How Do Providers Feel About Extended Business Office Services Vendors?

As revenue cycle challenges persist, provider organizations are turning to vendors that offer extended business office services (EBOS), a KLAS report indicated.

The Extended Business Office Services 2024 report shared insights on client satisfaction and adoption and highlighted providers’ plans for outsourcing revenue cycle services.

PwC received the highest overall performance score among vendors offering EBOS, scoring 90.0 on a 100-point scale. Clients said the firm maintains strong relationships, responds quickly, and accommodates their needs. PwC received an 8.0 for strength of partnership, a 7.9 for strategic ability, and an 8.1 on driving tangible outcomes, all on a 9-point scale.

In addition, clients value the vendor’s analytical tools and all respondents said they would purchase the services again. Some PwC clients said they would like the firm to be more hands-on and engage more proactively in identifying and addressing performance gaps.

AGS Health scored 86.8 for overall performance, with client satisfaction growing over the last year. Organizations using AGS Health reported greater transparency from leaders and timely responses and proactive problem-solving from account managers, leading to a strengthened partnership.

The vendor received an 8.2 for strength of partnership, 7.1 for strategic ability, and 7.7 for driving tangible outcomes.

AGS Health clients also reported general satisfaction with offshore resources. Some respondents said AGS should improve strategic engagement by offering best practices and handling complexity in billing and collections.

Guidehouse was the third-best overall performer for EBOS, receiving an 84.5. Provider organizations using Guidehouse appreciate the vendor’s strong revenue cycle expertise, attentiveness, and collaboration in addressing problems, the report shared. Most clients say the firm drives strong value through their work on cash collections and A/R management. One respondent noted misses due to insufficiently trained frontline staff.

Acclara, receiving an 83.3 for overall performance, was praised by larger organizations for its involved executive team and willingness to listen to and accommodate client needs, including returning accounts to the client or assisting with additional projects. Smaller organizations said the vendor struggles to train staff to have the necessary expertise and the ability to work accounts swiftly.

Firstsource’s overall performance score was below the market average at 64.5. Some users said they want the firm to be more collaborative in teaching clients how to improve the revenue cycle. Clients noted having to do additional work due to staff mistakes, poor handoffs, and inflexibility regarding client needs.

Some Firstsource users were satisfied overall, but respondents tended to report they wished the firm was more proactive and did more to meet their engagement expectations.

Among smaller healthcare organizations, R1 RCM received positive reviews. Respondents said the vendor is transparent and collaborative in guiding organizations to improve their revenue cycle operations. Clients also noted the firm’s partnership in optimizing processes and achieving prioritized outcomes. Some users reported challenges with undertrained offshore staff that impacted R1 RCM’s execution, but all said they’d buy the services again.

Meanwhile, small organizations using TruBridge for EBOS said frontline workers lack the training and expertise to proactively identify problems, find solutions, and improve the revenue cycle. Clients also said the vendor has struggled to hire and retain staff and is not great with transparency or producing accurate reports and cash posting. However, respondents are satisfied with the firm’s account managers and higher-up leaders, pointing to the firm’s responsiveness and partnership.

Healthcare organizations satisfied with their firm’s partnership tend to expand their plans with the same firm. Less satisfied organizations plan to decrease their scope with their current partners. Around 30 percent of respondents plan to broaden their scope to outsource more of the revenue cycle, 46 percent of whom will outsource more to their current vendor.