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Revenue Cycle Management Technology

In the revenue cycle management market, hospitals show high adoption of technology focused on eligibility and scheduling, with much work left to be done around charity screening and propensity to pay, according to a new report from HIMSS Analytics.

The study, “2013 Inpatient Revenue Cycle Management,” is one in a series of strategic industry reports. It represents unique “voice of customer” insight from more than 500 respondents on market share, market opportunity and vendor mind share across the U.S. market.

Respondents indicated their intent to replace or purchase new solutions for RCM functions such as address validation, pre-authorization and bill estimation, among others.

The report focuses specifically on: eligibility, address verification, scheduling, registration QA, medical necessity, pre-authorization, bill estimation, cashiering, charity screening and propensity to pay.

“We wanted to provide granularity around functions used in the inpatient RCM arena, including how hospitals are approaching those functions and how large of a role they play in conducting transactions on an annual basis,” said HIMSS Analytics Research Director Brendan FitzGerald in a statement upon the report’s release.

FitzGerald told Healthcare IT News that he was surprised that many hospitals have not yet adopted RCM modules that could help them accomplish specific tasks more accurately and efficiently.

“As the industry continues to change, a move toward vendor solutions by hospitals could help ease the burden of keeping up with financial regulations and help organizations move toward more seamless revenue cycle transactions,” he said.

The report details findings on The Advisory Board Company, Emdeon, Experian/Search America, HDX/Sismens, MedAssets, MedeAnalytics, Passport, Recondo, RelayHealth, SSI and TransUnion.

Interviewed by Healthcare IT News Managing Editor Mike Miliard last June regarding a separate study on RCM, HIMSS Analytics Executive Vice President John Hoyt predicted a rebound of the RCM market, spurred by payment reform.

“The vendors are telling us that they’re preparing, and they’re looking at revenue cycle redesigns to take into account bundled payments and ACO reimbursements,” Hoyt said. “We think there’s going to be a boom.”

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