Hospitals Selectively Choosing Revenue Cycle Vendors

Hospitals are increasingly attuned to the need for forward-looking revenue cycle management technology and are eying vendors very closely according to a peer60 report. In doing so, they are becoming increasing picky about the vendors they select reports HealthCare Dive.

“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. “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.”

The report found that although 35 percent of the hospitals surveyed have contracted with companies for RCM tools, 61 percent of them are still on the fence when it comes to choosing a technology partner. As hospitals look to cut costs and find vendors to help, the study found that 46 percent of hospital CFOs would consider outsourcing collections, while 24 percent cited contract management and 23 percent denial management as services most likely to be outsourced.

Among the most critical areas to address in order to improve revenue cycle management, CFOs named ICD-10 migration, improving the patient experience, and point-of-sale collections. To meet these goals, hospitals are searching for innovative vendor partners.

“The revenue cycle management market is growing and providers’ needs are changing,” explain the report’s author. “This is prompted by the 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.”

Some of the companies with current market share include the Advisory Board, OptumInsight and Truven Health Analytics, MedAssets, Aetna/ActiveHealth, Verisk Health, Lumeris, Phytel, Wellcentive, Emdeon, MedeAnalytics, Availity, Lightbeam, and Xerox.



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