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Revenue Cycle Outsourcing 2013

Revenue Cycle Outsourcing 2013
Tools, Expertise, and Resources Key to Improved Collections

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Providers are reaching out to revenue cycle outsourcing firms more than ever as their environments increase in complexity and the need for improved collections, greater efficiency, and accuracy grows. With some of the largest contracts signed in the past two years, the market has seen tremendous growth, resulting in over 38 organizations encompassing 460 total hospitals currently using revenue cycle outsourcing. For this report, KLAS spoke with 28 of these organizations to highlight the differences in each firm’s collection tools and strategies as well as to show strengths, weaknesses, and other differences between them.

ESTIMATED MARKET SHARE VS. OVERALL PERFORMANCE SCORE

WORTH KNOWING

COLLECTIONS IMPROVING FOR PROVIDERS, BUT RESULTS VARY BY FIRM

Parallon scored highest in reducing A/R days and the cost to collect and in increasing the net collection ratio. This is due to the strong tools, technologies, and processes they have developed over the last decade inside HCA. Conversely, Accretive Health received some of the lowest scores in impact on A/R days and reduction of the cost to collect due to newly acquired clients that require additional time to make improvements. Also, in one instance a provider mentioned a slight calculation error in the tool that had to be resolved.

TOOLS/TECHNOLOGY ARE KEY TO IMPROVED COLLECTIONS

Providers expect RCO firms to deliver strong tools to improve outcomes by improving processes and providing dashboards to better manage staff’s efforts. Parallon and Cymetrix stand out from others in this area. Providers convey that both firms have tools that improve processes and provide informative dashboards. Additionally, providers say that Conifer Health’s technology is really strong with revenue cycle processes but lacks actionable dashboards for executives. Accretive Health clients expected to have great tools, but a couple say the tools are outdated and underdeveloped or have some issues around workflow and functionality.

FEW FIRMS PROVIDE PATIENT ACCESS AND HIM SERVICES

While many firms indicate providing patient access and HIM services is important to effectively improve revenue cycle results, many providers say they are getting mostly back-end business office services. Cerner stands out as the only vendor delivering managed services in all three areas for all clients. MedAssets provides only back-end business office services.

IMPACT OF COLLECTION METRICS VS. TECHNOLOGY

RCO LAY OF THE LAND

WHAT IMPACT DOES YOUR RCO FIRM'S TECHNOLOGY HAVE? (n=21)

BOTTOM LINE ON FIRMS

RANKED FIRMS

CONIFER HEALTH

Well known in the market, tends to perform better with larger clients, and excels in their methodology and process improvement, DNFB deliverables, and denials management. RCO tools enhance process but have some gaps including weak dashboards, with clients relying on daily or weekly reports. Conifer Health is a subsidiary of Tenet and recently signed a deal to provide services to CHI. Provides patient access, HIM, and back office services, and also has population health tools and expertise.

PARALLON

Receives the highest performance scores with strengths in DNFB, reducing the cost to collect, and helping clients prepare for ICD-10. Providers indicate tools are complex because so much data is available. Parallon is a subsidiary of HCA and can provide patient-access, HIM, back-office, payroll, and supplychain services. Gaining market share of hospitals by signing two large deals, LHP and CHP. Recently announced corporate CEO leadership change.

PRELIMINARY DATA FIRMS

ACCRETIVE HEALTH

Delivers services by overlaying leadership and management instead of outsourcing the entire department; some say this results in greater flexibility and effectiveness. Standout strength is collecting high percentage of accounts. Lowest overall rating in this report, with some complaints of young, undertrained consultants and underdeveloped tools that are weak in functionality and workflow. Experienced significant leadership change this year; Ascension Health has an ownership stake in Accretive Health.

CERNER

Exceeding many veteran vendors’ performances even though they are a relatively newer player in RCO. Currently only offers to Cerner CIS clients; signed one of the biggest RCO contracts this year. They are the only vendor in this study providing full managed services for the front end, middle, and back end for all their clients in this report. Some clients have yet to see reduced costs to collect and wish for better dashboards.

CYMETRIX

A strong EBOS player providing full RCO services. Preliminary data shows client satisfaction is very high, though Cymetrix has a much smaller client base. Experienced little growth since entering RCO market, but providers indicate they have strong tools and the ability to deliver value.

MEDASSETS

Provides full managed services. Some clients praise them for their communication, relationships, and technology. Some clients question their process and focus but like certain applications they provide. NOTE: MedAssets was not included in charts due to insufficient number of responses.

WHAT IMPACT IS YOUR RCO FIRM HAVING ON THE FOLLOWING? (n=20)

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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. © 2018 KLAS Enterprises, 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.