Revenue Cycle Outsourcing 2021
Choosing A Strategic Partner

Ensemble Health Partners’ clients tend to be smaller (in terms of total beds) and highly satisfied—100% interviewed would choose the firm again and nearly all say the firm consistently exceeds their expectations; some specifically say they feel Ensemble collects faster and better than competitors. Clients note that Ensemble has stayed proactive, responsive, and client focused despite recent growth. Because of this, clients view the firm as a partner in their success. In general, R1 clients, who tend to be larger, are optimistic about the firm’s direction and use of technology to drive results but note the need for more improvement and greater speed in achieving outcomes. More-satisfied clients report tight partnerships that get results. Nearly half of interviewed clients do not feel the firm has exceeded expectations, pointing to unmet revenue and collection targets (particularly for A/R) and to the firm focusing too heavily on high-dollar accounts. Clients of Guidehouse (formerly Navigant) tend to be smaller. Clients feel the firm does well at meeting expectations. Nearly half feel Guidehouse does not exceed their expectations—these clients would like more innovation and strategic involvement in identifying areas of revenue opportunity.

nThrive No Longer Seen as Trusted Partner for RCO

A majority of nThrive’s interviewed clients have lost faith in the firm—more than 80% are dissatisfied and the firm receives an overall performance score of 61.3 (out of 100.0). Existing challenges have only been exacerbated by the recent separation of nThrive’s technology and services divisions. Clients say nThrive is disorganized in getting claims out the door, and some report having to babysit nThrive for even basic tasks, like adding modifiers to claims to ensure successful processing. Additionally, missed collection expectations and unexpected costs for the underlying technology have significantly reduced client perceptions of value. Respondents have not been encouraged by nThrive’s response to concerns—several say nThrive doesn’t listen well when issues are escalated, and one stated that nThrive has “lost sight of what true customer service is” (business office VP). Client dissatisfaction is not limited to RCO—nThrive significantly trails competitors in all services segments in which the firm is rated by KLAS.

Conifer Health Solutions’ Ongoing Execution Misses & R1’s Early Implementation Missteps Have Reduced Client Perceptions of Value

43% of interviewed Conifer Health Solutions clients report overall dissatisfaction. Dissatisfied clients often cite poor execution—several say the firm does not actively work all accounts, leading to less-than-desirable collections results and lower perceptions of value. Several respondents are frustrated that despite requests for more communication, Conifer does not proactively reach out about problems or roadblocks. Additionally, Conifer is not generally seen as innovative, and this has tempered enthusiasm for the firm among even the most satisfied clients. Though R1 currently scores similarly to Conifer for both money’s worth and engagement execution, the tone among R1’s client base is much more optimistic. Several clients that rate R1 low for execution experienced initial challenges with the implementation and go-live but say the firm is now performing well and meeting expectations. These clients haven’t quite forgotten their early frustration but believe the experience with R1 will continue to improve.

Ensemble Health Partners & R1 Clients Most Likely to Buy Again, Due in Part to High Strategic Ability

Clients of Ensemble Health Partners are impressed with the firm’s willingness and ability to proactively help clients improve internal workflows and processes so that money is not left on the table. Clients say the firm generates actionable insights to help them avoid costly mistakes and comes prepared with solutions. A CFO described Ensemble’s ability to help clients navigate “a complex, changing environment” as “invaluable”; this sentiment is shared by many other interviewed clients. R1 clients appreciate the firm’s wide range of revenue cycle services that can be scaled up or down depending on volume. Clients say R1 has strong leadership and is backed by an innovative technology platform and processes that help them meet clients’ needs and expectations. This combination of offerings, technology, and personal touch has led nearly all interviewed clients to report confidence in R1 as a trusted revenue cycle partner.

Economies of scale are one of the most commonly reported reasons healthcare organizations engage an RCO firm. Organizations report that because firms provide RCO services to a variety of healthcare organizations, they are able to reduce the cost to collect and help providers get paid at a higher rate than they would managing the revenue cycle on their own. Many interviewed organizations also feel firms have a level of experience and expertise that would be difficult to replicate in-house. This includes revenue cycle expertise as well as experience with specific EMR vendors (mainly Cerner and Epic). Several respondents also note that local staffing challenges make it hard to find high-quality revenue cycle resources in their communities, necessitating the need for an RCO firm that has a national presence and can recruit from a wider pool of applicants.

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 6 unique respondents. When a vendor’s sample size for a particular question is less than 6, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 3, 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.