RCM ROI: The Impact of Analytic
Software Tools on Hospital Revenue
Management
WHITE PAPER
Sponsored by: Accuro Healthcare Solutions Inc.
Eric Hatcher
January 2008
Alex Kim
HEALTH INDUSTRY INSIGHTS OPINION
The complex nature of healthcare service delivery and the multiplicity
of contracts, policies, and regulations that govern third-party
reimbursement for those services make medical billing, in general, and
hospital billing, in particular, among the most complex customer
billing and accounting processes of any industry.
Today, virtually 100% of U.S. hospitals have automated these
processes, but despite the relative saturation of this market for
software products that provide core functions, the dynamic nature of
hospital billing requirements has created a robust "aftermarket" for
specialized "add-on" software tools products designed to facilitate
and enhance specific process components.
Two critical components of the hospital revenue cycle management
(RCM) process are third-party contract management and patient
liability cost estimation. Software tools that support these components
are typically available from two sources: add-on options offered by
vendors of hospital patient billing products and independent third-
party vendors that specialize in such tools.
Our assessment of customer experiences with the products of one such
specialized vendor, Accuro Healthcare Solutions Inc. (Accuro),
suggests that buyers can realize significant returns on such
investments. Based on in-depth interviews with various hospitals, and
a financial model developed by Health Industry Insights (HII), we
conclude that there is a significant return on investment (ROI) to be
realized from the use of Accuro's products. The results of our analysis
suggest an estimated cumulative ROI on the order of $6.00 for every
$1.00 invested in these tools and an average payback period of seven
to eight months.
Given the current state of and future trends in healthcare financing and
reimbursement, Health Industry Insights believes that the revenue cycle
analytic software tools segment of the healthcare IT (HIT) market will
see significant and sustained growth over the next several years.
January 2008, Health Industry Insights #HI210391
Marc Holland
