State of Small-Hospital Patient Accounting 2023 Trends

State of Small-Hospital Patient Accounting 2023 Trends
State of Small-Hospital Patient Accounting 2023 Trends


KLAS: State of Small-Hospital Patient Accounting 2023

What You Should Know:

– Small hospitals are changing their EMRs and patient accounting systems at a greater rate than that of their large-hospital counterparts. Most market selection energy is going to Oracle Health (Cerner), MEDITECH, and Epic; small hospitals also use other vendors like athenahealth, CPSI, and MEDHOST.

– While many vendors offer viable clinical systems, there are significant differences across the customer experience with patient accounting that should not be overlooked by small hospitals. To help these organizations make more informed decisions, a new report by CLASS examines feedback from small hospitals (≥250 beds) about their patient accounting solutions.

Better Understanding and Meeting the Needs of Smaller Hospitals

Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 12 months using KLAS’ standard quantitative evaluation for healthcare software, which is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.

Key findings of the report include:

MEDITECH Excels at Creating Strong Relationships with Small-Hospital Customers: MEDITECH is a market-share leader in this space. Small- hospital customers praise their partnership and transparency; executives are available when problems arise, and frontline support staff are helpful, knowledgeable, and effective at resolving concerns quickly and completely. Respondents also appreciate that MEDITECH listens to and implements feedback without overpromising the product’s capabilities or committing to impossible timelines. This has led to customers highly trusting the vendor and valuing the relationship they have built.

Due to the unique setup of Epic’s Community Connect program, customers seeking support work directly with their host organization, not Epic. Respondents state they receive up-front transparency about the product’s capabilities and gaps. The relationship quality varies across hosts. Some small hospitals say their host is responsive and informed and makes sure their needs are continually met; other respondents’ host relationships are hindered by long resolution times, requested changes that aren’t delivered, and insufficient resources from their host site.

Epic Offers High-Quality Product; CPSI & Oracle Health Customers Dissatisfied with Product Capabilities

Epic’s solution is highly functional for small hospitals; the vendor provides the tools customers need and continually delivers new technology in response to changing reimbursement rules. Respondents especially appreciate the deep integration they have with other Epic entities in their area, and this integration is often a key driver in their decision to move to Epic. Interviewed customers of MEDITECH state the functionality is solid, and they are excited about the vendor’s road map and optimistic that their satisfaction with the product will increase.

CPSI’s solution isn’t as customizable as customers would like. They report a wide range of missing features as well as upgrade bugs, and several respondents feel the solution may have capabilities they aren’t aware of. 60% of Oracle Health (Cerner) respondents are unsatisfied with the system’s ability to meet their functionality needs, and they report having to supplement the product with third-party solutions. Additionally, some customers express concern about having to move to Oracle Health’s new revenue cycle solution—RevElate—in coming years; these customers doubt whether RevElate will improve their current revenue cycle situation.

Oracle Health (Cerner), CPSI, MEDHOST & athenahealth (Latter Two Limited Data) Fail to Deliver on Expectations

The solution from Oracle Health (Cerner) has significant reporting, patient access, and patient refund gaps that customers say they weren’t made aware of during the sales process. Respondents further note the vendor has failed to fulfil long-standing promises to fix these functionality issues, placing undue burden on organizations and leaving them to wonder whether the vendor will deliver promised functionality in RevElate. (More information about the vendor’s performance will be in an upcoming Oracle Health report.) CPSI customers are having to purchase third-party add-ons due to unexpected gaps in product functionality. They feel they have to stay on top of support issues in order to get them resolved and want CPSI to provide more proactive guidance on how to optimize the product, gain efficiencies, and fill perceived gaps with existing features.

Limited feedback from MEDHOST customers indicates the product generally works as promoted but is outdated. While customers view the solution as a low-cost option, they note the vendor lacks a proactive approach to support and hasn’t delivered new functionality that meets their needs. Small hospitals using athenahealth (limited data) report that their expectations around development haven’t been met, leaving customers feeling neglected and unable to attain desired outcomes.

All Vendors Struggle to Provide Training That Meets Small Hospitals’ Needs

No vendor in this report excels at providing training suited to the needs of small hospitals. Customers of MEDITECH—who has the highest operations score—say the training materials are not detailed enough and the vendors’ resources cover things too quickly. Epic customers similarly feel their Community Connect hosts do not have the needed resources or knowledge to help customers successfully navigate an implementation and go-live. MEDHOST’s (limited data) operations score has increased by 10 points (on a 100-point scale) within the last year; customers note the vendor has improved the product’s ease of use and integration, though initial and ongoing training is still a pain point.

CPSI provides self-directed training, which leaves respondents feeling stranded, insufficiently trained, and unsure of how to find needed materials. Small hospitals using athenahealth (limited data) report training is severely lacking and want the vendor to provide training tailored to the inpatient market. Oracle Health’s uCern program contains a lot of information for training; however, customers have to find needed information on their own and want more proactive guidance from the vendor.

MEDITECH Stands Out for Driving Tangible Outcomes; Oracle Health (Cerner) Customers Report Low Value Due to Price & Missing Features

MEDITECH stands out for the value they provide to small- hospital customers, who highlight that the vendor drives tangible outcomes by offering a very affordable and stable solution, keeping up with regulatory items, and consistently developing new functionality. All respondents report they are not nickel-and-dimed and receive no unexpected charges. They also say the reporting enables them to understand and meet financial metrics by staying on top of revenue, A/R, and DNFB accounts. Oracle Health (Cerner) respondents note the solution has an expensive price tag and lacks expected functionality and stability. They also express frustration with the vendor’s representatives, who are described as lacking product knowledge and unhelpful when resolving problems.



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