Optum360, WayStar Named Top Revenue Cycle Management Vendors
Health systems preferred Optum360 for end-to-end healthcare revenue cycle management software and outsourcing, while physician practices favored Waystar.
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By - The eighth annual revenue cycle management technology and outsourcing solutions survey from Black Book recently uncovered the top client-rated healthcare revenue cycle management vendors for health systems, hospitals, and physician practices.
The market research company polled nearly 4,500 hospital and health system CFOs, VPs of Finance and Revenue Cycle Management (RCM), Controllers, Business Officer Managers, and other financial staff. Another 3,660 physician office business managers and 941 staff from outpatient, alternative care, clinics, IDN physician practices, and ancillary facilities also participated in the 2018 ratings.
The survey showed that providers are investing in healthcare revenue cycle management solutions as health system margins shrink to less than three percent nationwide and providers in all settings transition away from fee-for-service.
“The latest wave of challenges accompanying the shift to value-based care find most providers navigating through empowering virtual health, initiating highly patient positive experiences and sinking margins," stated Black Book's Managing Partner Doug Brown. "Revenue cycle management is now the most pressing strategic focus in health systems nationwide with system transformation vendors, solutions optimization consultants and RCM outsourcing firms in huge demand.”
Based on 18 indicators of client experience, loyalty, and customer satisfaction, the survey revealed the top-rated RCM solutions for various parts across the entire healthcare revenue cycle.
In terms of end-to-end revenue cycle management software, health systems and large hospital chains preferred Optum360, followed by Waystar, Change Healthcare, Recondo, and Conifer.
Health systems named Optum360 as their top end-to-end revenue cycle management software solution for the second year in a row.
Waystar and Optum360 also took top spots for hospitals with 101 to 200 beds, while small hospitals favored the RCM software from Trubridge and large hospitals ranked Change Healthcare as number one.
Physician practices and groups rated Waystar as their top RCM software vendor, followed by Change Healthcare, Allscripts, Cerner RevWorks, and athenaCollect.
Optum360 was also the highest ranked revenue cycle management outsourcing solution for health systems and large hospital chains shifting their financial and business functions outside of their organizations.
However, top revenue cycle outsourcing solutions was a mixed bag for standalone hospitals and physician practices.
Small hospitals identified Trubridge as their top outsourcing solution, while medium-sized hospitals preferred Gebbs and large hospitals liked Cognizant Trizetto.
R1 RCM was the highest rated end-to-end RCM outsourcing solution among physician practices and groups.
Additionally, the survey found the highest ranked vendors for other parts of the healthcare revenue cycle, including patient payments, provider contract management, and claims and denials management. Notable rankings included:
- Patient payment solutions: InstaMed
- Complex claims solutions: Cognizant Bolder
- Patient access solutions: Recondo Technology
- Hospital claims and denials management: Experian Health
- Physician claims clearinghouse: Cognizant Trizetto
- Patient payment analytics: RevSpring
- Provider contract management systems: nThrive
- Revenue recovery solutions: Revint Solutions
- RCM optimization consultants: Hayes Management Consulting
- RCM business intelligence and decision support: Dimension Insight
Provider organizations of all sizes are seeking healthcare revenue cycle management solutions to optimize all parts of their financial and business processes.
Revenue cycle management optimization was a top priority for hospitals, according to a September 2017 Black Book survey. Almost three-quarters of struggling hospitals prioritized revenue cycle management over other initiatives key to the value-based reimbursement transition, including population health, data analytics, and patient engagement.
The hospital and physician practice leaders surveyed said they planned to allocate 2018 capital resources for revenue cycle management upgrades, including dashboards, data analytics, and business intelligence solutions.
Revenue cycle management optimization investments are likely to continue well into the near future as provider organizations face more competition, greater patient financial responsibility, and a shifting healthcare environment.
“Healthcare providers will have no choice but to evaluate and optimize their solutions end-to-end in a future state that leverages analytics and enhanced connectivity with payers, all keeping pace with the advances in healthcare technology,” Black Book’s Brown stated in 2017.
