2014 black book hospital revenue cycle management...

BLACK BOOK™ TOP HOSPITAL REVENUE CYCLE MANAGEMENT & ANALYTICS OUTSOURCING VENDORS Published November 2014

© 2014 Black Book Rankings LLC. This report is a licensed product. Do not duplicate or distribute without permission.

BLACK BOOK RANKINGS 2014 USER SURVEY

Top Outsourcing Vendors

Revenue Cycle Management & Analytics

Community Hospitals and

Academic Medical Centers Over 200 Beds

Includes Proprietary/Investor Chain Facilities and Non-Profit System Hospitals over 200 Beds Contracting as Individual Business Units



Black Book™ annually evaluates leading health care/medical software and outsourcing service providers across 18

operational excellence key performance indicators completely from the perspective of the client experience.

Independent and unbiased from vendor influence, more than 428,000 healthcare IT users are invited to contribute to

various annual customer satisfaction polls. Suppliers also encourage their clients to participate to produce current and

objective customer service data for buyers, analysts, investors, consultants, competitive suppliers and the media. For

more information or to order customized research results, please contact the Client Resource Center at +1 800 863 7590

or [email protected]

© 2014 Black Book Market Research LLC All Rights Reserved.

Reproduction of this publication in any form without prior written permission is forbidden. The information contained

herein has been obtained from sources believed to be reliable. Brown-Wilson Group, Inc. the parent corporation of Black

Book™, Black Book Rankings LLC, Black Book Market Research LLC, and The Black Book of Outsourcing®, disclaims

all warranties as to the accuracy, completeness or adequacy of such information. Brown-Wilson Group shall have no

liability for errors, omissions or inadequacies in the information contained herein or for interpretations thereof. The reader

assumes sole responsibility for the selection of these materials to achieve its intended results. The opinions expressed

herein are subject to change without notice. Brown-Wilson Group's unrivaled objectivity and credibility is perhaps your

greatest assurance. At a time when alliances between major consultancies and suppliers have clouded the landscape,

Brown-Wilson Group remains resolutely independent. We have no incentive to recommend specific software or

outsourcing services vendors. Our only allegiance is to help you achieve the results you want with the best possible

solution.

For more information, visit www.BlackBookMarketResearch.com

mailto:[email protected]

2014 Black Book Hospital Revenue Cycle Management Outsourcing Top Vendors Report



TABLE OF CONTENTS

2014 BLACK BOOK™ HOSPITAL REVENUE CYCLE OUTSOURCING SURVEY OVERVIEW 5-14

INTRODUCTION 5

KEY FINDINGS

SURVEY OVERVIEW

BLACK BOOK METHODOLOGY 15

HOW THE DATA SETS ARE COLLECTED

UNDERSTANDING THE STATISTICAL CONFIDENCE OF BLACK BOOK DATA

WHO PARTICIPATES IN THE BLACK BOOK RANKING PROCESS

COMPARATIVE VENDOR ANALYSIS

TOP 20 HOSPITAL REVENUE CYCLE MANAGEMENT OUTSOURCING VENDORS 15

TOP #1 HOSPITAL RCM VENDOR OVERALL, TOP VENDORS BY FOUR FUNCTIONAL SUBSETS

TOP 20 HOSPITAL RCM VENDORS, RANKED LIST 1 THROUGH 20

STOP LIGHT SCORING KEY 17

OVERALL KPI LEADERS 21

SUMMARY OF CRITERIA OUTCOMES

TOP SCORE PER INDIVIDUAL CRITERIA

INDIVIDUAL KEY PERFORMANCE

TABLE OF FIGURES

Figure 1: Comprehensive Hospital RCM vendors defined

Figure 2: Key to raw scores

Figure 3: Color-coded stop light dashboard scoring key

Figure 4: Raw score compilation and scale of reference

Figure 5: Scoring key




TABLE OF TABLES

Table 1: Top 20 Hospital Revenue Cycle Management Outsourcing Vendors 2014

Table 2: Summary of criteria outcomes

Table 3: Top score per individual criteria

Tables of Individual Key Performance Indicator, Top Ten Highest Mean by KPI 24

Table 4: Vendor overall preference/vertical industry recommendations

Table 5: Innovation

Table 6: Training

Table 7: Client relationships and cultural fit

Table 8: Trust, Accountability and Transparency

Table 9: Breadth of offerings, client types, delivery excellence

Table 10: Deployment and outsourcing implementation

Table 11: Customization

Table 12: Integration and interfaces

Table 13: Scalability, client adaptability, flexible pricing

Table 14: Compensation and employee performance

Table 15: Reliability

Table 16: Brand image and marketing communications

Table 17: Marginal value adds

Table 18: Viability, Managerial Stability

Table 19: Data security and backup services

Table 20: Support and customer care

Table 21: Best of breed technology and process improvement




PART ONE INTRODUCTION

Black Book™ gathers insights via an interactive online survey and related telephone discussions and follow-up

polling. The result is intended to serve as an annual barometer of the IT client satisfaction and managed

services experience of medical groups, hospitals, clinicians, physicians, administrators, financial officers and

technology professionals in the healthcare industry.

The largest user opinion poll of its kind in healthcare Black Book collects over a half million viewpoints on

information technology vendor performance annually. In this segmented survey of healthcare financial leaders,

over 8,000 respective administrative/financial/technology support staff of hospitals and physician practices

contributed their perceptions to Black Book™ between April 2014 and November 2014 to measure outcomes

and performance in the Revenue Cycle Management, Patient Accounting, HIS/CIS and Electronic Health

Record technology continuum.

In a series of four research segments on the 2014 State of the Revenue Cycle Management industry, Black

Book™ is releasing comprehensive findings of users on the trends and directions of hospitals and physician

practices, as well as the top ranked vendors in customer satisfaction and client experience.

Included in the 2014 Black Book™ Revenue Cycle Management survey sets released in October/November

are:

Physician Integrated EHR/Practice Management/Revenue Cycle Management Software - (1) Physician

Practices Seamless PM/RCM/EHR Software

Hospital Revenue Cycle Management Software - (2) Large Hospital and Academic Medical Center RCM

Software; (3) Small and Community Hospital RCM Software; (4) Hospital Chains/System IDN and ACO RCM

Software

Outsourcing RCM Services – (5) RCM Outsourcing in Hospital Systems/IDNs/Systems/Chains and RCM

Outsourcing in Large Hospitals/Academic Medical Centers/Faculty Practices & Clinics over 200 Beds; (6) RCM

Outsourcing in Community Hospitals 100-200Beds and RCM Outsourcing in Small/Rural Hospitals under 100

Beds, and (7) RCM Outsourcing for Physician Groups

Revenue Cycle Consultants and Transformation Experts – (8) RCM Consultants

STATE OF HOSPITAL REVENUE CYCLE INNOVATION

Revenue cycle management (RCM) is the life force of any hospital, private or nonprofit. Effective patient registration, insurance and benefit verification, charge capture, and claims processing are essential to maintaining viability.

In a marketplace of several hundred core and niche Revenue cycle management (RCM) vendors, Black Book survey respondent’s evaluated 130 outsourcing services /solutions. Many vendors offer both software and outsourced business services, while some only focus on one specialty. This report’s vendor results center on hospitals and outsourced solutions only.

RCM software applications are usually characterized in two segments

- Core, Platform and/or Point Solutions - Bolt-on Solutions (providing added functionality to core solutions)




The current penetration of RCM solutions for inpatient medical/surgical hospital environment varies by type of application. Software applications and outsourcing services needed for the core functions of patient registration, scheduling, billing, coding, and claims processing are adopted in 100% of hospitals today, while other RCM applications are less penetrated or significantly vary in penetration across various types of hospitals.

Difficulty in Finding Skilled RCM Human Resources for New RCM Software/Reimbursement Challenges

HOSPITAL SIZE

CFO/Finance Director/ Business Office Management

Foresees Staffing Issues with new RCM implementation

Small/Rural Hospitals under 100 Beds 83%

Community Hospitals 101-200Beds 66%

Large Hospitals & Academic Medical Centers over 200Beds 40%

Hospital Chain, Systems, Shared Services, Networks and ACOs 24%

Staffing Concerns make Outsourcing core or bolt-on RCM services a better short term alternative to Software Implementations

HOSPITAL SIZE

CFO/Business Office Manager

Agrees/YES

Small/Rural Hospitals under 100 Beds 69%

Community Hospitals 101-200Beds 41%

Large Hospitals & Academic Medical Centers over 200Beds 15%

Hospital Chain, Systems, Shared Services, Networks and ACOs 10%

What is your facilities top-related technology issue impacting total organizational revenue?

HOSPITAL SIZE

ICD-10 Coding

EHR & Clinical

Integrations

Billing & Claims

Contractual Analysis

Interoperability

Small/Rural Hospitals 35% 36% 21% 5% 3%

Community Hospitals 27% 25% 14% 28% 6%

Large Hospitals 6% 13% 4% 46% 31%

Hospital Chain, Systems 7% 12% 7% 42% 32%

Which scenario best describes your hospital’s short term (2014-2016) RCM strategy for software versus outsourcing acquisition

HOSPITAL SIZE

One Core Legacy RCM Vendor

Solution

Seamless Array of Core and Bolt-on RCM Solutions

Outsourcing either End-to-End or

Partial Segments

Small/Rural Hospitals 4% 20% 65%

Community Hospitals 7% 29% 52%

Large Hospitals 6% 56% 37%




Roughly two-thirds (3,000 of all US hospitals) predicting in 2012 that they would replace their core RCM solution have failed to initiate a sustainable RCM plan as of January 2014. The stalled strategy and or vendor selection process was stuck in an otherwise do nothing/status quo or autopilot stage. Myopic task forces on ICD-10 coding, physician practice EHR integration, siloed EHRs, lack of connectivity, poor interfaces and insurance verification/eligibility issues had taken priority over comprehensive RCM solution strategies, claimed 28% of hospital CFOs. Once functioning well among small hospitals and community facilities, the now under-optimal core legacy systems needed to be bolstered bolt on RCM solutions. Then the EHR marketplace additionally complicated some clinical information integrations and offered very limited financial decision support.

Small and community hospitals under 200beds particularly braced for the impact of operating at a fiscal loss with inpatient revenues decreasing and costs rising, including the implementation costs of electronic health record implementations.

Technologically advanced academic medical centers, larger inpatient facilities, hospital systems and chains, ACO organizations, and affiliated provider networks are also supporting and growing the Bolt on market products, particularly eligibility and analytics, as they have adapted RCM strategies to value based reimbursement and complex contractual agreements with payers.

51% of hospitals under 200beds are delaying making an RCM transformation program functional until after 2015 coding transitions are complete and meaningful use checks are cashed. 65% of large hospital considering RCM transformation initiatives expect to execute their plans before October 2015.

82% of hospital financial executives in hospitals under 200beds are concerned that neglected RCM transformations by Q1 2016 will likely cease to operate, as insurers move to pay for quality not services from a system that thrived on sickness to one that rewards wellness and health. 95% of those respondents worry it will likely cost them their CFO jobs.

69% of CFOs in hospitals under 100 beds expect their RCM strategy will be selected solely on their CIS vendor relationship, compared to 15% of CFOs in larger facilities.

Hospital CFOs and CIOs are at odds with the prioritization of RCM above all other technology spends in 2015, as was the case in 2013 and 2014. Although 74% of CIOs and 91% of CFOs agree current RCMs need to be replaced, the project implementation acquisition, timing and urgency differ.

CFOs and CIOs also are polarizing on the organizational preference to manage fewer vendors and favor single-source clinical and financial software vendors. In a boomerang shift starting from a 2010 Black Book survey, 85% of CFOs were amenable to implementing a single source software vendor following the direction of the hospital’s clinical information system selection committee. The general sentiment of 77% of CFO’s in 2013 was they could make any RCM solution work if the hospital’s clinical staff was satisfied with the health care delivery element of the system.

However, in the Black Book survey ending in November 2014 of the same topic, only 6% of CFOs want their RCM system or services decisions driven by other hospital leaders including CIOs and/or clinicians. Even in small hospitals under 100 beds, 97% of CFOs have strong preference for a best in breed RCM vendor, regardless of the hospital’s single-source enterprise strategy, which is overwhelmingly driven by the established or new choice of the clinical system vendor.

CFOs (76%) in a pre-purchase mode of RCM claim to be biased towards bolt-on functionalities that have a higher probability of delivering high results to hospital and its bottom line.

Enterprise integration with an incumbent clinical system is no longer the biggest motivator when making an RCM vendor selection, except in hospitals under 100 beds, according to 70% of CFOs. Narrowing margins and escalating costs, drops in Medicare, Medicaid and commercial reimbursements are forcing executives to collaborate across agendas to increase efficiencies and automate to save the bottom line. Hospital budgets are




already struggling with decreased reimbursements have the demand of purchasing or upgrading integrated RCM and clinical software.

OTHER KEY CFO FINDINGS Q3 2014

47% of hospital (under 200 beds) CFOs do not intend to let the facility’s legacy clinical system have bearing on their RCM decision, compared to 93% of large hospital CFOs.

80% feel the pressure to make a RCM decision is actually a threat to their job stability.

28% feel they will lose their jobs in 2016 regardless of the RCM choices they make in 2014.

87% of small and community hospitals anticipate declining-to-negative profitability in 2015 due to diminishing

reimbursements, unrecovered collections, and underutilized or inefficient billing and records technology.

90% of CFOs fear that the ramifications of their outdated and/or auto-piloted revenue cycle management

systems, particularly those not integrated to other systems will force the hospital to outsource the entire

business office function, end-to-end, or purchase a new “next generation” RCM solution by 2016.

94% of small and community hospitals integrating recently acquired (independent) physician practices find the

RCM systems in those medical offices obsolete or dysfunction for current patient financial processes with the

hospital.

81% of Hospital CFOs consider outsourcing to be the best stop gap measure until new RCM software is

afforded and installed

71% of Hospital CFOs consider end-to-end RCM outsourcing to be the best solution until after value-based

payment models are better established.

62% of small and community hospitals are considering using a Consultant to assist in integrations, vendor

selections, outsourcing determinations, and total transformations or new RCM product implementations.

However, 83% of hospital CFOs considering RCM consulting advice report delays and/or difficultly in securing

RCM consulting engagements with the top rated firms based on current demand.

69% of hospitals under 200 beds are considering a combination of new software and outsourcing services to

improve their RCM systems before ICD-10 launches.90% of hospitals with more than 200 beds anticipate

supplementing their existing RCM software with outsourcing services in Q1 2015.




HOSPITALS CONFIRMING RCM SYSTEM REPLACEMENT ACTIVITIES

(CHANGE WITHIN NEXT 24 MONTHS) HOSPITALS OVER 200 BEDS

Primary Three Goals of Hospital acquiring new RCM Software and/or Outsourcing Services

2012-2014 Strongly Prefer

2014-2016 Strongly Prefer

Upgrade RCM Software Solution only, End-to-end and/or Bolt-on solutions

55%

35%

Upgrade RCM/EHR Collectively

8%

10%

Outsource RCM (Full Enterprise)

16%

46%

Part RCM Software Upgrade/Some Outsourcing

80%

82%

Seamless RCM/Clinical Information System

79%

40%

Prefer One Vendor for RCM/CIS-HIS Solution

4%

1%

Vetting a RCM solution is extremely complex as many hospitals have discovered that after purchasing a

solution set, they are unable to do much of what was promised and even less has been delivered. The lagging

legacy vendors are mainly built to compliance specifications and providers are finding these are completely

unusable for a hospital with variable census and payer mix.

NEW RCM SOFTWARE ACQUISITIONS (IMPLEMENTED IN LAST 12-18 MONTHS)

Situation/Insight

After 6 months

After 12 Months

After 18 Months

Still in New User Survival Mode

60%

13%

8%

Cannot customize due to staffing issues/turnover

53%

9%

12%

Will not maximize RCM software (ever)

92%

80%

25%

Cannot integrate network practice technologies

64%

48%

55%

Limited data building and underutilized features

92%

84%

81%

Mastered basic and intermediate tasks so that return on investment is being realized

64%

87%

97%

Capabilities and expertise of system and staff have made tangible financial impacts

12%

51%

79%




IMMEDIATE IMPROVEMENTS TO HOSPITAL REALIZED AFTER RCM IMPLEMENTATION

& TRANSFORMATION INITATIVES

Source: Black Book™

Select Six or Less of the Top Improvements Noted after RCM Transformation Activities

NEW RCM

SOFTWARE IMPLEMENTED

NEW RCM

OUTSOURCING SERVICES

Productivity & Re-balanced Workflows

85%

25%

EHR Charge Sweeps & Reconciliation

93%

49%

Accurate and Actionable Daily Reports

89%

80%

Payment Resolution

89%

81%

Filing Insurance Claims (Primary & Secondary)

88%

92%

Resolve Rejections

80%

79%

Post Payments

90%

72%

Perform Collections

62%

95%

Follow up on Appeals and Denials

71%

83%

Perform Audits A/R & Charge Lags

91%

98%

Review payer denials and rejections

32%

57%

Improve Coding and Compliance

73%

89%




RCM OUTSOURCING VENDOR SATISFACTION BY HOSPITAL (BED) SIZE

Community hospitals (101-200beds) report highest satisfaction and ROI from legacy system RCM

implementations within the past twelve months. Academic medical centers are the least satisfied with recent

RCM software implementations. Complex system vendors, typically in use at large hospitals and academic

medical centers over 400 beds, hospital systems, IDNs, CINs, chains, clinics and groups use more bolt-on RCM

vendors with greatest satisfaction. End-to-end outsourcers Conifer, Parallon and Optum ranked as the top three

service vendors across all inpatient settings.

INDUSTRY EVOLUTION TO END-TO-END RCM OUTSOURCING VENDORS TOP TEN OFFERINGS TO ALL HOSPITAL GROUPS/SYSTEMS/NETWORKS RESPONDING

2014 RCM OUTSOURCER

HOSPITAL & STANDARDIZED FACILITIIES

OUTSOURCED RCM SOLUTIONS

COMPLEX PROVIDER NETWORK OUTSOURCED RCM SOLUTIONS

Small & Rural

Hospitals

(100 Beds or Less)

Community Hospitals

(101-200Beds)

Large Hospitals

& Academic Medical Centers

(200+ Beds)

Hospital

Systems & Proprietary

Chains, IDNs and ACOs

CONIFER HEALTH

A

A

A

A

PARALLON

A

A

A

A

OPTUM

A

A

B

A

CONVERGENT

A

B

B

B

EMDEON

C

B

A

A

XTEND

C

A

A

B

MCKESSON RELAYHEALTH

C

A

A

C

MEDASSIST FIRSTSOURCE

B

B

B

B

HBCSI

C

B

C

B

MEDASSETS

B

‘ B

B

B





KEY: A = 90%+ SATISFACTION RATING B = 80%-90% SATISFACTION C = 70%-80% SATISFACTION

TOP 20

COMMUNITY & LARGE HOSPITALS OVER 200 BEDS

OUTSOURCING VENDORS: REVENUE CYCLE MANAGEMENT & ANALYTICS


2014 Rank by User

Satisfaction/ Client Experience

Hospital Revenue Cycle Management & Analytics Outsourcing Services RCM Vendor

1 CONIFER HEALTH

2 OPTUM

3 PARALLON

4 CONVERGENT

5 EMDEON

6 XTEND

7 MCKESSON RELAYHEALTH

8 MEDASSIST FIRSTSOURCE

9 HBCS

10 MEDASSETS

11 CITADEL

12 BANCTEC

13 GEBBS

14 MEDSYNERGIES

15 CCI INC

16 CARDON OUTREACH

17 ADVANT EDGE

18 NCO GROUP

19 EXPERIAN

20 CYMETRIX





User Reasons for Revenue Cycle Management highest vendor satisfaction rates 2014 Implementations Clients select top five that apply to their respective vendor performance and relationships

ACO development & Payment Reform Preparations 90.1%

Analytics and Business Decision Support

Seamless EHR Integration

90.0%

75.3%

Demonstrated cost savings & ROI

74.8%

Improved charge/reimbursement execution & coding 72.9%

Continuous productivity improvements 15.2%

Innovation in reimbursement capabilities 14.5%

Clinician (physician and nursing) satisfaction 14.0%

Ongoing flexibility to adapt 12.1%

Customization, disparate systems issues resolved

10.4%

Vendor Responsiveness to users 8.2%




SURVEY PARTICIPATION: RCM

This segment of the Black Book™ Revenue Cycle Management Software and Outsourcing survey for hospitals

included insights from 2,246 users from 590 hospitals. Each survey pool was collected across three separate

polls in April and July and November 2014.

Respondent Title

Respondents

CEO or Corporate Officer 75

CFO or Finance Director/Manager 885

CIO or IT Director/Manager 440

Business Office Supervisor 605

Business Office Staff (Representative for Management) 106

Physician 20

Nurse or Clinician 54

Other 61

TOTAL 2246

Hospital Respondent Title

Percent of RCM PM Survey Participation Pool 2014

CEO or Administrator or Corporate Officer 3%

CFO or Finance Director/Manager, System or Facility 39%

CIO or IT Director/Manager 20%

Business Office or Billing Manager/Staff including Corporate Staff 32%

Physician 1%

Nurse/Clinician or Other 2%




2014 BLACK BOOK™ METHODOLOGY

How the data sets are collected

Black Book collects ballot results on 18 performance areas of operational excellence to rank vendors by electronic medical and health

record product lines. The gathered data are subjected immediately to an internal and external audit to verify completeness and accuracy

and to make sure the respondent is valid while ensuring that the anonymity of the client company is maintained. During the audit, each

data set is reviewed by a Brown-Wilson executive and at least two other people. In this way, Black Book's clients are able to clearly see

how a vendor is truly performing. The 18 criteria on operational excellence are subdivided by the client's industry, market size, geography

and functions outsourced, and are reported accordingly.

Situational and market studies are conducted on areas of high interest such as e-Prescribing, Health information Exchange, Accountable

Care organization, hospital software, services providers, educational providers in e-health, benchmarkers and advisors. These specific

survey areas range from four to 20 questions of criteria each.

Understanding the statistical confidence of Black Book data

Statistical confidence for each performance rating is based upon the number of organizations scoring the electronic medical and health

records service. Black Book identifies data confidence by one of several means:

Top-10-ranked vendors must have a minimum of 10 unique clients represented. Broad categories require a minimum of

20 unique client ballots. Data that are asterisked (*) represent a sample size below required limits and are intended to be

used for tracking purposes only, not ranking purposes. Performance data for an asterisked vendor's services can vary

widely until a larger sample size is achieved. The margin of error can be very large and the reader is responsible for

considering the possible current and future variation (margin of error) in the Black Book performance score reported.

Vendors with more than 20 unique client votes are eligible for top 10 rankings and are assured to have highest

confidence and lowest variation. Confidence increases as more organizations report on their outsourcing vendor. Data

reported in this form are shown with a 95% confidence level (within a margin of 0.25, 0.20 or 0.15, respectively).

Raw numbers include the quantity of completed surveys and the number of unique organizations contributing the data for

the survey pool of interest.

Who participates in the Black Book Ranking Process?

More than 428,000 hospital leaders and other users ranking from system executives, clinicians, IT specialists and front-line implementation

veterans are invited to participate in the 2013 annual Black Book EMR EHR e-Health initiative satisfaction survey. Non-invitation receiving

participants must complete a verifiable profile, utilize a valid corporate email address and are then included as well. The Black Book

survey web instrument is open to respondents and new participants periodically for several surveys at http://blackbookrankings.com, http://

blackbookmarketresearch.com and http://blackbookpolls.com Only one ballot per corporate email address is permitted and changes of

ballots during the open polling period require a formal email request process to ensure integrity. Follow up RCM surveys were conducted

from August 1 to October 15 to analyze the replacement market phenomenon within the RCM marketplace. Additionally, from April 15 to

July 31 to collect data on Revenue Cycle Management solution satisfaction including Physician Practice Management applications,

services and initiatives.

Hospital Revenue Cycle Management outsourcing vendor rankings and results – 2014

2,246 qualified users of systems with validated corporate/valid email addresses ranked 105 RCM software solution, technology and

outsourcing services suppliers offering individual or bundled arrangements as part of the Black Book annual survey, which was conducted

http://blackbookrankings.com/

http://blackbookpolls.com/




via web survey instruments. Additionally 2,440 users answered questions about budgeting, vendor familiarity and vendor selection

processes. The four most highly utilized systems of RCM solutions are included as subsets. 2055 replacement market prospective RCM

buyers took part in the follow up 2014 survey.

1,829 Physician Practices, Groups and Clinics (staffers and clinicians) also submitted satisfaction ballots to rank and report client

experience among practice management and revenue cycle management software and services vendors. 590 inpatient hospitals in total

participated in the 2014 RCM vendor review process.

Stop Light Scoring Key

TOP BLACK BOOK™ REVENUE CYCLE MANAGEMENT OUTSOURCING VENDOR


STOP LIGHT SCORING KEY

Figure 1: Comprehensive Hospital Revenue Cycle Management & Analytics vendors are defined as being comprised of four surveyed

functions

BILLING, CHARGE CAPTURE, CODING

CLAIMS MANAGEMENT

REIMBURSEMENT, INSURANCE/

PAYOR MANAGEMENT

PAYMENT, RESOLUTION & COLLECTIONS






Source: Black Book Rankings


Figure 3: Color-coded stoplight dashboard scoring key

Green (top 10%) scores better than 90% of RCM vendors. Green coded vendors have received constantly highest client satisfaction scores.

8.71 +

Clear (top 33%) scores better than 67% of RCM vendors. Well-scored vendor which have middle of the pack results.

7.33 to 8.70

Yellow scores better than half of RCM vendors. Cautionary performance scores, areas of improvement required.

5.80 to 7.32

Red scores worse than 66% of RCM vendors. Poor performances reported potential cause for service and contractual cancellations.

Less than 5.79

0.00–5.79 ►

◄ 5.80–7.32 ►

◄ 7.33–8.70 ►

◄ 8.71–10.00

Deal breaking dissatisfaction

Does not meet expectations

Cannot recommend vendor

Neutral

Meets/does not meet expectations

consistently

Would not likely recommend vendor

Satisfactory performance

Meets expectations

Recommends

vendor

Overwhelming satisfaction

Exceeds expectations

Highly recommended vendor






Black Book raw score scales

0 = Deal breaking dissatisfaction ◄ ► 10 = Exceeds all expectations


Individual vendors can be examined by specific indicators on each of the main functions of EHR PM/RCM as well as grouped and summarized subsets. Detail of each subset is

contained so that each EHR PM/RCM vendor may be analyzed by function and end-to-end EHR PM/RCM services collectively.

Overall KPI Leaders



Figure 5: Scoring Key


Overall rank – this rank references the final

position of all 18 criteria averaged by the mean

score collectively. This vendor ranked fifth of the

20 competitors.

Criteria rank – refers to the number of the

question or criteria surveyed. This is the sixth

question of the 18 criteria of which this vendor

ranked first of the 20 vendors analyzed

positioned only on this particular criteria or

question.

Company – name of the Hospital Revenue Cycle Management Outsourcing Solutions vendor (sample name).

Subsections – each subset comprises one-

fourth of the total RCM vendor mean at the end

of this row, and includes all buyers and users

who indicate that they contract each respective

service subsection with the supplier, specific to

their enterprise.

Mean – congruent with the criteria rank, the

mean is a calculation of all four subsets of RCM

functions surveyed. As a final ranking reference,

it includes all vertical industries, market sizes and

geographies.

OVERALL RANK

Q6 CRITERIA RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS MANAGEMENT

REIMBURSEMENT, INSURANCE/PAYOR

MGMT

PAYMENT, RESOLUTION

& COLLECTIONS

MEAN

5 1

HOSPITAL RCM

OUTSOURCING CORPORATION

9.02 7.56 5.59 5.82 7.00

2014 Black Book™ Top 20 Outsourcing Vendors

Hospital Revenue Cycle Management & Analytics


OVERALL KEY PERFORMANCE INDICATOR LEADERS

OUTSOURCED HOSPITAL REVENUE CYCLE MANAGEMENT & ANALYTICS

SUMMARY OF CRITERIA OUTCOMES:

LARGE AND COMMUNITY HOSPITALS OVER 200 BEDS

RCM Table 1: Summary of criteria outcomes, HOSPITAL RCM OUTSOURCING VENDORS

Total number one criteria ranks Vendor Overall rank

12 CONIFER HEALTH 1

3 OPTUM 3

1 CONVERGENT 4

1 EMDEON 5

1 XTEND 6





TOP SCORE PER INDIVIDUAL CRITERIA: HOSPITAL SYSTEMS/CHAINS IDNS ACOS REVENUE CYCLE MANAGEMENT OUTSOURCING

Criteria RCM Vendor Overall Rank

Vendor overall preference/vertical industry recommendations

CONIFER HEALTH 1

Innovation, Risk Models

CONIFER HEALTH 1

Training

CONIFER HEALTH 1

Client relationships and cultural fit

CONIFER HEALTH 1

Trust, Transparency, Accountability

OPTUM 3

Breadth of offerings, client types, delivery excellence

CONIFER HEALTH 1

Deployment and outsourcing implementation

OPTUM 2

Customization

EMDEON 5

Integration and interfaces

XTEND 6

Scalability, client adaptability, flexible pricing

OPTUM 3

Compensation and employee performance

CONVERGENT 4

Reliability

CONIFER HEALTH 1

Brand image and marketing communications

CONIFER HEALTH 1

Marginal value adds

CONIFER HEALTH 1

Viability, Managerial Stability

CONIFER HEALTH 1

Data security and backup services

CONIFER HEALTH 1

Support and customer care

CONIFER HEALTH 1

Best of breed technology and process improvement

CONIFER HEALTH 1





PART TWO: RANKED RCM OUTSOURCING VENDOR PERFORMNCE

2014 INDIVIDUAL KEY PERFORMANCE:

REVENUE CYCLE MANAGEMENT & ANALYTICS SOLUTIONS

LARGE AND COMMUNITY HOSPITALS (OVER OVER 200 BEDS)

Individual Key Performance: 200+ BEDS

REVENUE CYCLE MANAGEMENT OUTSOURCING

Published November 2014

© 2014 Black Book Rankings LLC. This report is a licensed product and requires permission to distribute and/or duplicate.

2014 Rank

OUTSOURCED RCM VENDOR

Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8 Q9 Q10 Q11 Q12 Q13 Q14 Q15 Q16 Q17 Q18 MEAN

1 CONIFER 9.80 9.76 9.39 9.52 9.51 9.71 9.48 8.98 9.49 9.31 8.96 9.58 9.92 9.62 9.38 9.58 9.66 9.65 9.52

2 PARALLON 9.35 9.52 8.96 9.42 8.41 8.79 9.54 9.16 9.24 9.08 9.10 9.11 8.57 9.19 9.21 9.20 9.52 9.14 9.14

2 OPTUM 9.36 9.75 8.97 9.44 9.52 9.25 9.10 8.57 9.56 9.71 8.95 8.66 9.08 8.82 8.44 9.33 8.83 9.20 9.14

4 CONVERGENT 9.19 9.28 8.46 9.37 9.35 8.63 9.35 8.87 8.98 9.21 9.43 8.65 8.90 9.05 9.23 8.88 9.07 9.10 9.06

5 EMDEON 9.25 9.43 8.72 8.46 8.93 8.89 8.92 9.50 8.64 9.16 8.86 8.83 8.84 8.01 8.30 9.40 8.34 9.14 8.87

6 XTEND 8.93 8.15 9.33 9.03 7.79 8.38 8.05 8.97 9.58 8.11 8.35 8.12 9.22 9.14 9.00 9.14 9.23 9.11 8.76

7 MCKESSON 9.59 8.65 8.99 7.89 8.94 9.10 8.71 8.32 8.47 7.55 7.79 8.69 9.00 8.18 8.92 8.67 8.15 8.67 8.57

8 MEDASSIST 8.65 8.35 8.28 7.80 8.81 9.34 8.39 7.86 9.08 7.64 8.24 7.95 8.07 8.87 7.73 8.12 8.75 8.40 8.35

9 HBCS 7.41 8.95 8.19 8.64 7.66 9.25 8.30 7.77 7.62 8.24 8.15 8.36 8.85 9.46 7.51 8.07 8.79 8.31 8.31

10 MEDASSETS 8.30 8.36 8.36 9.29 9.17 7.56 9.07 7.50 7.72 7.68 8.02 7.94 9.67 8.08 9.01 8.39 6.95 8.55 8.31

11 CITADEL 6.91 7.75 8.51 8.69 8.73 9.14 8.12 7.12 9.15 9.37 7.45 7.38 8.08 8.67 7.77 8.80 8.00 8.34 8.22

12 BANCTEC 8.75 8.17 8.52 8.40 7.01 6.99 8.21 8.54 7.76 7.53 8.25 8.82 8.55 8.33 7.60 8.19 8.71 7.99 8.13

13 GEBBS 8.47 7.62 8.07 7.92 8.28 8.09 7.13 8.19 8.60 7.69 8.21 7.47 8.79 8.22 7.26 8.21 8.07 8.64 8.05

14 MEDSYNERGIES 8.44 9.20 7.81 8.23 8.54 7.81 8.97 7.51 7.05 8.42 7.93 7.73 7.47 7.82 7.31 7.72 7.96 8.61 8.03

15 CCI INC 7.78 7.82 7.51 7.75 8.06 8.40 6.93 7.80 7.63 7.97 7.45 7.81 8.26 7.22 8.01 8.44 7.92 8.37 7.84

16 CARDON 6.98 7.70 7.92 7.86 7.15 8.03 8.12 7.64 8.79 7.21 7.16 7.56 6.75 7.09 8.07 8.92 9.11 8.30 7.80

17 ADVANT EDGE 8.22 8.04 7.62 6.82 8.03 7.70 8.35 8.60 7.92 7.15 6.24 7.16 7.65 8.76 6.99 7.46 7.59 7.58 7.66

18 NCO GROUP 7.39 7.69 8.03 7.53 6.82 7.39 8.14 6.57 7.17 7.74 7.36 7.20 8.17 7.21 8.34 7.81 8.87 7.74 7.62

19 EXPERIAN 8.34 8.03 7.81 7.72 8.02 8.65 7.59 6.79 6.95 7.99 7.56 6.94 7.51 7.86 7.11 8.15 7.43 6.67 7.62

20 CYMETRIX 7.07 8.48 7.70 7.63 6.95 5.78 7.81 6.76 8.76 6.47 7.66 8.85 5.75 8.29 6.63 8.29 5.62 7.07 7.31





Q1. Vendor overall preference by similar users of Revenue Cycle Management peer group vertical industry recommendations for vendor expertise

RCM Table 4: Organizational structure meets the needs of stakeholders or customers and stakeholder satisfaction is the most important priority. Hospital RCM client is likely to

recommend the vendor to similar sized facilities.

Q2.

Innova

tion

R

C

M

T

a

b

l

e

5

:

C

OVERALL

RANK

Q1

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.84 9.85 9.73 9.77 9.80

7 2 MCKESSON RELAYHEALTH 9.51 9.38 9.81 9.64 9.59

3 3 OPTUM 9.27 9.47 9.37 9.33 9.36

2 4 PARALLON 9.27 9.41 9.42 9.29 9.35

5 5 EMDEON 9.42 9.21 9.32 9.04 9.25

4 6 CONVERGENT 9.28 9.38 9.30 8.81 9.19

6 7 XTEND 9.02 8.80 8.89 9.01 8.93

12 8 BANCTEC 8.59 8.34 8.95 9.10 8.75

8 9 MEDASSIST FIRSTSOURCE 8.48 8.58 8.36 9.19 8.65

13 10 GEBBS 9.00 7.33 8.84 8.69 8.47






ustomers are also continuing to push the envelope for further enhancements to which the RCM vendor is responsive. RCM clients also believe that their vendors’ technology is helping

them manage hospitals more effectively, generate accurate records and reimbursement billings and cut their overhead in ways that were difficult or impossible to accomplish before the

outsourcing was implemented. Vendor is responsive to make client recommendations with cutting edge improvements specific to hospitals.

OVERALL

RANK

Q2

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.73 9.79 9.59 9.93 9.76

3 2 OPTUM 9.86 9.66 9.77 9.69 9.75

2 3 PARALLON 9.16 9.84 9.59 9.49 9.52

5 4 EMDEON 9.30 9.66 9.41 9.33 9.43

4 5 CONVERGENT 9.54 9.48 8.69 9.41 9.28

14 6 MEDSYNERGIES 9.03 9.20 9.43 9.15 9.20

9 7 HBCS 9.11 8.87 9.17 8.63 8.95


20 9 CYMETRIX 8.54 8.64 8.92 7.80 8.48

10 10 MEDASSETS 8.31 8.61 7.94 8.58 8.36






Q3. Training

RCM Table 6: Outsourcing vendor leadership provides significant and meaningful training opportunities for internal employees and client staff in RCM. Leadership strives to develop

technology staff, RCM client service and customer servicing consultant employees, in particular. Training modules are effective and practical so that minimal post-implementation

training is required on or off site. Regular updates are timely and require minimal additional training to implement.

OVERALL

RANK

Q3

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS MEAN

1 1 CONIFER HEALTH 9.36 9.53 9.27 9.40 9.39

6 2 XTEND 9.45 9.44 9.21 9.21 9.33


3 4 OPTUM 9.09 8.48 9.35 8.94 8.97

2 5 PARALLON 9.21 8.68 9.34 8.60 8.96

5 6 EMDEON 8.73 8.61 9.04 8.49 8.72

12 7 BANCTEC 7.95 8.74 8.92 8.48 8.52

11 8 CITADEL 8.86 8.13 8.02 9.01 8.51

4 9 CONVERGENT 8.00 8.96 7.78 9.11 8.46

10 10 MEDASSETS 8.99 7.56 9.01 7.89 8.36

Source: Black* Book Rankings





Q4. Client relationships and cultural fit

RCM Table 7: RCM outsourcing vendor leadership honors customer relationships highly. The relationship with the vendor elevates the customer reputation. Improving hospital financial

services and healthcare delivery efficiency and effectiveness is a priority of the supplier. Governance of engagement is neither complex for buyer nor does it require vendor management

attention regularly. There is no regular transparency or quality issue. There are no culture clashes or misfits that threaten relationship’s success or client’s satisfaction.

OVERALL

RANK

Q4

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.45 9.60 9.65 9.38 9.52

3 2 OPTUM 9.50 9.40 9.45 9.41 9.44

2 3 PARALLON 9.31 9.50 9.62 9.25 9.42

4 4 CONVERGENT 8.91 9.54 9.44 9.60 9.37

10 5 MEDASSETS 9.58 9.54 8.89 9.13 9.29

6 6 XTEND 9.37 8.92 9.17 8.65 9.03

11 7 CITADEL 8.59 8.68 8.46 9.02 8.69

9 8 HBCS 8.16 8.23 9.48 8.68 8.64

5 9 EMDEON 8.43 9.30 7.87 8.23 8.46

12 10 BANCTEC 8.72 8.08 9.16 7.64 8.40






Q5. Trust, Accountability and Transparency

RCM Table 8: Trust in enterprise reputation is important to RCM clients as well as prospects. Client possesses an understanding that its organization has the people, processes, and

resources to effectively deliver the desired business and clinical results, based on its industry reputation and past performance. There are no disconnects between promises and

delivery, and integration between hospital clinical and financial applications and revenue cycle management outsourcing is seamless.

OVERALL

RANK

Q5

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

3 1 OPTUM 9.39 9.83 9.51 9.35 9.52

1 2 CONIFER HEALTH 9.15 9.59 9.52 9.78 9.51

4 3 CONVERGENT 9.32 9.11 9.25 9.72 9.35

10 4 MEDASSETS 8.97 9.62 8.57 9.51 9.17


5 6 EMDEON 8.78 8.94 9.22 8.79 8.93


11 8 CITADEL 8.86 8.80 8.43 8.82 8.73

14 9 MEDSYNERGIES 8.61 8.46 9.00 8.09 8.54

2 10 PARALLON 8.14 8.68 8.52 8.29 8.41






Q6. Breadth of offerings, varied client settings, delivery excellence across all user types

RCM Table 9: Hospital RCM vendor offers industry recognized horizontal functionality and vertical industry applications, and manage bundled services such as ACO, reimbursement

reform and developing new e-Health initiatives. Vendor routinely drives operational performance improvements and results in the areas they affect. Comprehensive offerings are

constructed to meet the unique needs of the client’s billing and collections initiatives. Breadth of vendor modules offers comprehensive system services and broad modules.

OVERALL

RANK

Q6

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.64 9.85 9.66 9.69 9.71


9 3 HBCS 9.19 9.47 9.15 9.17 9.25

3 4 OPTUM 9.10 8.94 9.42 9.55 9.25

11 5 CITADEL 9.46 9.37 8.56 9.19 9.14


5 7 EMDEON 8.98 9.08 8.84 8.66 8.89

2 8 PARALLON 8.50 9.49 8.95 8.25 8.79

19 9 EXPERIAN 8.68 8.63 8.12 9.15 8.65

4 10 CONVERGENT 8.82 8.43 8.51 8.77 8.63






Q7. Deployment and Revenue Cycle Management solution implementation & System-wide Standardization

RCM Table 10: RCM outsourcing client deploys at a pace acceptable to the client. RCM solutions eliminate excessive supervision over vendor implementations. Vendor overcomes

client implementation obstacles and challenges effectively. Technical, organizational and cultural implementation obstacles are handled professionally and punctually. Application

implementation time meets standard expectations. Implementations are efficient and sensitive to users’ specific situations which may cause delays.

OVERALL

RANK

Q7

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

3 1 OPTUM 9.07 9.44 9.92 9.75 9.54

1 2 CONIFER HEALTH 9.14 9.82 9.62 9.34 9.48

4 3 CONVERGENT 9.45 9.20 9.15 9.60 9.35

2 4 PARALLON 9.32 8.95 9.07 9.04 9.10

10 5 MEDASSETS 9.25 8.96 9.29 8.78 9.07

14 6 MEDSYNERGIES 8.71 9.20 8.47 9.51 8.97

5 7 EMDEON 8.86 8.85 8.98 9.00 8.92



17 10 ADVANT EDGE 8.05 8.41 8.71 8.22 8.35






Q8. Customization

RCM Table 11: Hospital RCM outsourced services are customized to meet the unique needs of specific facility client purpose, processes and models. Little resistance is encountered

when changing performance measurements as clients’ needs vary. Extraordinary efforts are made to adapt and convert client special needs into workable solutions with efficient cost

and time considerations. All outsourced solutions allow for modifications that are not costly or complex.

OVERALL

RANK

Q8

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

5 1 EMDEON 9.46 9.68 9.14 9.71 9.50

2 2 PARALLON 8.93 9.18 9.11 9.43 9.16

1 3 CONIFER HEALTH 8.41 9.06 9.28 9.18 8.98

6 4 XTEND 9.15 8.83 9.15 8.76 8.97

4 5 CONVERGENT 8.93 9.12 8.26 9.17 8.87

17 6 ADVANT EDGE 8.28 8.84 8.82 8.45 8.60

3 7 OPTUM 7.94 8.68 8.87 8.79 8.57

12 8 BANCTEC 7.92 9.01 8.91 8.22 8.54


13 10 GEBBS 8.78 8.18 7.79 8.01 8.19






Q9. Integration and interfaces

RCM Table 12: RCM vendor supports interfaces so information can be shared between necessary applications. Solutions are easily integrated to existing backend systems as needed

and feasible for connectivity and interoperability purposes. Seamless interfaces to legacy applications and cloud systems alike are performed as required for optimal functioning. Human

integration and interface activities are administered precisely. Systems communicate effectively among provider groups and ancillaries. True interoperability with other healthcare

organizations is factored into implementation including financial and clinical data.

OVERALL

RANK

Q9

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

6 1 XTEND 9.52 9.68 9.57 9.53 9.58

3 2 OPTUM 9.53 9.47 9.68 9.54 9.56

1 3 CONIFER HEALTH 9.16 9.63 9.51 9.67 9.49

6 4 PARALLON 9.14 9.79 9.37 8.67 9.24

11 5 CITADEL 9.10 8.76 9.33 9.29 9.15


4 7 CONVERGENT 8.81 9.19 9.18 8.74 8.98

16 8 CARDON OUTREACH 8.45 8.75 9.25 8.71 8.79

20 9 CYMETRIX 8.87 8.45 8.56 9.15 8.76

5 10 EMDEON 8.77 7.72 9.14 8.94 8.64






Q10. Scalability, client adaptability, flexible pricing

RCM Table 13: RCM outsourcing vendor provides flexible pricing allowing the client to choose and pay for the precise functionality and services needed. Vendor invests in significant

infrastructure and has the ability to provide services to enterprise organizations. RCM hospital products and services meet the changing and varied needs of the customer. Pricing is not

rigid or shifting and meets needs of client hospital.

OVERALL

RANK

Q10

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

3 1 OPTUM 9.85 9.67 9.52 9.79 9.71

11 2 CITADEL 9.11 9.49 9.45 9.44 9.37

1 3 CONIFER HEALTH 9.48 9.24 9.29 9.22 9.31

4 4 CONVERGENT 8.89 9.22 9.30 9.43 9.21

5 5 EMDEON 9.31 9.27 8.93 9.14 9.16

2 6 PARALLON 9.04 8.98 9.48 8.83 9.08

14 7 MEDSYNERGIES 8.05 8.37 8.76 8.49 8.42

9 8 HBCS 8.63 8.12 9.17 8.31 8.24

6 9 XTEND 8.50 7.54 8.12 8.26 8.11

19 10 EXPERIAN 8.23 7.98 8.11 7.64 7.99






Q11. Vendor staff expertise, compensation and employee performance

RCM Table 14: RCM vendor team of employees is considered top in industry for professionalism and skill. Vendor attracts and retains high performing staff. Vendor is focused on

building and developing a strong employee team of producers. Employees and contractors act like owners/leaders. Company is moving towards leveraged pay at all levels. Vendor is

using effective tools to tie performance metrics to compensation policy and compensating top leaders. Human resources-related criteria are scored from the client perspective on this

indicator.

OVERALL

RANK

Q11

CRITERIA

RANK

EHR PM/RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

4 1 CONVERGENT 9.41 9.33 9.42 9.55 9.43

2 2 PARALLON 9.26 8.80 9.31 9.04 9.10

1 3 CONIFER HEALTH 8.55 8.97 8.92 9.38 8.96

3 4 OPTUM 8.90 8.95 9.10 8.85 8.95

5 5 EMDEON 9.04 8.79 8.31 9.29 8.86

6 6 XTEND 7.99 8.87 8.76 7.79 8.35

12 7 BANCTEC 8.38 8.26 8.69 7.65 8.25


13 9 GEBBS 7.53 8.65 8.79 7.87 8.21

9 10 HBCS 8.34 7.73 8.40 8.14 8.15






Q12. Reliability

RCM Table 15: RCM outsourcing supplier meets agreed terms as evidenced by routine, acceptable service level reporting and industry expectations. Depth and breadth of

applications/solutions are acceptable in meeting client needs. Online reliability is maximized and outages/downtimes are minimized. Solid product and service capacities are

demonstrated consistently. Service levels are consistently met as agreed. Services and support response is maximized by RCM vendor team.

OVERALL

RANK

Q12

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.63 9.64 9.58 9.46 9.58

2 2 PARALLON 8.84 9.36 9.04 9.20 9.11

20 3 CYMETRIX 8.74 8.90 9.36 8.39 8.85

5 4 EMDEON 8.67 8.88 8.69 9.07 8.83

12 5 BANCTEC 8.92 8.94 8.57 8.84 8.82


3 7 OPTUM 9.02 8.49 8.74 8.38 8.66

4 8 CONVERGENT 9.00 7.94 9.02 8.63 8.65

9 9 HBCS 8.59 8.05 8.29 8.50 8.36







Q13. Brand image and marketing communications

RCM Table 16: RCM vendor’s marketing and sales statements/pitches are accurately and appropriately represented by actual product and service deliverables. Image is consistent with

top vendor rankings scored by client base. Sales presentations and proposals are delivered upon and corporate integrity/honesty in marketing and business development are highly

valued. Company image and inte6grity are values upheld top-down consistently. High level of relevant client communications enhances the RCM vendor.

OVERALL

RANK

Q13

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.85 9.93 9.90 9.99 9.92

10 2 MEDASSETS 9.74 9.69 9.54 9.70 9.67

6 3 XTEND 9.43 9.04 9.37 9.02 9.22

3 4 OPTUM 9.07 9.09 9.24 8.92 9.08


4 6 CONVERGENT 9.28 8.46 9.39 8.46 8.90

9 7 HBCS 8.20 9.51 8.63 9.06 8.85

5 8 EMDEON 8.53 9.02 8.61 9.21 8.84

13 9 GEBBS 8.74 9.24 8.70 8.49 8.79

2 10 PARALLON 8.81 8.42 8.39 8.64 8.57






Q14. Marginal value adds

RCM Table 17: Beyond stimulus achievement, RCM vendors' cost savings are realized as generally estimated and not over-positioned or over/underestimated in ways that effect major

client satisfaction or costs. Vendor offers value-adds as a hospital partner in cost savings and avoidance initiatives and creative programs through bundled RCM product design. Vendor

provides true RCM and hospital business transformation opportunities.

OVERALL

RANK

Q14

CRITERIA

RANK

EHR PM/RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.71 9.66 9.54 9.56 9.62

9 2 HBCS 9.63 9.16 9.57 9.47 9.46

2 3 PARALLON 9.22 8.80 9.12 9.64 9.19

6 4 XTEND 9.25 9.35 9.00 8.96 9.14

4 5 CONVERGENT 9.03 9.60 8.70 8.87 9.05


3 7 OPTUM 9.22 8.60 9.25 8.20 8.82

17 8 ADVANT EDGE 8.44 8.78 8.77 9.05 8.76

11 9 CITADEL 8.75 8.05 8.58 9.30 8.67

12 10 BANCTEC 8.48 8.03 8.41 8.39 8.33






Q15. Viability and managerial stability

RCM Table 18: Vendor’s viability, employee turnover, financial stability and/or cultural mismatches do not threaten relationship. Senior management and the board exemplify strong

leadership principals to steward appropriate resources that impact RCM buyers. Client is confident of long term industry viability for this vendor based on investments, client adoption,

exceptional outcomes and service levels. Field management is notably competent, stable and supportive of clients. Entire vendor organization demonstrates and provides evidence of

competent financial management and leadership.

OVERALL

RANK

Q15

CRITERIA

RANK

EHR PM/RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.52 9.10 9.52 9.39 9.38

4 2 CONVERGENT 9.12 9.40 9.14 9.27 9.23

2 3 PARALLON 9.15 9.20 9.23 9.26 9.21

10 4 MEDASSETS 9.37 8.87 9.12 8.68 9.01

6 5 XTEND 9.24 8.56 8.95 9.23 9.00


3 7 OPTUM 8.84 8.18 8.78 7.94 8.44

18 8 NCO GROUP 8.39 7.84 8.96 8.16 8.34

5 9 EMDEON 8.12 8.36 7.99 8.72 8.30

16 10 CARDON OUTREACH 8.00 7.89 8.51 7.89 8.07






Q16. Data security and backup services

RCM Table 19: In order to provide secure and constantly dependable revenue cycle management service offerings for hospitals, an RCM vendor has to provide the highest level of

security and data back-up services. The vendor’s service in these two areas is superior to the security and back-up system of past internal systems of the hospital.

OVERALL

RANK

Q16

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.60 9.75 9.58 9.40 9.58

5 2 EMDEON 9.57 9.21 9.21 9.60 9.40

3 3 OPTUM 9.42 9.50 9.03 9.35 9.33

2 4 PARALLON 8.89 9.39 9.33 9.18 9.20

6 5 XTEND 9.32 8.82 9.14 9.28 9.14

16 6 CARDON OUTREACH 9.12 9.07 8.87 8.60 8.92

4 7 CONVERGENT 9.25 8.53 9.00 8.75 8.88

11 8 CITADEL 8.11 9.36 8.75 8.96 8.80


15 10 CCI INC 8.38 7.96 8.52 8.90 8.44






Q17. Support and customer care

RCM Table 20: Account management provides an adequate amount of onsite administration and support to clients. There exists a formal account management program that meets client

needs. Media and clients reference this vendor as an RCM services leader and top vendor correctly. Customer services and relationship satisfaction is manifested through significant

flagship clients as well as smaller and newest customers similarly. Vendor provides appropriate number of accessible support and customer care personnel.

OVERALL

RANK

Q17

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.70 9.51 9.76 9.66 9.66

2 2 PARALLON 9.59 9.36 9.74 9.37 9.52

6 3 XTEND 9.48 9.18 9.08 9.17 9.23

16 4 CARDON OUTREACH 8.96 9.30 9.30 8.87 9.11

4 5 CONVERGENT 9.22 8.96 9.00 9.09 9.07

18 6 NCO GROUP 8.15 9.31 8.48 9.53 8.87

3 7 OPTUM 9.11 8.52 8.60 9.09 8.83

9 8 HBCS 8.81 9.06 8.45 8.83 8.79


12 10 BANCTEC 8.76 8.58 8.42 9.06 8.71






Q18. Best of breed technology and process improvement

RCM Table 21: A seamless EHR/RCM/PM product management and related technology services are considered best of breed. Vendor technology elevates customers above

competitors via interface capabilities, equipment, processes, deliverables, professional staff, leadership, quality assurance and innovative initiatives. RCM services are delivered above

previous in-house billing and collection service levels. Technology is relevant to exchanging health information among providers, as well as sufficiently offering patient access.

OVERALL

RANK

Q18

CRITERIA

RANK

RCM VENDOR

BILLING, CHARGE

CAPTURE, CODING

CLAIMS

MANAGEMENT

REIMBURSEMENT,

INSURANCE/

PAYOR MGMT

PAYMENT,

RESOLUTION &

COLLECTIONS

MEAN

1 1 CONIFER HEALTH 9.68 9.54 9.71 9.66 9.65

3 2 OPTUM 9.26 9.23 9.10 9.21 9.20

5 3 EMDEON 9.09 9.27 9.06 9.13 9.14

2 4 PARALLON 9.36 8.97 9.56 8.67 9.14

6 5 XTEND 9.35 9.23 8.82 9.04 9.11

4 6 CONVERGENT 9.41 9.30 9.03 8.64 9.10


13 8 GEBBS 9.07 8.99 8.30 8.18 8.64

14 9 MEDSYNERGIES 8.37 8.60 9.00 8.45 8.61

10 10 MEDASSETS 8.89 8.84 8.53 7.94 8.55


APPENDIX

BLACK BOOK™

A DIVISION OF BROWN-WILSON GROUP INC., BLACK BOOK CONSULTING

We hope that the data and analysis in this report will help you make informed and imaginative RCM/RCO/PM/EMR/EHR

business decisions. If you have further requirements, the Brown-Wilson Group consulting team may be able to help you. For

more information about BWG and Black Book’s consulting capabilities, please contact us directly at [email protected]

DISCLAIMER

All Rights Reserved.

No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form by any means (electronic,

mechanical, photocopying, recording or otherwise), without the prior permission of the publisher, Black Book Rankings.

The facts of this report are believed to be correct at the time of publication but cannot be guaranteed. Please note that the

findings, conclusions and recommendations that Black Book Rankings delivers will be based on information gathered in good

faith from both primary and secondary sources, whose accuracy we are not always in a position to guarantee. As such, Black

Book Rankings can accept no liability whatever for actions taken based on any information that may subsequently prove to be

incorrect.

2014 black book hospital revenue cycle management...

Documents