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Frost & Sullivan: Growing Reimbursement Challenges Force Hospitals to Reengineer Revenue Cycle Management
Date:4/17/2013

ceiving unprecedented attention as hospitals seek to ensure maximum collections in the face of growing financial challenges.  Healthcare reform and the push for deficit reduction is forcing hospitals to address long-standing inefficiencies and shortfalls around the RCM process, driving the market for a host of next-generation RCM solutions.

Frost & Sullivan Connected Health Principal Analyst Nancy Fabozzi , author of the analysis, emphasizes the urgency hospitals are feeling around the need to ensure financial stability for the future. "The focus in recent years was clearly on installing or upgrading clinical systems, particularly electronic health records (EHRs), and that is still a top concern for many healthcare providers," explained Fabozzi.  "But the reality of 2014 is sinking in fast."

Legacy RCM solution providers, particularly the large, diversified healthcare IT (HIT) vendors, failed to innovate over the past decade, which opened the door for vendors of point solutions that provide added functionality to core systems.

"However, as competitive pressures heat up and the market for clinical systems matures, the large, established HIT vendors will increasingly take on more of an entrepreneurial spirit and broaden their efforts to drive innovation across all their product offerings, not just clinical solutions," continued Fabozzi.  "This scenario will likely create a highly dynamic market characterized by robust M&As as large vendors seek to quickly add new functionalities required by healthcare reform."

The hospital RCM market is primarily a replacement market, and this may or may not include a switch in vendors. Explained Fabozzi, "hospitals, in general, are rather conservative and most would prefer not to rip and replace unless they must."

U.S Hospital Revenue Cycle Management: Overview and Outlook 2012-2017 and its companion analysis, U.S. Physician Revenue Cycle Mana
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