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Patient Accounting 2018
Transitioning from Legacy Systems
Author
Boyd Stewart
Author
Alex McIntosh
The legacy patient accounting solutions that provider organizations have used for years are often stable and highly customized. However, many organizations are now cautiously moving to newer PA systems in pursuit of clinical integration. These legacy conversions go primarily to Cerner and Epic, who are the only vendors with enough such conversions to be included in this report. The page below gives a brief overview of the overall market, while the rest of the report zeroes in exclusively on Cerner and Epic.
Industry Insight & Context
PATIENT ACCOUNTING
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Patient Accounting 2018
Nearly all Epic customers have fully implemented both the clinical and PA systems from Epic, and these customers consistently report hitting their financial targets. In contrast, revenue cycle has long been Cerner’s Achilles’ heel—over half of Cerner’s Millennium EMR customers have not yet implemented Cerner’s Millennium PA solution, often due to functionality concerns and uncertainty as to whether the product can drive a healthy revenue cycle. While success is possible with either solution, the road maps are different. What does it take to be successful with Cerner or Epic?
Success with Cerner Patient Accounting Is Not a Guarantee—and It’s Harder Than It Should Be
Cerner customers who are meeting their organization’s revenue cycle targets often attribute much of their success to their own internal commitment and investment. A VP at one successful organization said success has come “in spite of” Cerner—a sentiment shared by others. Respondents report having to push Cerner to provide highly capable implementation resources, and some have had to add FTEs in order to meet the demands of the Cerner solution. Among customers meeting their revenue cycle targets, over one-third would not buy the solution again given the choice, and optimism in the solution’s future declines as organizations are live with it for longer. On a positive note, some customers praise Cerner’s support team and say that there are more knowledgeable resources than there used to be.
Getting the Best Start with Cerner
The advice below comes from an executive at a newly live and successful organization. Several other recently live organizations validated that the statements also reflect their own experiences with Cerner.
Front End Must Be Reengineered—and Your Cerner Resource Might Not Know How
"If we had followed Cerner’s advice, it would not have gone well. . . . Cerner Patient Accounting is philosophically different from other revenue cycle products. The patient status orders require physicians to order a level of care. That is what we should be doing to be compliant with CMS, but most hospitals don’t do this. . . . However, with Patient Accounting, if a doctor doesn’t order things, the ancillary departments can’t put the charges in. The system forces the documentation process to be done correctly up front. All our issues with Cerner are really about clinical workflow." —Executive
The Extensive Change Necessitates Strong Internal Buy-In
"Our revenue cycle team resisted the change to Cerner all the way through. We had always done things a certain way, and that is how the team wanted to set up Cerner Patient Accounting. . . . There was a lot of unwillingness to throw out our own ways of doing things. We had to have confidence that the new way was going to work, but that confidence takes time to build. We wouldn’t have gotten there without strong people." —Executive
Fight For the Right Cerner Resource
"One of the issues with Cerner’s implementation is their resources. They do not have enough quality people to lead these implementations. Cerner expects their consultants to lead customers through the decision-making process, but the consultants have to be smart enough and know the system well enough to do that. Instead, they are green and lack experience. We had to redo a lot of workflow things because of the initial model, and Cerner’s resources didn’t know enough about the system or how to put it together." —Executive
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Nearly All Epic Customers See Improved Financial Performance
Among all patient accounting vendors, Epic leads in overall satisfaction by nearly 15 points. Several customers point to their own internal efforts as principal drivers of their success. Organizations that have switched to Epic in the past five years are nearly universal in reporting improved cash, revenue, cost to collect, collections, clean claims, and net A/R days (with 41.9 days being the average). Many of these organizations also report that these metrics are still trending in the right direction. In addition, nearly all interviewed Epic customers report that Resolute offers better integration, functionality, efficiency, and visibility/analytics than their previous patient accounting solution.
Road Map to Success with Epic
Success with Epic Isn’t Automatic
"We did a lot of planning and training in preparation for our move to Resolute Hospital Billing. We got all of our ducks in a row, and we didn't have any backlogs. We were really able to focus. . . . We put a lot of preparation and thought into Resolute Hospital Billing. We could have practiced a little more, but we are doing fine." —VP/Executive
Epic Certification Proves Its Value in Patient Accounting
"Epic has a rigorous certification process. That is especially true for analysts. . . . Epic is very good at training the end users. . . . Training is key. We try to ensure that new employees are getting the best training possible so that they can be successful in their roles. . . . Training is definitely a key to success, and that isn't just for our revenue cycle side; it applies to physicians, nurses, and anybody else using the system." —Director
Listen to the Epic Team
"I think Epic is one of the best firms at using their project plan to lead us through the implementation. They were very thorough, and they had best practices ready for us. They had a really good implementation plan and good documentation, and they made suggestions for how to transition into a new system. . . . Anytime we have a question on anything, we can call them up without going through a help desk. The access to those resources has been really helpful." —VP, Revenue Cycle
Writer
Elizabeth Pew
Designer
Jess Wallace-Simpson
Project Manager
Robert Ellis
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.