5 Essential Elements of Revenue Cycle Management (RCM) Success: Quality of Service and Value (Part 4 of 4)

Healthcare providers require specific capabilities for operational and financial success. For hospitals, laboratories, radiology practices, and other diagnostic providers, selecting the right revenue cycle management (RCM) partner is one vital step toward ensuring access to the comprehensive set of capabilities essential for:

• Maximizing revenue
• Increasing cash flow
• Lowering the cost of collecting reimbursements
• Reducing denials
• Decreasing average AR days

While selecting the right RCM partner can profoundly impact a healthcare provider’s operational and financial performance, it’s critical to continually monitor and evaluate your RCM partner’s capabilities against industry data and benchmarks to ensure they continue to be the best partner to help your organization achieve its unique mission and goals.

At XiFin, we recommend using the following five criteria to frame this evaluation:

1. Innovation
2. Expertise
3. Reliability
4. Security, Compliance, and Trustworthiness
5. Quality of Service and Value

Your RCM partner must consistently demonstrate these five core competencies to support your operational and financial success. In this final article in our series, we focus on the specific capabilities related to “Quality of Service and Value.”

Quality of Service and Value Are Core Principles in All Successful Business Relationships

Quality and value are core tenets of any successful business relationship. RCM partners must prioritize delivering products, technology, services, and experiences that consistently meet or exceed client expectations. Quality speaks to the performance of the work itself. At the same time, value addresses whether the client organization perceives it is getting all the expected benefits in exchange for the cost of the technology solutions and services.

Establishing and maintaining high levels of quality and value in RCM business relationships is vital to an ongoing, collaborative partnership with meaningful and lasting outcomes. By prioritizing quality and value, RCM providers demonstrate long-term sustainability and a commitment to meeting their clients’ needs.

Quantifying Quality of Service and Value

One valuable tool laboratories, hospitals, radiology practices, and other diagnostic organizations can use to help evaluate the essential capabilities for effective RCM outsourced services providers is the 2024 Black Book Revenue Cycle Management Vendor Report.” Black Book Market Research conducts an annual, in-depth study on how diagnostic leaders evaluate outsourced RCM service providers across 18 key performance metrics. The 2024 report is based on the real-world experiences of over 3,100 diagnostic/ laboratory physicians, clinicians, specialists, and administrative, IT, and finance leaders from 2,787 provider organizations.

The XiFin team associates six of the 18 Black Book Research performance metrics with “Quality of Service and Value.”

1. Client Relationships and Cultural Fit (question 4, table 8, page 16)

One of the metrics that can help your organization evaluate its RCM outsourced services partner on “Quality of Service and Value” is categorized by the Black Book Market Research team as “Client Relationships and Cultural Fit.” For this metric, the Black Book Market Research team asked study participants to evaluate RCM outsourced service providers on the following statements:

• RCM solutions vendor leadership honors customer relationships highly
• The relationship with the vendor elevates the customer’s reputation
• Improving practice and healthcare delivery efficiency and effectiveness is a priority of the supplier
• Governance of engagement is neither complex for buyers nor does it require vendor management attention regularly
• There is no regular transparency or quality issue
• There are no culture clashes or misfits that threaten a relationship’s success or the client’s satisfaction

On this performance metric, XiFin ranked first, with an average score of 9.59 and a score of 9.71 among respondents from both hospital laboratories and pathology practices. This average score is 13.2% higher than the average score received by the other vendors evaluated in this study for this performance metric. Access the full report to see how your RCM vendor compares.

2. Customization (question 8, table 12, page 20)

In a second performance metric related to “Quality of Service and Value,” Black Book Market Research asked study participants to assess RCM outsourced service providers on the following statements about “Customization.”

• RCM solutions and services are customized to meet the unique needs of specific client purposes, processes, and care delivery models
• Little resistance is encountered when changing performance measurements as clients’ needs vary
• Extraordinary efforts are made to adapt and convert client special needs into workable solutions with efficient cost and time considerations
• RCM solution allows for modifications that are not costly or complex

XiFin ranked first in this category with an average score of 9.70, 12.4% higher than the average score received for this performance metric by the 9 other vendors evaluated in the study. It is also higher than the 9.43 average score for this method that XiFin received in the 2023 study.

3. Deployment and Implementation (question 7, table 11, page 19)

Another performance metric in the Black Book Research study related to “Quality of Service and Value” asked study participants to evaluate RCM outsourced service providers on the following statements related to “Deployment and Implementation:”

• RCM solutions vendor deploys at a pace acceptable to the client
• Services delivered eliminate excessive supervision over vendor implementations
• Vendor overcomes client implementation obstacles and challenges effectively
• Technical, organizational, and cultural implementation obstacles are handled professionally and punctually
• The implementation time meets standard expectations
• Implementations are efficient and sensitive to users’ specific situations, which may cause delays

XiFin ranked #1 in this performance category with an average score of 9.83, 14.3% higher than the average score the other vendors received in this category and slightly higher than the 9.76 average score XiFin received in the 2023 study.

4. Training (question 3, table 7, page 15)

Black Book Research classifies another performance metric related to “Quality of Service and Value” as “Training.” For this evaluation, Black Book Research asked study participants to evaluate RCM outsourced service providers on the following statements:

• RCM vendor leadership provides significant and meaningful training opportunities for internal employees and client staff
• Leadership strives to develop technology staff, client service, and customer servicing consultant employees
• Training modules are effective and practical so that minimal post-implementation training is required on or off-site
• Regular updates are timely and require minimal additional training to implement

XiFin ranked #1 in this performance metric with an average score of 9.50 and a score of 9.90 among respondents representing hospital laboratories. This is slightly higher than the 9.37 average score XiFin received in this category in the 2023 study. It is also 6.6% higher than the average score for this category received by the other vendors evaluated.

5. Support and Customer Care (question 17, table 21, page 29)

The fifth performance metric related to “Quality of Service and Value” is “Support and Customer Care.” For this evaluation of RCM outsourced service providers, the Black Book Market Research team asked study participants to evaluate providers on the following statements:

• Account management provides an adequate amount of onsite administration and support to clients
• There exists a formal account management program that meets client needs
• Media and clients reference this vendor as an RCM solutions and services leader and top vendor correctly
• Customer services and relationship satisfaction are manifested through significant flagship clients as well as smaller and newest customers
• The vendor provides an appropriate number of accessible support and customer care personnel

XiFin was rated highest in this performance category with an average score of 9.81, higher than the 9.53 average score received in this category in the 2023 study and 14.3% higher than the average the other vendors evaluated received in this category.

6. Scalability, Client Adaptability, Flexible Pricing (question 10, table 14, page 22)

The final performance metric covered in the Black Book Research study related to “Quality of Service and Value” asked participants to appraise RCM outsourced service providers on the statements below, which Black Book classifies as “Scalability, Client Adaptability, Flexible Pricing.”

• The RCM vendor provides flexible pricing, allowing the client to choose and pay for the precise functionality and services needed
• Vendor invests in significant infrastructure and can provide services to enterprise organizations
• Managed products and services meet the changing and varied needs of the respective customer
• Pricing is not rigid or shifting and meets the needs of the client

XiFin received an average score of 9.49 in this category, higher than the 9.28 average score received in this category in the 2023 Black Book study. This average score is 8.4% higher than the average score received in this category by the other 9 vendors evaluated in this study.

Outsourced RCM service providers that rank high for these six key performance metrics deliver the Quality of Service and Value that hospitals, laboratories, radiology practices, and other diagnostic providers need to achieve their financial and operational goals. Objective industry data and benchmarks, such as the Black Book Market Research report, help laboratories and diagnostic providers quantitatively determine whether they have partnered with a provider that can deliver the capabilities needed to help them maximize cash flow, accelerate time to collection, and optimize return on cash.

Download the full 2024 Black Book Market Research “Diagnostic/Laboratory/ Ancillary Services Revenue Cycle Management” report to see which outsourced RCM service partners can best help your organization accelerate cash collection, increase profitability, and reduce your cost to collect.

If you missed an earlier post in this series, read parts 1, 2, and 3, here: