Assessing Quality of Service in an RCM Outsourcing Partner
December 7, 2023
Please note: This article series addresses the unique issues and complexities that hospital and IDN ancillary services and outpatient diagnostic departments face. If you’re interested in a methodology tailored for clinical laboratories or medical device, remote patient monitoring, and durable medical equipment departments, we recommend those series instead.
PART 4: QUALITY OF SERVICE AND VALUE
According to Black Book Research, healthcare outsourcing is on a trajectory to double by 2024. In its 20th annual outsourcing survey, Black Book found that the reasons behind this trend include:
- Constraints on in-house expertise
- Implementing technology expediently with reduced capital
- Risks in failing to support existing technology
- Maintaining focus on strategic priorities and patient-centric competencies
With that projected level of growth, the field of RCM service providers is likewise likely to grow. And with so many potentially new and growing service providers, it’s all the more critical–and challenging–for hospitals and health systems to choose the ideal RCM partner for their ancillary and outpatient departments. They need a proven partner who understands their unique challenges and processes, who provides solutions that meets those challenges, and who ultimately helps them:
- Improve financial margins
- Mitigate staffing challenges
- Accelerate cash flow for the department–and the entire health system
To determine the strength of current and potential RCM outsourcing partners, we recommend assessing them using four key criteria:
- Expertise and Excellence
- Security, Compliance, and Trustworthiness
- Innovation
- Quality of Service and Value
Previously, we covered Excellence and Expertise, Security, Compliance, and Trustworthiness, and Innovation. In the final blog post of this series, we wrap up with the role Quality of Service and Value plays in evaluating an RCM outsourcing partner.
Defining Quality of Service and Value
It may seem circular that “service” is an important component of evaluating an RCM outsourcing partner. Outsourcing is, after all, a service. But because it is a service, evaluating the level and quality of customer care that provider delivers is essential. How that partner treats its customers–before, during, and after solution implementation–speaks volumes.
Value flows from quality of service. In the contracted solution–you’re seeing the results you need and expect, on a level that matches or exceeds your investment. Because really, value is your return on investment (ROI). The solution is paying off. It’s worth your investment – in both dollars and staff time.
ROI, however, is difficult to predict before you’ve actually made that investment. Likewise, it’s hard to know how a solution provider will treat you after you’ve signed your contract. When it comes to both, however, weighing the experiences of your peers pays off.
Service and Value: Does Your Partner Deliver?
As mentioned in prior posts, the Black Book Market Research annual report, “Diagnostic/Laboratory/Ancillary Services Revenue Cycle Management: Outsourced & Managed Support RCM Services User Survey,” can help you assess current and potential partners. This annual, in-depth study on how your peers in outpatient and diagnostic services evaluates outsourced RCM service providers across eighteen (18) key performance metrics. More than 2,600 survey respondents shared their real-world experiences. Four of those relate directly to Quality of Service and Value:
1. CLIENT RELATIONSHIPS AND CULTURAL FIT (Question 4, page 13)
A partner who visibly values relationships with their customers directly informs the overall quality of the service they provide. That’s why we include the metric Black Book Market Research identifies as “Client Relationships and Cultural Fit” here. For this metric, the Black Book Market Research team asked study participants to evaluate RCM outsourced service providers on the following statements:
- Outsourcing vendor leadership honors customer relationships highly.
- The relationship with the vendor elevates the customer’s reputation.
- Improving healthcare delivery efficiency and effectiveness is a priority of the supplier.
- Governance of engagement is neither complex for buyers nor requires vendor management attention regularly.
- There is no regular transparency or quality issue.
- Culture clashes don’t threaten the relationship’s success or client’s satisfaction.
2. DEPLOYMENT AND CONTRACT IMPLEMENTATION (Question 7, page 16)
How well a partner implements a solution–that speaks to the heart of the service they provide. Getting our solution up and running smoothly and efficiently requires is more than an indicator of skill and experience; it is a clear indicator that they have listened to and understood your needs and expectations. It is a harbinger of service quality in the days ahead. And it’s the pathway to a speedier realization of ROI.
Along those lines, the second 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:
- Outsourcing services client 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.
3. SCALABILITY, CLIENT ADAPTABILITY, FLEXIBLE PRICING (Question 10, page 19)
Next, the third 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 classified by Black Book as “Scalability, Client Adaptability, Flexible Pricing.” Covered here is the vendors willingness–and ability–to understand their customers’ climate and conditions, adapt when those conditions change, and align their solution offerings accordingly. Survey respondents evaluated their partners related to these statements:
- Outsourcing services vendor provides flexible pricing allowing the client to choose and pay for the precise functionality and services needed.
- Vendor invests in significant infrastructure and could provide services to enterprise organizations.
- Managed services meet the changing and varied needs of the outsourcing customer.
- Pricing is not rigid or shifting and meets the needs of the client.
4. SUPPORT AND CUSTOMER CARE (Question 17, page 26)
Finally, you want your partner to provide superior care and support for the duration of your relationship. An RCM outsourcing partner should respond to issues expediently and help you resolve them–and they should have the staff and processes to facilitate that.
To that end, Black Book Market Research team asked study participants to evaluate providers on the following statements, categorized as “Support and Customer Care,” which heal you assess Quality of Service and Value:
- 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 outsourcing services leader and top vendor.
- Customer services and relationship satisfaction are manifested through significant flagship clients as well as smaller and newest customers similarly.
- A vendor provides an appropriate number of accessible support and customer care personnel
Wrapping Up
Outsourced RCM service providers that rank high for these four key performance metrics deliver the Quality of Service and Value that hospitals and health systems need to achieve their financial and operational goals in outpatient diagnostic and ancillary services. Objective industry data and benchmarks, such as the Black Book Market Research report, help you quantitatively determine whether you have partnered–or will partner–with the outsourced RCM services provider that can deliver the capabilities needed to help them improve financial margins and mitigate staffing challenges.
We’ve now examined four key evaluation categories core RCM services capabilities–from partner expertise to innovation. To see how your current–or potential–RCM outsourcing partner stacks up, download the full 2023 Black Book Market Research report. Your peers have weighed in. Find out what they have to say.
