Nearly half of the providers KLAS interviewed for the recent study, "Seismic Shift in Revenue Cycle: Market Heading toward Sole-Source Landscape," told the research firm they plan to replace their existing revenue cycle management (RCM) system over the next five years – with 87 percent of them planning to do so in the next three years.

There are many factors influencing this shift – from integration and single source solutions to cost and bolt-on functionality – and providers are going about their RCM buying decision processes with more than just the revenue cycle in mind, the KLAS study found. One CFO of a community hospital on the East Coast said, “I put the decision to find a new hospital-wide system into the hands of my clinical team. I decided that if they were happy, I could make any patient financials package work.”

Most providers are looking at a new RCM system in terms of how it fits in with a single-source enterprise strategy, often driven by the clinical vendor. Nearly three of four providers in this study mention their CIS as influencing their decision to replace or upgrade their RCM. One in four say that accountable care organizations (ACOs), ICD-10, or other government initiatives were also influences. However, while fewer providers are gravitating toward the best-of-breed approach, the study found that larger development shops and those with a weak RCM system are the most likely to choose a best-of-breed replacement.

Epic and Siemens top the list for providers with more than 200 beds, while McKesson and MEDITECH were the most considered by community hospitals with 200 or fewer beds.

The report also examines how enterprise integration and single-source solutions have increased momentum in the RCM replacement market, the strengths and weaknesses of various RCM solutions, the bolt-on market and the influence of ACO and government initiatives.