Vertical remains active as companies are poised to capitalize on tailwinds from growing healthcare market. Vendor consolidation at the provider level is driving strategic M&A as vendors look to be a full revenue cycle solution.
By CAS November, 2022
The revenue cycle management vertical continues to be active with deal count down around 30% from a highly active Q3 2021, but up 7% from Q2 2022. In terms of deal volume, the market remains strong with nearly $1.3B in deal volume taking place in Q3 2022 alone. A variety of tailwinds remain as we pull out of the COVID-19 pandemic and revenue cycle management providers are positioned well to solve some of the pain points that healthcare providers are facing.
Some key deals to note that were completed in Q3 2022 involved private-equity-backed Revecore acquiring both Kemberton and Cura to further bolster their service offering in revenue cycle. Wakefield & Associates acquired CollectRx, expanding their client base and service offering in the complex claims vertical. Strategic mergers continue to take place in the revenue cycle vertical where performance issues are less pronounced than other verticals in the broader economy.
In a trend that continues to take shape, the national media continues to focus on unpaid medical debt as a potential rally cry heading into midterm season. There have been numerous studies issued recently trying to account for the amount of medical debt outstanding that is impacting consumers. In a recent study published by JAMA, nearly 17.8% of Americans currently have a debt in collections. The debt burden is carried mostly by the middle- and lower-class incomes. Deductibles are up nearly 25% in the last 5 years per a survey by Kaiser Family Foundation, which is leading to increased financial burden on patients. In August 2022, Capio, a purchaser of non-performing healthcare accounts receivable, launched a new technology product geared towards financial wellness in healthcare called BuoyFi. The idea and intention of BuoyFi, set to launch in Q3 2022, is to provide patients free tools to calculate and negotiate affordable settlement and payments plans. The platform is also expected to launch further up the patient lifecycle over time.
A key trend to watch in the revenue cycle vertical is the increased emphasis on medical coding accuracy. If there are issues during the intake, the organizations’ chance of receiving payment for services provided decrease significantly. Physicians and other healthcare providers are already spread thin, so asking them to focus on a non-patient item is a challenge. However, health systems are starting to head off the problem. As part of onboarding new employees and working with tools and templates in the system of record used, providers can increase their number of accepted claims, thus reducing denials. We at CAS feel that companies solving this issue for providers or showing increased efficiency or denials reductions will fetch premium valuation due to their service.
The CFPB published an analysis of how actions of Experian, EquiFax and TransUnion will impact the consumers who have medical debt on their credit reports that will no longer be common practice beginning in 2023. Medical collection accounts less than $500 will no longer be reported on consumer credit reports. This will reduce the volume of medical collection accounts on credit reports by nearly two-thirds, per the CFPB’s research. The industry anticipates this change to have a large impact on the tools of anyone responsible for the recovery of bad debt related to medical bills. The second order impacts of the price of care remain to be seen and will likely take years to pop up, but undoubtedly, this will have a negative impact on companies reliant on credit reporting as a strategy for recoveries on behalf of healthcare providers.
Revecore acquired Kemberton & Cura.
Wakefield & Associates acquired CollectRx
PayrHealth acquired Supero Healthcare Solutions