Enterprise Strategy for Revenue Cycle Tech Not Fully Realized Yet

Enterprise strategies for revenue cycle technology is not a reality yet, but it could be in the near future, according to a small group of vendor technology superusers.

Market research firm KLAS recently surveyed and interviewed nearly 40 “advanced users” in enterprise revenue cycle, which meant the respondents adopted a broad range of functionality from a single enterprise revenue cycle vendor.

The resulting report found that no advanced-user organization is currently using one vendor – Change Healthcare, Experian Health, nThrive, and Waystar for the purposes of this analysis – for all of their revenue cycle needs.

However, advanced users report higher satisfaction with their vendor and better value compared to users with standard, ad hoc revenue cycle technology adoption. Some noted benefits across all vendors included greater billing efficiency, quicker issue resolution, and fewer failure points within the revenue cycle.

The findings hint at a possibility for enterprise revenue cycle technology adoption in the future, KLAS stated.

“As more and more healthcare organizations realize value from having fewer revenue cycle vendors, enterprise adoption will likely become the norm—though, as it has in other markets, this transformation will take time,” the firm wrote in the report.

While healthcare organizations have taken an enterprise approach to clinical technology, doing the same on the financial side of healthcare has been a challenge.

For one, the revenue cycle comprises many moving parts and its sheer complexity has made it difficult for one vendor to provide all the functionality healthcare organizations need.

Among advanced users though, the biggest barrier to enterprise revenue cycle technology adoption is the use of best-of-breed products.

Already having a high-performing best-of-breed revenue cycle solution in place was the most common reason advanced users told KLAS they were hesitant to take a more enterprise approach to revenue cycle technology adoption.

Another reason was the EHR system. According to KLAS, all four vendors in the report had advanced users who said they have chosen to use functionality in their EHR system over the adoption of additional functionality from their revenue cycle vendor.

Few advanced users said enterprise adoption of a vendor’s functionality was not a priority, and even fewer reported satisfaction with self-developed tools and cost were reasons for not taking a more enterprise approach.

As advanced-user organizations replace best-of-breed technologies, though, the future is clear for enterprise revenue cycle technology adoption, KLAS stated.

Most healthcare organizations use more than one vendor for revenue cycle management technology.

According to a 2018 survey conducted by Dimensional Insight and HIMSS Analytics, almost 69 percent of healthcare organizations reported using more than one vendor solution for revenue cycle management. These respondent organizations were also more likely to have claims denial management problems.

Healthcare organizations have seemingly made little progress with consolidating revenue cycle management solutions. And another thing that appears to remain constant is the importance of the EHR.

EHR implementations may have occurred years ago, but the system is still a major investment for most providers, especially considering optimization efforts as of late. Providers continue to lean on this investment for revenue cycle management despite known gaps in financial capabilities.

But revenue cycle vendors like Change Healthcare, Experian, nThrive, and Waystar are now claiming that their technology portfolios are extensive enough to fill those gaps and they have a customer base who have already adopted a broad range of revenue cycle technology, KLAS reported.

Providers may not have adopted all functionalities their revenue cycle vendor offers yet, but high satisfaction rates and clear ROI reported by advanced users indicate a clear path for enterprise strategy implementation.