Price, Reputation Turn Away Revenue Cycle Outsourcing Customers

Price tag and vendor reputation are among the top reasons why some revenue cycle outsourcing customers did not select a particular firm, according to a new KLAS report.

The report explores market energy data from 15 recent revenue cycle outsourcing contracts and the level of satisfaction current clients have with their selections. The report found that experience with the organization’s EHR vendor, a firm’s reputation, expertise, and relationships were all factors considered when deciding on a final revenue cycle outsourcing partner.

But just as frequently, some of these factors also turned away some potential revenue cycle outsourcing customers.

KLAS reported that providers are motivated to outsource revenue cycle management to tap the economies of scale outsourcing can provide. Since firms provide revenue cycle outsourcing services for many healthcare organizations, current clients said they are able to reduce cost to collect and get paid at a higher rate than if they managed revenue cycle on their own.

Many respondents also felt firms “have a level of experience and expertise that would be difficult to replicate in-house,” according to the report.

The other top reason and selected by just as many current clients was revenue cycle expertise, followed by experience with specific EHR vendors. Meanwhile, down on the priority list were staffing challenges and standardization.

Revenue cycle outsourcing firms that could not address the top motivating factors were least likely to be selected by healthcare organizations, while clients were more likely to cite a firm’s EHR vendor experience and good reputation as primary reasons for choosing that firm, the report showed.

Reputation was particularly key, with some current clients citing perceptions about a firm’s performance and EHR vendor experience for reasons they decided not to go with a particular firm.

On the other side, clients told KLAS that strong engagement from leadership and a firm’s alignment with the organization’s revenue cycle management goals were deciding factors.

“Entrusting your organization’s financial health to a revenue cycle outsourcing (RCO) firm can feel like giving up the keys to the kingdom,” KLAS stated. Therefore, the decision on which firm to select is not taken lightly by healthcare leaders.

KLAS found that Ensemble Health Partners is the top revenue cycle outsourcing firm in terms of overall performance and its ability to drive tangible outcomes. Although its clients tend to be smaller, all respondents using the vendor said they would choose the firm again and nearly all said they feel Ensemble collects faster and better than competitors.

Ensemble Health Partners was the segment winner, according to the 2021 Best in KLAS report.

Coming in second was R1 whose current clients tend to be larger. Clients told KLAS they are “optimistic about the firm’s direction and use of technology to drive results but note the need for more improvement and greater speed in achieving outcomes.”

Notably, more-satisfied clients reported tighter partnerships that get results.

Smaller organizations were more likely to use Guidehouse for revenue cycle outsourcing. Clients reported that the firm does well at meeting expectations, although nearly half of those interviewed said the firm does not exceed their expectations. Some of these clients sought “more innovation and strategic involvement.”

KLAS also reported that nThrive clients “have lost faith in the firm.” Over 80 percent of responding clients are dissatisfied with the firm and “existing challenges have only been exacerbated by the recent separation of nThrive’s technology and services divisions.”

“Clients say nThrive is disorganized in getting claims out the door, and some report having to babysit nThrive for even basic tasks, like adding modifiers to claims to ensure successful processing,” the report stated. “Additionally, missed collection expectations and unexpected costs for the underlying technology have significantly reduced client perceptions of value.”

The other revenue cycle outsourcing firm analyzed as part of the KLAS report was Conifer Health Solutions. KLAS reported that the firm has experienced “ongoing execution misses” and 43 percent of clients interviewed by KLAS reported overall dissatisfaction.