The healthcare provider industry has been plagued with numerous issues – care providers have been operating on thin margins due to high claims denials, increasing bad debts, and the higher cost of operations, partially because of the lack of integration between multiple clinical and revenue cycle platforms. COVID-19 has further added to their woes, with the deferral of elective procedures and a rising number of uninsured and unemployed population, affecting their collections and, consequently, margins. Moreover, with telehealth coming under the spotlight, providers are struggling to come up with a clear strategy to enable virtual health.

Thus, buyers are seeking third-party support to address these challenges through multiple engagement models, such as software, services, and solutions. In particular, the Revenue Cycle Management (RCM) solutions engagement model is gaining traction due to its ability to offer customized solutions to healthcare providers. Consequently, many service providers / vendors are building their capabilities in the market.

Scope

Industry: RCM solutions

Service providers / vendors studied: AdvancedMD, Allscripts, Apexon Health, Athenahealth, Availity, Cerner, Change Healthcare, Cognizant, Conifer Health, Epic, HGS, MedAssist (Firstsource), NextGen Healthcare, nThrive, Optum, Parallon, R1 RCM, and Waystar

Contents

In this report, we focus on:

• Key issues faced by healthcare providers
• Key outsourcing trends in the RCM solutions market
• The RCM solutions outsourcing service provider / vendor landscape

Membership(s)

Healthcare Payer and Provider Business Process

Healthcare Payer and Provider Information Technology

Sourcing and Vendor Management