Acquisitions of Ambulatory RCM Vendors Barely Impacted Performance

The ambulatory revenue cycle management (RCM) market is evolving as vendors engage in a large volume of acquisitions, according to a new market report from KLAS.

The healthcare IT data and insights company recently analyzed ambulatory RCM companies, including major EHR vendors offering revenue cycle management capabilities and several third-party companies with solution-agnostic products.

The report titled “Ambulatory RCM Services 2020: Dynamic Market Changes and New Players” showed that ambulatory RCM vendors have undergone a significant number of acquisitions in the past couple of years, with six of the eight companies analyzed reporting an acquisition.

Past research from KLAS has shown that most acquisitions led to “a solid uptick or downturn in customer satisfaction” about 12 to 18 months after the transaction. However, acquisitions among ambulatory RCM vendors have barely impacted client experience or have improved experience.

Both EHR and third-party vendors saw similar responses from clients, with Allscripts, athenahealth, Bolder Healthcare, and R1 RCM clients reporting that the transitions they experienced were largely uneventful. Some also said the acquisition was beneficial.

R1 RCM, Bolder Healthcare, and athenahealth clients also stated in the market report that the ambulatory RCM vendors had strong partnerships. The firms were most likely to be described by customers as partners focused on client success, and clients noted that the ambulatory RCM services increased revenue efficiently. Customers also reported being able to reduce office staff as a result of the vendor’s offerings.

athenahealth won the 2020 Best in KLAS award for ambulatory RCM services. In this report, clients still reported a fairly consistent experience, with overall scores ranging from the high 70s to the low 80s out of 100 total points.

An acquisition, however, may be tied to inconsistent performance from eMDs' ambulatory RCM services. The company acquired Aprima in 2019 in a move that has resulted in significant satisfaction declines, according to KLAS.

The firm found that 80 percent of acquired clients were dissatisfied with the vendor’s services and all attributed their experience with acquisition-related problems, including issues with support, communication, executive involvement, and knowledge gaps. These issues resulted in more mistakes, as well as, lower-than-expected collections, higher A/R days, and negative impacts on patient-provider relationships.

“In light of this poor experience, many clients who used to be satisfied are now reconsidering their future plans with eMDs,” the report stated.

eMDs, CareCloud, and Greenway Health all faced a mixed bag when it came to delivering outcomes. Clients interviewed by KLAS reported that revenue cycle outcomes among the three ambulatory RCM vendors were inconsistent, with many reporting that knowledge gaps and internal staffing issues led to lost revenue.

CareCloud was acquired by MTBC, a cloud-based healthcare IT and revenue cycle management solutions vendor. The ambulatory RCM vendor announced the acquisition in January 2020.

KLAS has previously ranked CareCloud Best in KLAS for its cloud-based ambulatory RCM services for small clinics. But clients have recently reported problems with accuracy, timeliness, and account mistakes, according to the new report.

The effects of the acquisition have yet to be seen, KLAS reported.

Despite some performance issues, at least half of clients would still buy ambulatory RCM services from eMDs, CareCloud, and Greenway Health.

Overall scores for all the ambulatory RCM vendors analyzed in the KLAS report were:

• Bolder Healthcare Solutions, 93.2 points (n=7)
• R1 RCM, 90.5 points (n=16)
• Athenahealth, 83.8 points (n=20)
• Allscripts, 77.4 points (n=17)
• NextGen Healthcare, 76.5 points (n=15)
• Greenway Health, 75.2 points (n=24)
• CareCloud, 68.3 points (n=11)
• eMDs, 56.4 points (n=15)