RCM market expected to grow by leaps
The $2.4 billion hospital revenue cycle management software and services industry expects double digit increases in 2014 because of business shifts, reimbursement and payment reforms, accountable care participation, ICD-10 coding challenges, physician practice acquisitions, collection issues, and overall declining margins, according to two reports released Sept. 23 by market research firm Black Book.
The two RCM reports, "Top Hospital Software Vendors, Revenue Cycle Management: Small/Rural and Community Hospitals under 250 Beds," and "Top Hospital Software Vendors, Revenue Cycle Management: Hospitals over 250 Beds, Chains and Networks," provide analysis on the replacement RCM market as healthcare systems to upgrade patient billing and collection processes.
More than 1,900 hospital CFOs, CIOs, business office managers, tech and financial staffers contributed their perceptions to Black Book between April 2013 and August 2013. Additionally the business managers of 1,800 physician practices owned by hospital systems also submitted responses, evaluated separately. There were 557 hospital and inpatient organizations represented in the survey.
"Shifting payment models and regulations are forcing hospital leaders to redirect previously launched budgets, priorities and strategic plans to assess if new RCM solutions can rescue them from imminent hospital layoffs, even bankruptcies," said Doug Brown, managing partner, Black Book Rankings.
"Most hospital CFOs have no choice but to leverage next-generation RCM solutions in order to keep their organizations solvent. The reimbursement challenges ahead to get paid may require several new RCM applications, and the frank reality is that a failing RCM could quickly close a marginally performing hospital for good," Brown said.
HIMSS Analytics found similar market trends earlier this year. In an interview with Healthcare IT News Managing Editor Mike Miliard, HIMSS Analytics Executive Vice President John Hoyt asserted, "There's a new future for revenue cycle." It's time - past time - for replacement, he suggested.
"We're looking at ages 8 to 11 years for these revenue cycle systems" Hoyt said. "Patient billing is different from registration is different from scheduling, but they're generally up there: 8 to 11 years. And that's basically the kind of thing that the auto industry watches. How old are the cars on the road? There's a point at which people just have to start buying new cars."
In its report Black Book also highlighted the top performing RCM software vendors as ranked by customer satisfaction on 18 client experience-based key performance indicators.
ZirMed, rated No.1 RCM software for large hospital hospitals and academic medical centers over 250 beds. Other large hospital and academic medical center top performing ranked software include: OptumInsight, Conifer Health Solutions, McKesson RelayHealth, Emdeon, SSI Group, MedAssets, Experian Healthcare, Cerner, Passport Health, Craneware, Infor, Quadramed, Obsidian, Convergent, 3M, Meditech, Revenue360, Epic Systems, and Siemens.
SSI Group, ranked first in RCM software for small/rural and community hospitals under 250 beds. Other RCM vendors rated highly by client experience surveying are: Emdeon, Experian Healthcare, ZirMed, Passport Health, MedAssets, OptumInsight, Craneware, CPSI, Cerner, Convergent, McKesson RelayHealth, Streamline Health, Trizetto Gateway, Conifer Health Solutions, Rycan, Quadramed, Epic Systems, Healthland and Allscripts.
McKesson RelayHealth scored highest in customer satisfaction by hospital systems, IDNs, CINs, chains and ACOs for RCM software. Hospital chains, networks and system RCM software additionally receiving top honors are: Emdeon, MedAssets, OptumInsight and ZirMed.
"The brakes have been applied to slow the radical RCM change out trend in which eight out of 10 hospitals predicted they would be replacing their RCMs between 2011 and 2013. Thirty-six percent of all CFOs confirm they are reassessing the capabilities of their current legacy, core and bolt-on RCM applications, optimistically looking for options in solutions they already own," said Brown.