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Outsourced Revenue Cycle Services 2019 Outsourced Revenue Cycle Services 2019
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Outsourced Revenue Cycle Services 2019
Are Outsourced Revenue Cycle Services Worth the Investment?

author - Daniel Zeitner
Daniel Zeitner
June 25, 2019 | Read Time: 3  minutes

Provider organizations investing in outsourced revenue cycle services to relieve cost and resource burdens need their firms to take true ownership of the complex revenue cycle and deliver accordingly. Unfortunately, some firms are falling short—most common for clients using full revenue cycle outsourcing (RCO). As a result, organizations are increasingly choosing and generally report more success with extended business office services (EBOS), which are more focused in scope. KLAS spoke to 140 provider organizations using RCO or EBOS to determine which firms are delivering and which are falling behind.

rco image70% of Cerner RCO Clients and 33% of All Respondents Have Buyer's Remorse

would you buy again vs delivery of servicesAcross RCO firms, one-third of customers would not buy their firm’s services again, and a large number are dissatisfied. Since 2017, multiple firms have seen declining overall satisfaction—Cerner by 18 points (out of 100), nThrive by 13 points, and Parallon by 10 points. 70% of interviewed Cerner clients would not use the firm's RCO services again. Nearly half of respondents report nickel-and-diming, and many feel Cerner oversold their services; some describe resources as inexpert and slow to work on outstanding claims. nThrive clients report there are few consequences for the firm if they underperform and that little strategic guidance is offered to help improve clients’ revenue cycle. Parallon clients feel resources are quick to give up on hard-to-resolve claims and slow to respond to concerns. Organizations using Conifer Health Solutions report a cookie-cutter approach and insufficient staffing, and they would like the firm to more proactively identify and resolve revenue cycle inefficiencies.

Navigant Partners with a Flexible Approach; Analytics Tools from R1 RCM (Limited Data) Drive Satisfaction

A wide gap divides high performers Navigant, R1 RCM, and Ensemble Health Partners (data on the latter two is limited) from the previously discussed firms. Navigant and R1 customers are the most likely to be using a wide scope of services (business office, patient access, and HIM services). Navigant customers, mostly smaller organizations (less than 500 beds), praise the firm’s flexible approach in contracting for and executing services. Contracts often require the firm to meet certain performance metrics, and resources proactively identify gaps in processes and share best practices. R1 RCM clients feel the firm’s tools bring value by providing clear visibility into revenue cycle weak spots. Clients also praise staff members’ analytics expertise that helps clients get more out of the tools. Of the three interviewed Ensemble clients, two report high satisfaction, saying engaged executives respond quickly and make proactive recommendations when denial rates increase.

scope of rco firms

ebos imageMediRevv Drives Outcomes with Strong 
Pre-Engagement Planning; PwC Offers Strategic Guidance Based on Analytics Insights

MediRevv’s strong pre-engagement planning, which focuses on setting clear expectations and understanding clients’ objectives, has a strong positive impact on financial, efficiency-related, and patient-satisfaction outcomes. MediRevv also incorporates patient complaints into resource training. Bolder clients are highly satisfied as well and see increased patient satisfaction, partly because of customer-centric resources who walk patients through the billing process. Bolder also analyzes patient phone calls to identify how to better respond to patients and sends call recordings to clients when requested. Of the measured EBOS firms, PwC has the highest impact on financial and efficiency outcomes due to strong financial analytics tools that identify trends and new revenue opportunities. PwC also offers strategic guidance for improving workflow efficiency.

scope of ebos firms

MedAssist & HGS (Limited Data) Create Transparency with Proactive, Detailed Performance Reports and Regular Review Meetings

Clients of MedAssist and HGS (both limited data) report a standout experience with their firms’ transparency into EBOS performance. MedAssist proactively brings claims-processing issues to clients’ attention and, when urgent concerns arise, contacts them before regularly scheduled performance updates. Organizations using HGS say the firm holds performance-review meetings as often as clients would like, and meetings begin with a detailed performance summary and analysis. Cerner clients are highly dissatisfied with the firm’s lack of transparency. Some respondents have to continually remind Cerner to send these reports, and the quality of these reports varies.

firms proactivity in providing performance transparency
author - Amanda Wind Smith
Amanda Wind Smith
author - Jess Wallace-Simpson
Jess Wallace-Simpson
author - Ally Dove
Project Manager
Ally Dove
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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.