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Extended Business Office Services 2021
Achieving Profitability While Reducing the Administrative Burden

author - Mac Boyter
Mac Boyter
author - Alex McIntosh
Alex McIntosh
October 21, 2021 | Read Time: 6  minutes

Citing labor shortages, slimmer budgets, and higher costs, more and more healthcare organizations are turning to outside firms to fill gaps in their business office operations and meet their revenue cycle needs. With specialized expertise, firms that offer extended business office services (EBOS) can achieve economies of scale, allowing healthcare organizations to remain profitable while delivering quality care. The firms measured in this report have previously been included in KLAS’ revenue cycle outsourcing (RCO) research; given increased market interest, the EBOS segment is now measured independently.

GeBBS Healthcare Solutions, PwC & Guidehouse Demonstrate Strong Partnership

Clients of GeBBS Healthcare Solutions have high praise for the firm’s work, saying the quality metrics often exceed their expectations. Clients feel GeBBS overdelivers, helping clients realize positive outcomes and reach performance levels not previously achieved. PwC clients attribute their high level of trust in PwC to the strong relationships and extensive communication provided by the firm. By employing high-quality staff and rapidly resolving any and all concerns, PwC consistently exceeds clients’ expectations and delivers tangible results that positively impact revenue and collections. Guidehouse is seen as a trusted partner who operates highly efficiently, communicates well, and quickly resolves any client concerns; this all results in a high level of client trust in Guidehouse.

overall performance and offerings

Savista (nThrive) and Cognizant Fall Significantly Short of Expectations

Clients of Savista (formerly nThrive) do not feel the firm meets their expectations, with several respondents saying the situation has deteriorated significantly since the nThrive services division was spun off from the technology division. Half of interviewed clients would not select the firm again, and more than two-thirds of respondent commentary was negative. Particular pain points include communication breakdowns, negative impacts on A/R and revenue metrics, and Savista not holding staff members accountable for performance. Satisfaction with Cognizant has declined across multiple segments KLAS measures. The limited number of interviewed EBOS clients report that communication, leadership consistency, and overall performance have declined since their previous firm (Bolder) was acquired by Cognizant. They note that the firm does the minimum to fulfill their contract but doesn’t strive to be a strategic partner or to proactively identify issues that could be leading to underpayment or missed revenue. Two of the three interviewed Firstsource clients are highly satisfied with the firm and describe them as a trusted partner. The third client feels the firm oversold their capabilities, leading to unresolved issues, subpar work, and a loss of confidence that Firstsource will meet expectations in the future.

PwC Stands Out for Applying Equally Strong Effort in Commercial & Government Contracts

 how well do firms give equal effort across all accountsInterviewed PwC clients report that the firm goes to great lengths to understand and then meet the needs and expectations clients have for the engagement and to devote sufficient resources to ensuring all assigned accounts are worked. Conversely, MediRevv (a Tegria company) and AGS Health clients report concerns in this area. Several MediRevv clients say the firm does not supply sufficient resources to meet their needs, leading to dissatisfaction with the engagement. Several AGS Health clients have encountered staffing and communication issues since AGS Health was acquired; more recently, these issues have improved.

Robust, Transparent Reporting Leads to High Client Satisfaction with PwC and Parallon

how well do firms communicate outcomes or resultsClients give PwC a perfect score for their communication of outcomes and results, praising the firm’s high transparency even when the results indicate room for improvement. Additionally, PwC strives to perform root cause analyses of issues so that solutions can be proactively suggested, leading to better outcomes and tangible results. Parallon clients are also very satisfied with the level of communication they receive and note that the firm shares prolific, detailed feedback on their performance and any challenges they encounter with payers. Clients highlight the firm’s ability to quickly generate any needed report. Cognizant struggles with communication. Client relationships have weakened since the firm’s acquisition of Bolder, and clients report they now experience resistance when asking for additional communication or assistance.

AGS Health, GeBBS, and MediRevv Most Likely to Improve the Patient Financial Experience

what impact have ebos firms had on the patient experienceAcross firms, clients report achieving a variety of positive patient-experience outcomes, including faster turnaround, reduced patient frustration, and more-positive patient interactions. AGS Health clients say improvements to their patients’ billing experience stem from the firm’s accurate billing and quick turnaround times. Clients of GeBBS Healthcare Solutions report a faster billing turnaround time and a reduction in the number of patient complaints about billing. MediRevv (a Tegria company) is frequently contracted to manage self-pay accounts, meaning the firm has significant contact with patients. MediRevv successfully meets this challenge—multiple clients have received positive patient feedback praising the MediRevv representatives for working with them to clear up confusion and get their bills paid. Guidehouse’s high billing accuracy has led to claims getting paid faster.

COVID-19 Has Had Little Impact on EBOS Operations

how have relationships with firms changed since covid 19While COVID-19 has obviously had significant impacts on many aspects of healthcare, the work performed by EBOS firms has gone largely unaffected given its outsourced nature and the fact that many firms were already utilizing a distributed workforce. GeBBS Healthcare Solutions, MediRevv (a Tegria company), and PwC clients report that while COVID-19 was wreaking havoc on healthcare facilities and providers, their EBOS firms went above and beyond to maintain open lines of communication and strong, productive relationships.

About This Report

The data in this report comes from two sources: (1) KLAS’ standard quantitative evaluation for healthcare IT services, and (2) a supplemental evaluation tailored specifically for the extended business office services (EBOS) market. Interviews were conducted over the last 18 months.

KLAS’ standard quantitative evaluation 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 customer experience pillars—loyalty, operations, relationship, services, and value.

customer experience pillars services

To supplement the customer satisfaction data gathered with the standard evaluation, KLAS also created a supplemental evaluation to delve deeper into several questions specific to the EBOS market. This evaluation asked respondents to rate how well their firm (1) supplies appropriate effort and resources across all assigned accounts, (2) communicates outcomes and results, (3) impacts the patient experience, and (4) has provided needed levels of relationship and engagement during the COVID-19 crisis.

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. Ratings from these individuals are aggregated in order to prevent any one organization’s feedback from disproportionately impacting a service’s score. 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.

about this report

Some respondents choose not to answer particular questions, meaning the sample size for any given firm or service can change from question to question. When the number of unique organization responses for a particular question is less than 6, 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 firm has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.

author - Elizabeth Pew
Elizabeth Pew
author - Natalie Jamison
Natalie Jamison
author - Natalie Jamison
Project Manager
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.