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The New HIS Revenue Management

March 30, 2009
by root
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As the number of acute care organizations implementing revenue management systems grows, so too are questions about their value

KLAS says: Forty-five acute care organizations have just implemented new revenue management (RM) systems, 25 with next-generation systems from Cerner, Epic, and Siemens. Cerner (1999), Epic (2002), and Siemens (2002) launched their next generation RM solutions at about the same time. Only Epic has delivered as promised, with over 34 live clients (about 60 hospitals) and with the highest overall satisfaction. Cerner ProFit has about 20 live clients (20 hospitals) with the lowest overall client satisfaction; they have implemented only three new live clients in the past three years. Siemens Soarian's delivery was delayed several years and with nine live clients as of July 2008, their mid-tier performance scores are improving.

McKesson announced a totally new RM solution in June 2008 and expects two live clients by the middle of 2009. Eclipsys, GE, Meditech, and QuadraMed, the other main players, continue to upgrade their solutions; for instance, Eclipsys has some new patient access pilots. Yet, providers do not describe these as futuristic RM solutions. Are these newly live RM clients enjoying the benefits and capabilities they expected? In the current replacement market, our purpose was to measure the rollout of the newest RM systems. CFOs were asking if these new systems are worth the effort, so we asked why hospitals are putting in new RM solutions. What systems are being implemented? What has been the impact to collections and A/R? Do providers still need bolt-ons? Are hospitals going live on time? The answers to these and related questions, along with product performance metrics, make up the December 2008 KLAS report on revenue management solutions, focusing on new implementations in acute care provider facilities of over 200 beds. (The top five are shown here.)

“KLAS’ Bottom Lines”

Eclipsys - Plans to deliver an integrated solution with their clinical suite have not materialized yet. While the Eclipsys product itself tends to offer deep patient accounting functionality, customers are not satisfied with the overall performance and feel neglected by Eclipsys. Enhancements have been slower than expected compared to industry leaders. Clients desiring an integrated ambulatory and acute PA/RM will not find it today with Eclipsys.

Epic - Epic is one of the newest vendor entrants in the inpatient billing arena. Epic has successfully delivered a large number of live sites since the introduction of their Epic Resolute Hospital Billing. In terms of new sites implemented, Epic is significantly ahead of other vendors who have also launched new products in the same relative time period. Average days in A/R went down slightly after settle-in period. Epic has successfully replaced the most robust RM solutions (Siemens Invision).

GE - While GE performance scores are not strong, some customers speak highly of the workflow functionality and the value of the GE technology to the organization. GE Carecast and Flowcast HPA continue to compete for development resources. Their integrated Carecast RM solution is less robust than the standalone Centricity Business solution.

Meditech - Meditech delivers a solution that is integrated for both financials as well as clinicals. Organizations seeking a single-vendor solution should consider Meditech to be stronger in the delivery of financial applications than in clinical functionality. Average days in A/R went down after settle-in period.

QuadraMed - With the recent acquisition of Misys CPR, QuadraMed is postured to be an integrated CIS/PA/RCM vendor. QuadraMed is a product that has been around for a long time and has been updated over the years. It is generally considered to be a community to midsize solution, although QuadraMed does have some larger customers. Customers recognize QuadraMed for being responsive and proactive about regulatory issues. QuadraMed has had aggressive client and end-user input.

Healthcare Informatics 2009 April;26(4):24