For instance, 77 percent of providers "believe patient accounting and practice management integration is important and critical to their revenue cycle environment," but just 14 percent of vendors offer the capability.

"Cerner, Epic, GE, and Siemens all have integrated PA/PM solutions, but adoption levels and experience vary," she adds. "LSS is not integrated but rather is tightly interfaced with MEDITECH, with high satisfaction. McKesson and Allscripts don’t currently have integrated PA/PM offerings."

According to KLAS, 78 percent of providers say inpatient EHR integration is their key concern; 41 percent say it's ambulatory integration.

And to judge by the revenue cycle directors interviewed for the report, many of them are unhappy, and aren't holding out much hope for a positive change..

"The integration and functionality we get with our current solution is terrible, and there isn’t a viable solution in the near future for us to consider," says one. "We lack the overall confidence that our vendor can pull things off and offer a workable solution, which has pushed us to look elsewhere."

"With all the ICD-10, accountable care, and other changes coming, we know something needs to change here," says another.

That's a sentiment that was echoed by John Hoyt, executive vice president of HIMSS Analytics, in the June 2013 print issue of Healthcare IT News.

"There's a new future for revenue cycle," he said. "We've been nipping away at trying to save money in Medicare for years, but we need fundamental change, and we all know it. And it's coming in the form of ACOs or bundled payments and this type of thing."

Put simply, said Hoyt, "The revenue cycle systems we've had, for the past 10 years, are not prepared to do that."

New capabilities are on the way. But not just yet.

"The vendors are telling us that they're preparing, and they're looking at revenue cycle redesigns to take into account bundled payments and ACO reimbursements," said Hoyt. In the meantime, most providers have other things to invest in before they splurge on next-generation RCM systems, he said. "They're not going to buy them until they've gotten all they can get out of meaningful use."

After that? "We think there's going to be a boom"

[See also: RCM market expected to grow by leaps]