Last month, Capsite, a healthcare technology research and advisory firm, released their most recent study in a series of strategic industry reports focused on the revenue cycle management market, the 2012 U.S. Revenue Cycle Management (RCM) study.
The study included nearly 400 participants, such as CEOs, CFOs and IT directors, representing 360 U.S. hospital organizations of various sizes with the objective of assessing how the HITECH Act focus on stimulating the adoption of Electronic Health Records (EHR) and Health Information Exchange (HIE) solutions combined with the delay in the ICD-10 compliance deadline is impacting the RCM market.
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Within the study, it was found that 21 percent of participants say they are planning to replace core RCM in the next 24 months, and for hospitals with more than 400 beds, that number increased to 36 percent. Fifty-three percent of the respondents said they plan to upgrade core RCM due to healthcare financial regulatory changes, with that number increasing to 68 percent for the hospitals with more than 400 beds.
“Our study clearly shows an active RCM market over the next 24 months as more than 20 percent of U.S. hospitals will be replacing their core RCM solution while another half will be investing in upgrades of their current core RCM solution,” said Gino Johnson, Capsite senior vice president and general manager, in a press release. "What has happened is the clinical systems like EHRs have pushed aside the focus on many things, including updating the RCM process over the last three or four years. Our goal is to understand the current sentiment among hospitals as far as the investing and priotization of the revenue cycle goes."
In addition, the study also found that increasingly (58 percent this year compared to 40 percent in 2010), organizations favor utilizing the same vendor for EHR and front and back office RCM solutions.
"I think there is going to be an active market in replacing systems and investing in upgrades when it comes to RCM," said Johnson. "We expect the next two years to be an active revenue cycle market. There are signs that the hospitals are beginning to have a stronger opinion on wanting to have the same vendors for the systems as well. It's an increasing trend."
[See also: Revenue cycle optimization offers new hope for control]
Other key findings from the research include:
- Eligibility verification, POS collections and medical necessity checking round out the top three front office bolt-on solutions for planned investment.
- Kiosks are a strategic priority for institutions with 400 or more beds.
- Coding, denial management and contract management round out the top three back-office bolt-on solutions for planned investment.
- Forty-two percent of participants indicated the driver for bolt-on investment was improvement of collections (front and back office).
- Confidence levels (out of a maximum score of 10) for selected Clearinghouse and RCM vendors for ICD-10 migration were about even, with an average of 7.41 and 7.42 respectively, leaving room for an improved outlook.
- Denial management remains a challenge for institutions, regardless of size.
[See also: Revenue integrity tops list of concerns for hospital executives]