Firm Selection, Rollout Key Considerations of Revenue Cycle Outsourcing

Firm selection, contracting, and rollout are among the top considerations shared by providers who recently outsourced revenue cycle management, according to a recent KLAS report.

The KLAS report, “End-to-End Revenue Cycle Outsourcing 2023: Pursuing Financial and Staffing Stability,” includes insights from 19 organizations regarding satisfaction with their end-to-end RCO firm over the last 12 months and eight in-depth conversations with provider executives whose organizations have announced partnerships with large end-to-end RCO firms in the past two years.

Provider executives shared with KLAS that firm selection matters when transitioning to end-to-end revenue cycle outsourcing. Providers who recently outsourced revenue cycle management functions said providers need to take the time to determine if an outsourcing partner is a “cultural fit” while also being transparent and open to opportunities for improvement.

Overall, providers agreed that cost shouldn’t be the only consideration since firm selection impacts financial success so heavily.

Top firms according to KLAS’ survey of client satisfaction include Ensemble Health Partners, R1, Guidehouse, and Conifer Health Solutions. The report notably excluded Optum because the company’s revenue cycle outsourcing contracts are usually part of larger organizational decisions around technology and services beyond revenue cycle management. Clients experienced challenges with assessing revenue cycle outsourcing experiences in isolation.

Ensemble Health Partners took the top spot for overall performance, scoring 92.9 out of 100 points. R1 followed with 71.6 points, although there was limited data to assess overall performance. Finally, Guidehouse earned 89.5 points in the “other solutions" category since KLAS had not validated three or more unique outsourced clients with net patient revenue of >$1 billion.

Clients of Ensemble Health Partners were more likely to cite expertise, prior experience, and experience with EMR vendors as reasons for firm selection. However, more providers also cited contract terms and price as a reason for not selecting the firm.

Pricing was also an issue for Optum, while contract terms were favorable for R1 clients. Clients of the latter also selected the firm based primarily on model alignment and scale of clients. Some also cited expertise and partnership in the sales process.

Providers need to understand revenue cycle outsourcing contracts fully, according to peers who recently transitioned to outsourcing. Due diligence is critical because providers need to understand how firms calculate their impact and compensation.

Additionally, providers need to consider how revenue cycle outsourcing will impact other vendors and technologies they use, like the EMR, to avoid disruptions and delays.

How end-to-end revenue cycle outsourcing will impact key performance indicators (KPIs) is also important to understand, the report stated.

Other areas of consideration, according to the report, revolve around announcing, rollout, and onboarding. Providers who recently outsourced revenue cycle management recommended transparency with employees, especially around the current financial state of the organization.

Providers considering end-to-end revenue cycle outsourcing should also recognize the impact outsoucing will have on employees since the decision may be viewed negatively by workers. Outsourcing is a major lift, involving a lot of HR work and administrative changes.

End-to-end revenue cycle outsourcing is a large decision that more providers are considering in light of staffing shortages. The report found that hospitals and health systems are also outsourcing revenue cycle management because of the expertise a firm can bring and the financial challenges their organizations currently face.

Revenue cycle outsourcing can allow providers to leverage revenue cycle management expertise and technology that they may not have access to on their own, the report said.