Revenue Cycle Management in Healthcare: The Pulse of the Industry
Report Summary
Revenue Cycle Management in Healthcare: The Pulse of the Industry
Post-PPACA, RCM vendors are making wholesale changes to their revenue cycles.
Boston, April 8, 2013 – A new report from Aite Group takes the pulse of revenue cycle management (RCM) in post-PPACA U.S. healthcare payments. Based on a March 2013 Aite Group survey of product and business executives at RCM firms, the report examines the impacts of PPACA on healthcare payments, reveals opportunities related to B2B and B2C payments innovation, identifies payments channels set to take off, and pinpoints leaders and laggards in patient billing and payments.
Post-PPACA, RCM vendors in U.S. healthcare face conflicting agendas--one expands payments and one bundles them. As a result, RCM vendors are making wholesale changes to their revenue cycles, integrating broader B2C payments capabilities while turning service-based, provider-oriented B2B payment models into success-based, bundled payments. To enable B2C payments, RCM vendors must develop and integrate technology that supports B2C payment acceptance beyond card processing at the point of service. On the B2B front, RCM vendors must track every patient across each part of the care model, allocating a third-party payer bundled payment amount to participating entities.
“More RCM vendors will soon offer end-to-end solutions that provide practice managing, claims clearing, treasury banking, and merchant acquiring to healthcare providers,” says Michael Trilli, senior analyst with Aite Group and co-author of this report. “Those that do so stand to lead the market in B2C payment revenue, close the data loop in obtaining full revenue cycle data, and lay the groundwork to support B2B bundled payments.”
This report mentions the following companies: ADP/AdvancedMD, Allscripts, Aprima Medical, athenahealth, Availity, Bank of America, BNY Mellon, Cake, Capario, Carecloud , Cerner, Change Healthcare, Chase Paymentech, Citibank, Comerica, Deutsche Bank, Doc-toc, Dr. Chrono, eClincialWorks, Elavon, Emdeon, ENS Health, e-onlinedata, Epic, eZpay, Fifth Third Bank, Financial Health Systems, First Data Corporation, Gateway EDI, General Electric, Global Payments, Glostream, Greenway Medical, Healthcare Bluebook, Ingenix, InstaMed, Intuit, J.P. Morgan, Kareo, KeyCorp, McKesson, MedAssets, Meditech, mPay Gateway, Navicure, NextGen, Office Ally, Origin Healthcare, Passport Health, PatientPay, Phreesia, PNC Bank, Practice Fusion, Practice Insight, Premier, Pulse, RBS Citizens Bank, Royal Bank of Scotland (RBS), Recondo, Regions Bank, RelayHealth, Save on Medical, Siemens, Simplee, SSI Group, Texas Health Information Network, TransEngen, TransFirst, TransUnion, TSYS Merchant Services, U.S. Bank, Vantiv, Vitera Healthcare Solutions, Wells Fargo, and ZirMed.
This 29-page Impact Report contains 16 figures and two tables. Clients of Aite Group’s Health Insurance service can download the report.