Hospitals keeping close eye on revenue cycle vendors

'Vendors, beware,' warns new report
By Mike Miliard
10:54 AM
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"Healthcare is being pushed to a 90 percent adoption rate of value-based reimbursements by the end of the decade," said Jeremy Bikman, CEO of research firm peer60, whose new report finds hospitals increasingly attuned to the need for forward-looking revenue cycle management technology.

"Our research indicates that as providers transition to this new world, vendors that fail to innovate on this front are being viewed as deadwood, and CFOs are about to pick up their axes," said Bikman.

[See also: Revenue cycle ripe for radical change]

While 35 percent of hospitals polled by peer60 have already embraced value-based payment models – and have contracted with companies for RCM tools to help them pivot away from fee-for-service – most providers (61 percent) say they've yet to decide on whom their technology partner will be in the years ahead.

[See also: Revenue cycle headed for a 'new world']

The Advisory Board (50 percent) is comfortably tops in market share for those organizations embracing value-based care, according to the report, followed by OptumInsight at 19 percent. Truven Health Analytics, MedAssets and The Advisory Board were found to have the greatest mind share among providers still mullng their options.

Other top vendors being considered for revenue cycle and business intelligence needs are Aetna/ActiveHealth, Verisk Health, Lumeris, Phytel – recently acquired by IBM  Wellcentive, Emdeon, MedeAnalytics, Availity, Lightbeam and Xerox, according to peer60.

Outsourcing, too, is an option for some hospitals: Peer60 found that 46 percent of chief financial officers would consider outsourcing collections. Contract management and denial management, at 24 percent and 23 percent, respectively, were also considered for relegation to a third party.

Still, most providers see the need to improve revenue cycle at their own organizations, the report finds: Smooth ICD-10 migration, a better patient experience and efficient point-of-sale collections were all named as key areas that need to be addressed.

The big theme of the report, though, is that hospitals are looking for innovative vendor partners to help them chart the uncertain waters ahead.

"The revenue cycle management market is growing, and providers' needs are changing," peer60 researchers write. "This is prompted by consolidation of healthcare providers, a decline in reimbursement rates and changes in how hospitals are paid.

"As providers face the challenges presented by these new payment models, they will require help from RCM vendors far beyond what's historically been provided from these firms."

Access the full report here.