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Patient Accounting 2020 Patient Accounting 2020
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Patient Accounting 2020
Driving Tangible Outcomes in Revenue Cycle

author - Boyd Stewart
Boyd Stewart
author - Alex McIntosh
Alex McIntosh
December 17, 2020 | Read Time: 6  minutes

Provider organizations must have patient accounting (PA) solutions that are stable, well supported, and highly functional—all while navigating the ever-changing regulatory landscape. When PA vendors don’t measure up, organizations can suffer significant cash flow challenges. This report offers an update on available patient accounting solutions, with insights on which vendors are maintaining strong performance, stagnating, or shaking up the market. 

Epic Maintains Lead with Most Functional Solution; MEDITECH Making Strides

overall performance trending

Epic has maintained the market lead in patient accounting, with consistently strong overall performance, customer support, and product quality. Their prescriptive approach to implementation and support helps prevent customers from slipping between the cracks. The least-satisfied customers cite a need for more automation and difficulty overcoming the initial learning curve—though after this hurdle, the user experience improves significantly. Regardless of overall satisfaction, respondents describe “extremely helpful” support representatives and remark on the value of Epic’s transparency in this market. MEDITECH’s product is seen as sturdy and reliable, if not the most innovative solution. Overall, the product’s functionality helps organizations achieve their patient accounting goals. Respondents also feel MEDITECH is “more engaged” than other vendors, actively going out of their way to listen and respond to client needs. As a result, MEDITECH customers report the highest satisfaction with value of all measured customer bases.

Cerner Customers Still Waiting for Significant Improvement; Allscripts Not Ready for Prime Time

Throughout 2019, KLAS published a series of reports measuring Cerner’s progress in resolving the significant patient accounting struggles their customers have been experiencing for years. Today, Cerner customers are deeply discouraged. A number of customers have reported various small wins from Cerner around product development or fixes that solve ongoing solution issues, as outlined in Cerner’s road map. Despite these wins, satisfaction among these customers has remained largely flat over time, and these organizations remain dissatisfied. In general, Cerner customers say they need a clear ROI to improve their satisfaction, but what clients see as lack of commitment or understanding from Cerner makes them skeptical that change will happen. Some respondents feel Cerner does not understand the system themselves—different people at Cerner often give different answers to the same questions. The gap between the most and least satisfied clients has grown in the last few years, and both cohorts report a declining experience.

Allscripts' patient accounting solution (limited data) is not at the level customers would like due to the newness of the product, a bumpy workflow, and functionality issues (e.g., difficulty dealing with worksheets, extracting quality measures). Clients have put more work into the system than they initially expected to, partly due to overpromising from sales representatives. Multiple customers report recent improvements in their relationship with Allscripts.

Strong Results from Epic Cushion Initial Go-Live Difficulties

satisfaction with internal resources requiredEpic customers report the go-live requires a large internal lift up front. After the go-live and training, many feel the system’s ease of use and product quality are second to none. Users describe the system as “solid,” and several call it the Cadillac of revenue cycle solutions. Organizations using Allscripts say support personnel are available, willing to help when needed, and knowledgeable enough to help customers quickly work through issues.

Many Cerner customers have had to increase their number of patient accounting–related FTEs to make up for system deficiencies and keep the system running and bills going out the door. This need to hire additional employees was not expected at the time of contracting—organizations believed the system would be able to sustain itself without this additional investment. Some MEDITECH customers report they had to devote unexpected time and energy to ensure the solution was implemented to meet their needs—though very few needed to devote additional FTEs, partly due to the product’s basic nature.

Epic’s and MEDITECH’s Solid Solutions Generate Satisfaction with Financial Trending Metrics

satisfaction with financial trending metricsOverall, Epic customers are satisfied with their financial trending metrics. With the platform’s reporting and analytics functionality, organizations are able to closely monitor factors affecting financial metrics and stay ahead of any problems. Several respondents who recently went live report minimal disruption to their financial trending during the implementation and are currently satisfied with their status in these metrics. Some of what keeps Epic from excelling in this area is the aforementioned implementation struggles, causing these metrics to dip initially before (nearly universally) returning to normal levels. Organizations using MEDITECH feel their solution offers solid support of financial trending, saying it has helped them achieve “tremendous outcomes” and return to normal quickly after an initial increase in A/R days at implementation. Multiple respondents state the reporting capabilities and dashboards are a strength that allows them to keep on top of trending metrics and the product’s performance.

Satisfaction with A/R days trending is split among interviewed Cerner customers. Some have seen recent improvements in this area by working with Cerner. Nearly the same number feel the solution is increasing their A/R days and express doubt the situation will improve in the near future.

Epic Up Front about Solution Gaps; MEDITECH and Cerner Customers Find Unexpected Back-Office Gaps

While the Epic solution has room to improve, customers credit the vendor for being very up front about system capabilities and deficiencies, and most have had to fill very few gaps overall. Several respondents did mention robotic process automation and automation in general as unexpected gaps they would like Epic to fill in the future.

Several Cerner customers are frustrated by, in their words, the vendor’s lack of transparency and honesty about the system’s abilities and deficiencies. Some organizations say the system’s capabilities were oversold, requiring the use of additional technology. The most commonly mentioned gaps relate to reporting/analytics, workflows, and patient access. MEDITECH respondents report the highest total number of gaps that need to be filled by an outside vendor. Most are in back-office processes, such as contract management, clearinghouse, and statements. Organizations have also needed to find additional technologies to help with patient access activities, such as financial assistance, prior authorization, and quality assurance.

has your organization had to purchase technology to fill unexpected gaps in the pa solution if yes where were those gaps

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 in reports like this one and online in real time so that other providers and IT professionals can benefit from their peers’ experiences. To enable readers to more quickly understand high-level differences in vendor performance and give better context as to how each product compares to other offerings in the market, KLAS has organized the questions from the standard evaluation into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.

customer experience pillars

In addition to gathering customer responses to the questions in the standard evaluation (which are the same across market segments), KLAS has recently begun asking supplemental questions specific to the patient accounting market. These questions were added after data collection for this report had already begun and thus have a smaller number of respondents.

The data in this report was collected over the last 12 months; the number of unique responding organizations is given in the chart to the right.

about this report

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 6, 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 - Amanda Wind Smith
Amanda Wind Smith
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.