KLAS: 7 Healthcare Revenue Cycle “Unicorns” Disrupting the Market

December 13, 2019 - Provider organizations have many options when it comes to selecting a healthcare revenue cycle management solution. The market for such technology is rapidly growing, but some vendors are standing out for their unique approach to tackling revenue cycle management challenges, KLAS recently reported.

In a new report, the research foundation used a different strategy for examining healthcare revenue cycle technologies, opting to look at solutions that don’t fit into the traditional healthcare revenue cycle management market segment.

“The healthcare revenue cycle is a notoriously treacherous, high-stakes journey, and provider organizations who don’t have the right tools in hand are likely to get held up fighting high costs and lost revenue,” the report stated. “While KLAS has done extensive research in the past on revenue cycle solutions, this report focuses on the solutions that take a more unique approach to tackling revenue cycle issues—in other words, revenue cycle “unicorns.’”

Revenue cycle unicorns are vendors that do not align with the traditional healthcare revenue cycle management market, lack direct competitors, or are potentially disruptive to the normal way of doing business, KLAS explained.

Researchers from KLAS identified seven such unicorns in the market today, categorizing by what the solutions address.

Broad revenue cycle management solutions

READ MORE: After EHR Adoption, Revenue Cycle Technology Modernization Begins

Of the seven revenue cycle unicorns analyzed in the report, three were considered broad healthcare revenue cycle management solutions, meaning the solutions addressed front, middle, and back-end components of the revenue cycle.

The first identified by KLAS was MedeAnalytics’ Revenue Cycle Management product, which offered revenue cycle-specific business intelligence and analytics. The solution was one of the more widely used revenue cycle unicorns, with over 100 customers comprising the live customer base. Customers told KLAS that they valued the relationships the vendor fostered with clients and the new software-as-a-service offering, but the vendor could work on reducing complex functionality. The solution received an overall score distribution of 82.6 out of 100 points.

Olive’s OliveWorks solution also ranked on KLAS’ list of revenue cycle unicorns in 2019 for its automation of manual revenue cycle tasks. The small live customer base, which totaled less than 51 customers according to KLAS, helped to redirect full-time equivalents (FTEs) to more complex work. However, customers also reported system design and implementation challenges. Despite the hardships, the tool an overall score distribution of 90.9 points based on the limit data researchers had.

The final broad solution making the list this year was Vyne Medical’s Trace platform. Trace’s large live customer base of over 101 customers leverages the solution to centralize the management of healthcare communications, including voice, fax, and image. Customers complained about some functionality issues, such as reporting and integration. But they liked the tool’s ability to aggregate information and communication, including insights on payers, which helped the organizations reduce denials. The overall score distribution for this solution was 90.1 points.

Niche revenue cycle management solutions

Four of the revenue cycle unicorns identified by KLAS were considered niche solutions that target a specific part of the revenue cycle.

READ MORE: Patient Financial Experience the New Focus for Revenue Cycle Tech

Imprivata’s PatientSecure product, for example, made the list of unicorns in 2019 for its front-end solution to biometric positive patient identification. The technology had a small live customer base that gave the solution 87.6 points for an overall score distribution. The score reflected the solution’s ability to reduce time and increase security for registration, which was a plus according to customers. However, some clients criticized the solution for its misaligned expectations related to functionality and capabilities (e.g., scheduling identification, reporting).

The remaining three niche solutions in the report focused on back-end revenue cycle tasks. One of those solutions was Artiva HC from Ontario Solutions. The solution was recognized for its collections workflow automation, which customers said helped streamline payment and service calls and customize messages for patients. Although, the solution could benefit from improving training quality and resources, according to some of the live customer base, which KLAS estimated to be under 51 customers. The solution earned 87.2 points in overall score distribution based on limited data.

Recondo Technology’s ClaimStatusPlus was also examined by KLAS. Researchers stated that the technology automated claims statusing and prioritization for it’s small live customer base. Based on limited data, the solution earned an overall score distribution of 85.9 points. Customers commended the solution’s functionality, which helped to streamline denials workflows and reduce manual work. But some clients did not feel the vendor had strong project managers, which diminished the product’s value.

Finally, KLAS identified TransUnion Healthcare’s eSCAN as a revenue cycle unicorn in 2019. The solution provided post-service insurance discovery through data mining to a live customer base between 51 and 100 customers this year. Customers told KLAS the solution significantly increased revenue, but still had manual reporting and lacked system development. Overall, the solutions earned a score distribution of 87.8 points.