Investor Newsletter January 2023

KLAS Market Insights

How Revenue Cycle Management Solutions Are Used by Organizations to Achieve Outcomes

KLAS measures solutions in more than 25 areas of revenue cycle management (RCM). RCM software has many different moving parts, due to the numerous sources of payment. Some patients pay out of pocket, but most use some form of insurance from their employer, the government (i.e., Medicare and Medicaid), or a private insurance plan. When these additional entities become stakeholders, standards and policies around coverage and claims submissions become so complex that a small army of personnel is required to ensure healthcare organizations can collect revenue for rendered services.

RCM software helps streamline workflows and includes solutions for patient engagement, digital front door, insurance discovery, clearinghouse, prior authorization, and charge capture. Although HIT vendors are building platforms that consolidate functionality across different areas, change is slow, and most healthcare organizations are using various solutions to meet their needs. This has created an environment of active acquisition and consolidation; as part of their strategy, vendors are acquiring others’ solutions to expand their offerings and increase integration.

A healthcare organization’s financial performance is paramount, and healthy cash flows ensure their survival. Switching software solutions can be risky because the move can disrupt cash flow. Organizations may switch when their current platform is underperforming significantly or when a new platform will substantially improve performance and cost savings. Thus, the main challenge for vendors is to convince healthcare organizations that switching solutions is beneficial enough to risk cash-flow disruptions.

Notably, EMR vendors are moving into RCM spaces that have traditionally been filled by third-party vendors. EMR vendors have always been involved with RCM via patient accounting and patient management functionality, and they have started competing with third-party vendors by offering native interoperability with EMRs. The potential for seamless workflows, especially when offered by an EMR vendor at little or no additional cost, is highly valuable to healthcare organizations. Many EMR vendors are focusing on developing patient-facing tools to address the rise of consumerism and patient empowerment in healthcare.

Current trends suggest there is an increasing interest in software solutions and vendor consolidation in the revenue cycle market. However, purchase decisions show that organizations are still leaning heavily toward selecting best-of-breed solutions in an effort to not compromise their organization’s performance. Organizations are seeking only the best solutions for their RCM workflows. However, organizations’ buying hesitation will likely decline as the industry continues to evolve via innovation and acquisitions. Both EMR and third-party vendors are addressing critical needs for organizations. EMR vendors tend to replicate existing revenue cycle technology and offer less-expensive solutions, while third-party vendors drive innovation by pushing the envelope.

2023 Best in KLAS Report Publishing Soon!

The latest version of KLAS’ most popular industry report will be publishing February 2023!  The Best in KLAS report recognizes software and services vendors who excel in helping healthcare professionals improve patient care. All rankings are a direct result of the feedback that thousands of providers shared with KLAS over the last year. A Best in KLAS award signifies to the healthcare IT industry the level of commitment and partnership that top vendors are providing.

All KLAS investor/sponsor members receive a complimentary digial copy upon publication. To learn more about becoming a KLAS member or to purchase a copy of the 2023 Best in KLAS report, contact the KLAS Investment Advisory team at investorservices@klasresearch.com.

KLAS Reports—Recently Published & Upcoming

KLAS Emerging Solutions Reports

Each week, dozens of new companies knock on the doors of provider organizations and health systems to present their latest innovative solutions. KLAS publishes 70–80 individual reports per year which provide early performance data on solutions that have been designated as emerging, disruptive, or innovative. To view the KLAS reports library, visit our website.

Sectra Digital Pathology: Emerging Solutions Spotlight 2022

In the US, digital pathology for primary diagnosis is relatively new and still gaining traction. Robust and reliable digital pathology solutions are needed to accommodate the growth of this field. Sectra’s digital pathology solution already has a strong presence in Europe and is starting to gain one in the US as digital pathology for primary diagnosis becomes more common. This report examines the experience of Sectra’s first US customers.

Market Specialty Reports

KLAS publishes 75+ specialty reports annually, providing market insight based on customer perceptions of and experiences with the vendor/consultant solutions they employ. KLAS also validates industry trends, emerging technologies, purchasing decision insights, and market energy. Interested in KLAS report purchase options? Contact the KLAS Investment Advisory team at investorservices@klasresearch.com.

Enterprise Imaging 2022: Which Vendors Are Delivering in a Challenging Environment?

Recently Released and Upcoming KLAS Specialty & Emerging Solutions Reports

Automated Prior Authorization 2023:
What Impact Do Automated Prior Authorization Solutions Provide?

Prior authorization is mandated by payers to ensure that certain clinical procedures and medications being ordered are necessary. To alleviate the heavy administrative burden this requirement causes, healthcare organizations have adopted automated prior authorization solutions. For this report, KLAS interviewed 30 respondents from 26 unique organizations to understand their experiences using these solutions and what outcomes they have seen.

Best in KLAS 2023

An annual report that recognizes top software vendors and services firms for their outstanding efforts to provide a strong client experience to healthcare organizations.

Canada EMR Consulting Services 2023:
Which Firms Drive Success throughout the EMR Life Cycle?

The Canadian EMR market has seen steady purchasing activity in recent years, with healthcare organizations (ranging from small standalone hospitals to province-wide entities) making go-forward decisions, particularly in Ontario. This activity will likely continue, as eastern provinces like Quebec and Nova Scotia are in the process of selecting a go-forward solution. To maximize their chances of achieving success with an EMR, many organizations partner with third-party consulting firms, which can assist with various aspects of the EMR life cycle. This report—KLAS’ first to focus on EMR services in Canada—draws from perspectives of 21 Canadian organizations who have engaged firms for EMR services to identify what services these firms have provided to survey respondents and how well client needs have been met across engagement types. The data comes from engagements that occurred between November 2020 and November 2022.

Claims Management 2023:
Functionality Top of Mind for Organizations Making Purchase Decisions

The financial well-being of healthcare organizations is critical, especially given the macroeconomic pressures they face today. Many are looking at claims management and clearinghouse technology to maximize cash collections and reduce administrative burdens. To better understand what factors are influencing purchase decisions and which vendors are seen as capable of driving success, this report examines 24 recent purchase decisions validated by KLAS between February 2020 and November 2022. For additional context, satisfaction data from current customers is also included. It should be noted that the decisions in this report are not a comprehensive representation of all claims management purchase decisions made in the last several years.

DHIS 2022 White Paper

In September 2022, KLAS hosted the sixth annual Digital Health Investment Symposium (DHIS). Executives from healthcare provider organizations, HIT companies, investors, and innovators came together to collaborate on important developments in healthcare technology. Drawing on insights from a pre-summit survey as well as insights shared at the summit in small-group discussions, this paper highlights core challenges identified by summit participants and short-term and long-term solutions.

Mergers and Acquisitions 2023:
Vendors Learning to Mitigate Negative Impact

Since KLAS’ last report on M&A activity, there have been several notable vendor mergers and acquisitions affecting the healthcare IT landscape, and many healthcare organizations have needed to navigate the resulting disruptions. This report provides an update on how customer satisfaction has been affected by recent M&A activity and what makes vendors more or less resilient during this type of change. This report includes 26 solutions from 20 different vendors, all of which have been affected by a merger or acquisition in the last few years.

Bluesight CostCheck (formerly Kit Check Bluesight Insights):
Second Look Report 2023

The Bluesight CostCheck solution (formerly Kit Check Bluesight Insights) assists hospitals and health systems with making intelligent buying decisions by providing real-time market insights. KLAS reported on the product in May 2021, when it was Bluesight Insights and there were six unique customers live. The vendor has expanded the product to 44 fully live facilities at 15 unique organization and implemented several upgrades, including improved reporting and prioritized recommendations. This report provides a second look at how the CostCheck customer experience is progressing through the solution’s growth and changes.

To make a purchase or find more information on KLAS reports, contact the KLAS Investment Advisory team at investorservices@klasresearch.com.

KLAS Events 2023

KLAS Global Summit
June 6–8, 2023
Vila Vita Parc | Porches, Portugal

This invite-only event is limited to 150 executive-level attendees and is a unique opportunity to interact with global healthcare leaders who are mutually focused on improving the delivery of healthcare. If you are interested in attending the Global Summit, please email investorservices@klasresearch.com.

KLAS Digital Health Investment Symposium (DHIS)
September 12–13, 2023
Stein Eriksen Lodge | Park City, UT

Registration opens early February 2023! Reserve these dates for the must-attend event of the season. If you are interested in attending DHIS23, please message investorservices@klasresearch.com.