond how it is typically deployed by more standard users.

Defining “Advanced Users” in Enterprise Revenue Cycle

For the purposes of this report, advanced users are those who have adopted a broad range of functionality from a single enterprise revenue cycle vendor. Each measured vendor shared with KLAS a short list of the customers who have adopted the broadest range of the vendor’s revenue cycle technology. To determine whether enterprise-level revenue cycle adoption is currently a reality, KLAS then interviewed a small sample of organizations from each vendor’s list to validate which modules and functionality these organizations have adopted. These customers were also asked how satisfied they are with their enterprise revenue cycle vendor’s technology, how broad adoption from a single vendor impacts their perceptions of value, and what plans they have for future adoption.

Enterprise Revenue Cycle Not Yet Fully Realized; Change Healthcare, Experian Health Clients Have Adopted Highest Average Number of Component Pieces

No advanced-user organizations interviewed for this study are currently using one vendor for all of their revenue cycle needs, though many are interested in pursuing this strategy and adopting additional functionality from their vendor in the future. Advanced users of Change Healthcare and Experian Health have, on average, adopted the highest number of component pieces from their enterprise revenue cycle vendor, particularly in patient access, where customers report strong functionality. Waystar, a newer entrant to acute care patient access (following the acquisition of Recondo Technology), is not as broadly adopted in this area, but customers say they would like to implement additional patient access functionality in the future. Advanced users describe nThrive’s technology as highly advanced and say it can handle any complexity they throw at it; nThrive is the only vendor adopted by advanced users in all business office modalities measured by KLAS. Health information management (HIM) technology has seen little adoption at an enterprise level, with only nThrive and Waystar having more than a single interviewed customer using multiple HIM functionalities.

klas validated functionality adoption advanced users only

Note: Respondents could select multiple functionalities in each revenue cycle area.

Voice of the Provider: Benefits of an Enterprise Revenue Cycle Approach

quotation iconChange Healthcare
“The broad functionality increases the value exponentially and helps maximize the ROI for our organization. Working with a vendor like Change Healthcare, who offers a broad suite of tools that work together across the entire revenue cycle, saves our organization significant amounts of time and money. Our organization experienced time and cost savings during the product implementation stages and additional ROI once we went live and transitioned to a vendor support stage.” —Business office manager

quotation iconExperian Health
“We have one [Experian] person who represents our company and knows our company inside and out. That person knows what we are using, our software, and how one thing feeds into another and is like a personal concierge. Sometimes when we submit a ticket, Experian tells us that somebody else submitted a ticket that might be related to ours. Then they send our ticket to that team to work on, unlike vendors where the right hand doesn’t know what the left hand is doing. . . . We have a one-stop shop where the vendor understands our whole revenue cycle and how things are flowing.” —Business office manager

quotation iconnThrive
“One of the huge benefits of using nThrive’s technology is that we have a data-capture process and routine. We got everything set up at one time, and we were done once we did the setup. I don’t have to do things for several different vendors. I don’t have to build contracts for contract management in one place and then go to another product and build contracts for patient estimates. We have picked up a lot of efficiency from nThrive’s platform. It lifts a huge burden off of the revenue cycle leaders.” —Business office director

quotation iconWaystar
“We have had multiple vendors with a bunch of interfaces. From a revenue cycle perspective, . . . using the same vendor is an advantage to us because it streamlines the workflow. That approach makes more sense, especially when all of the EOBs and claims are sitting in another system. . . . Having one system creates more of a natural flow. In terms of value, the way things work together and the way we can streamline the flow of data are important to us as we look at products going forward.” —Executive director

Across Vendors, Advanced Users Report Higher Satisfaction Than Non-Enterprise Peers

Satisfaction scores from advanced users make it clear that adopting an enterprise approach brings positive returns in overall satisfaction, with advanced users consistently reporting higher satisfaction than peers with more standard, ad hoc adoption. This is true across vendors, from Experian Health, whose advanced users have the largest average organization size and have adopted the highest average number of revenue cycle modalities, to Waystar, whose advanced users typically report less complexity (i.e., smaller organization size and fewer adopted modalities). Advanced users note that having better integration and better flow exponentially increases the value of the technology and helps maximize ROI. Additionally, having fewer disparate solutions creates greater billing efficiency, and having fewer points of contact leads to quicker issue resolution and fewer failure points within the revenue cycle.

Customer Satisfaction—Advanced Users vs. Standard Users

overall performance score vs drives tangible outcomes
overall grade by revenue cycle area

Overall Satisfaction Trends: Advanced Users and Standard Users

While advanced users are clearly more satisfied than peers with more standard adoption, there are some common satisfaction trends that span both customer groups. Waystar stands out in all three revenue cycle areas examined in this report and is often viewed as more innovative than other enterprise revenue cycle vendors. The technology is described as intuitive and easy to use, particularly for HIM and business office. Relationships are also a strong point. Change Healthcare and Experian Health customers say their technology works as expected but is not being advanced or developed as much as they would like, especially for patient access and business office. nThrive customers feel the patient access product doesn’t integrate well, hindering data from flowing smoothly through the revenue cycle. Additionally, some customers of the latter three vendors report weak support relationships.

Advanced Users Still Hesitant to Replace Some High-Performing Best-of-Breed Products

While healthcare organizations may be slowly moving to a more enterprise approach to revenue cycle, the most common reason they choose not to adopt their enterprise revenue cycle vendor in any given area is that a high-performing best-of-breed solution is already in place. Despite promises of better outcomes and higher overall satisfaction from their enterprise revenue cycle vendor, organizations aren’t always willing to part with an existing solution that is meeting their needs. Additionally, all four vendors in this report had customers say they have chosen to use functionality from their EMR vendor (in all cases Epic) rather than adopt additional functionality from their revenue cycle vendor.

reasons for not adopting enterprise vendors functionality advanced users only

Note: Respondents could select multiple reasons.

Future of Enterprise Revenue Cycle

As more and more healthcare organizations realize value from having fewer revenue cycle vendors, enterprise adoption will likely become the norm—though, as it has in other markets, this transformation will take time. Multiple advanced-user organizations interviewed for this research feel that as they continue to replace best-of-breed technologies with solutions from their enterprise revenue cycle vendor, they will see improved efficiency and satisfaction.

About This Report

Each year, KLAS interviews thousands of healthcare professionals about the IT products and services their organizations use. These interviews are conducted using a standard quantitative evaluation, and the scores and commentary collected are shared online in real time so that other healthcare organizations can benefit from their peers’ experiences. Over the last 12 months, KLAS has collected standard evaluations from two types of revenue cycle software customers: (1) those who have broadly adopted functionality from one vendor (i.e., advanced users); and (2) organizations that have not yet started down an enterprise revenue cycle path (i.e., standard users).

To delve deeper into the enterprise experience, KLAS also used a supplemental evaluation to gather more in-depth feedback from a small sample of advanced users.

The number of unique responding organizations for each type of evaluation is given in the table below.

about this report table

What Does "Limited Data" Mean?

Some products are used in only a small number of facilities, some vendors are resistant to providing client lists, and some respondents choose not to answer particular questions. Thus a vendor’s sample size may vary from question to question and may not reach KLAS’ required threshold of 15 unique respondents. When a vendor’s sample size 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 3, no score is shown. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

Overall scores are measured on a 100-point scale and represent the weighted average of several yes/no questions as well as other questions scored on a 9-point scale.

author - Elizabeth Pew
Elizabeth Pew
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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.