Everest Group Revenue Cycle Management (RCM) Operations PEAK Matrix®
Assessment 2023
Focus on Cognizant
July 2023

Copyright © 2023 Everest Global, Inc.
This document has been licensed to Cognizant

Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Introduction

2022 was a tumultuous year for healthcare providers in the US. With patient volumes still below pre-pandemic levels, a jump in the average length of stay, intensified talent shortages, andrising costs, approximately half of the hospitals in the US witnessed negative margins. As revenue pressures on healthcare providers aggravate, focus on futureproofing the revenue cycle
operations has come to the forefront, and healthcare providers seek the support of third-party vendors to make the revenue cycle process more effective and efficient and to assuage thecurrent challenges.

Additionally, to better address the evolving needs of healthcare providers, service providers are investing in scaling their talent pools, strengthening their technology portfolio to drive value
through automation and analytics, and leaning toward mergers and acquisitions to expand their value chain coverage and depth in the hypercompetitive revenue cycle market.
In this research, we present an assessment and detailed profiles of 31 RCM operations providers featured on the Revenue Cycle Management (RCM) Operations PEAK Matrix®
Assessment 2023. Each provider profile provides a comprehensive picture of its service focus, key Intellectual Property (IP) / solutions, domain investments, and case studies. The
assessment is based on Everest Group’s annual RFI process for the calendar year 2023, interactions with leading RCM providers, client reference checks, and ongoing analysis of the
RCM services market.
In the full report includes the profiles of the following 31 leading revenue cycle operations providers featured on the RCM operations PEAK Matrix®:⚫

Leaders: Access Healthcare, AGS Health, Cognizant, Coronis Health, GeBBS, Omega Healthcare, Optum, and R1 RCM⚫

Major Contenders: Acclara, Atos, CorroHealth, Ensemble Health Partners, Exela Technologies, Firstsource, Genpact, Global Healthcare Resource, IKS Health, Innova Solutions,
NTT DATA, Parallon, Sagility (formerly HGS Healthcare), Shearwater Health, Sutherland Global Services, Teleperformance, Wipro, and WNS⚫

Aspirants: ACN Healthcare, GetixHealth, iMagnum Healthcare Solution, NextGen Healthcare, and Vee Technologies

Scope of this report
Geography
Global

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Providers31

Services
RCM BPS

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Revenue Cycle Management (RCM) Operations PEAK Matrix® characteristics

Leaders
Access Healthcare, AGS Health, Cognizant, Coronis Health, GeBBS, Omega Healthcare, Optum, and R1 RCM⚫

Leaders have established themselves as front-runners to support healthcare providers in their end-to-end operations of the RCM value chain spanning patient access, medical billing,claims management, and A/R management⚫

They are focused on expanding the depth and breadth of their offerings through mergers, acquisitions, and partnerships⚫

Leaders are also ramping up their talent pool and investing in expanding their technological offerings to serve the increased demand for outsourcing

Major Contenders
Acclara, Atos, CorroHealth, Ensemble Health Partners, Exela Technologies, Firstsource, Genpact, Global Healthcare Resource, IKS Health, Innova Solutions, NTT DATA, Parallon, Sagility(formerly HGS Healthcare), Shearwater Health, Sutherland Global Services, Teleperformance, Wipro, and WNS⚫

While Major Contenders may not have an integrated and extensively comprehensive coverage of the RCM value chain, they have been able to deliver value by strengthening theircapabilities in certain areas of the value chain⚫

They are focusing on investments in either people, processes, or technology levers to bridge the gaps in their proposition

Aspirants
ACN Healthcare, GetixHealth, iMagnum Healthcare Solution, NextGen Healthcare, and Vee Technologies⚫

Aspirants are typically focused on particular buyer segment(s) or value chain process(es)⚫

They have a relatively smaller scale of operations, a skewed delivery mix, and comparatively less focus on technology⚫

Increasing their brand visibility among buyers by showcasing relevant case studies of serving specific buyer segments is a focus area for Aspirants

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Everest Group PEAK Matrix®
Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023 |Cognizant is positioned as a Leader
Everest Group Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 20231,2,3,4
High
Leaders
Market impact
Measures impact created in the market

Major Contenders

Low

GeBBS Access Healthcare

Teleperformance
Sutherland Global Services

Parallon

AcclaraGlobal Healthcare
Resource

NextGen Healthcare
Vee Technologies
iMagnum Healthcare
GetixHealth
Solution
ACN Healthcare

Leaders
Optum

R1RCM
AGS Health Omega Healthcare
Coronis Health
CognizantAspirants
Star Performers

Ensemble Health Partners

Firstsource

Genpact
Innova Solutions
Sagility
IKS Health
Shearwater Health
WNS
Atos

Major Contenders

CorroHealth
Exela Technologies
NTT DATA
Wipro

Aspirants
Low

Vision & capability
Measures ability to deliver services successfully

High

1

Assessments for Acclara, ACN Healthcare, Atos, Coronis Health, CorroHealth, Ensemble Health Partners, GetixHealth, Global Healthcare Resource, IKS Health, NextGen Healthcare, Parallon, R1 RCM, and Vee Technologies exclude provider inputs
and are based on Everest Group’s proprietary Transaction Intelligence (TI) database, provider public disclosures, and interactions with buyers
2 In 2022, MiraMed Global Services was merged with Coronis Health. In this study, we have considered data for both entities, i.e., Coronis Health and MiraMed Global services, and called the combined entity Coronis Health
3 MediRevv (acquired by Tegria in 2021 and part of Tegria RCM), was rebranded to Acclara in 2023
4 In the assessment year, HGS Healthcare was rebranded to Sagility
Confidentiality: Everest Group takes its confidentiality pledge very seriously. Any information we collect that is contract specific will only be presented back to the industry in an aggregated fashion
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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Cognizant profile (page 1 of 6)
Overview
Company overview

Recent acquisitions and partnerships

Cognizant Technology Solutions Corporation is a publicly traded firm founded in 1994 as a technology
development arm of The Dun & Bradstreet Corporation. Cognizant has 100+ delivery centers and over
355,000 employees and is a member of the NASDAQ-100, the S&P 500, and the Forbes Global 2000. It is
ranked among the top-performing and fastest-growing companies in the world. It provides services to clients
across industries such as healthcare, life sciences, banking, financial services, manufacturing, retail,logistics, communication, media, and entertainment.
Headquarters: Teaneck, US

Website: www.cognizant.com

Key leaders⚫

Ravi Kumar S, Chief Executive Officer⚫

Jan Siegmund, Chief Financial Officer⚫

Ganesh Ayyar, Executive Vice President, Digital Operations⚫

Samir Malhotra, SVP and Global Delivery Head

Suite of services
Patient access⚫

Medical billing⚫

Claims management⚫

A/R management

RCM Operations

20201

20211

20221

Revenue (US$ million)⚫

2022: partnership – technology: introduced a patient access workflow management tool⚫

2021: partnership – technology: provided a platform that is a workflow tool, performance improvement
engine, and cloud-based technology platform that continuously deploys automation and innovation to improve
quality and financial outcomes⚫

2020: partnership – technology: automated outbound dialing for payers and handles initial IVR insertion
managing long hold times; also provided call transcriptions, call recordings, and a workflow tool⚫

2019: partnership – technology: enabled process mining and task mining to help analyze current work andidentify improvement and automation projects; also had a collection improvement impact⚫

2019: acquisition – technology: acquired a life sciences manufacturing technology services company, which
extends the capabilities to design, implement, and manage end-to-end operational and information technology
systems for connected biopharmaceutical and medical device manufacturers⚫

2022: realignment of provider business unit: the provider BU has realigned to be its own BU, reinforcing its
focus and commitment to growth in the provider space⚫

2022: increased use of automation: continues to transform its services by creating innovative technologies
using bots, AI, and ML⚫

2022: hiring knowledgeable talent: Cognizant has invested in leaders who are experts in all operational
areas of the revenue cycle⚫

2022: increase training: its goal is to continue developing high-level revenue management professionals andto provide them with advanced technological tools so it can deliver exceptional results for its clients⚫

2022: expanding front-end capabilities: Cognizant has expanded its front-end capabilities and can provide
enhanced digital first patient experiences by offering SMS/MMS text messages as a reminder to phone calls,
as well as the ability to view statements electronically via a link sent on SMS messages

Not disclosed

Number of clients12022: partnership – technology: provided enhanced digital first patient experiences by offering SMS/MMS
text messages, as well as the ability to view statements electronically via a link

Recent developments⚫

Number of FTEs⚫

12 months ending December 31 of any particular year, i.e., from January 1, YYYY to December 31, YYYY
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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Cognizant profile (page 2 of 6)
Capabilities and key clients
RCM operations mix by segment
Number of FTEs

RCM operations revenue mix by geography
Revenue in US$ million

RCM operations FTE split by delivery location
Number of FTEs

RCM operations revenue mix by engagement model
Revenue in US$ million

100% = Not disclosed

100% = Not disclosed

100% = Not disclosed

100% = Not disclosed

Patient access

Aggregators

10%

Medical billing

38%

19%

14%

Claimsmanagement

Onshore

35%

65%
33%
A/R
management

Offshore
86%

100%

Direct engagement

North America

Key RCM operations engagements
Client name

Processes served

RegionA New York-based fertility clinic

Patient access, medical billing, claims management, and A/R management

North America

2022

A locally-owned, non-profit medical facility

Medical billing

North America

2022

An anesthesia solutions company that offers a full suite of anesthesia services

Patient access, medical billing, claims management, and A/R management

North America

2021

A health center with a full range of diagnostic, medical, and surgical services

Patient accessNorth America

2021

A nationally-acclaimed health system anchored by a leading academic medical center Patient accessNorth America

2019

A multispecialty provider group and healthcare management company

Medical billing and A/R management

North America

2018

A national ranked non-profit, public health care system and academic medical center

Patient access, medical billing, claims management, and A/R management

North America

2017

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Client since6Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Cognizant profile (page 3 of 6)
Key delivery locations

Warrensville Heights
St. Louis
Linthicum

Worcester
Timonium

HyderabadBangalore
Coimbatore

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Kolkata
Chennai

ManilaCebu City

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Cognizant profile (page 4 of 6)
Technology solutions/tools

Description

No. of clients

Solution type(proprietary / joint development)2022

A solution used for mailing patient letters and statements; also used as PCI-compliant
credit card management solution that provides for self-serve and agent assist IVR
options

Not disclosed

Joint (third-party)

Medical billing

2022

A tool which automatically presents critical coding information to coders; helps
improve coding accuracy

Not disclosed

Joint (third-party)

Contact center solution

Patient access2022

A predictive Right Party Contact (RPC) Dialer Management solution with an inbuilt
IVR questionnaire for extending patient outreachNot disclosed

Joint (third-party)

ML-driven coding error
prediction

Medical billing

2020

Analytics intervention to identify patterns in coders' behavior; predictive model that
implements advanced techniques to predict error propensity for all cases

Not disclosed

Proprietary

Unified Single Platform (USP) Patient access, medical billing,claims management, and A/R
management

2021

Designed to service end-to-end RCM with robust workflow and workforce
management capabilities and integrated third-party solutions for extending capabilities
with downstream processes; also used for insurance hold queue management,
allowing associates to join calls with insurance after the hold time is complete

Not disclosed

Joint (third-party)

Rework reduction for claims
submission

Claims management

2020

Propensity model developed to identify claims that have high chances of rework; used
as a strategy to decrease the number of claim touches and improve productivity

Not disclosed

Proprietary

AR prioritization model

A/R management

2020

Systematic prioritization engine on AR to improve efficiency in collections; for bettertargeting and to minimize aging. It segregates aging claims into different buckets
based on dollar value, insurance, timely filing limit, last worked date, and age

Not disclosed

Proprietary

Payer pay prediction model

Claims management and A/R
management

2018

A predictive analytical model that uses historic data to predict payers’ propensity topay

Not disclosed

Proprietary

Collections dashboard

A/R management

2018

Studies financial collections or any other payment-related information, to profile
members into distinct clusters (e.g., timely payment, delayed payment, and refunds);
reports related to billing and collections can be analyzed to understand financial
inputs; insights generated help clients define niche strategies for specific member
groups based on collection trends

Not disclosed

Proprietary

Solution name

Processes served

Patient access solution

Patient access

Coding assist toolYear launched

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Cognizant profile (page 5 of 6)
Technology solutions/tools

Description

No. of clients

Solution type(proprietary / joint development)

2018

Analyzes all denials using reports related to billing, collections, and denials; presents
a drill-down into numerous types of denials and further dissects the information byvarious dimensions such as LoBs, geography, and specialty; insights derived from thedashboard, along with customized reports generated, can be used as a feedback loop
to improve collections process and make business decisions

Not disclosed

Proprietary

2017

Uses analytics to identify where and why denials occur; predicts the current inventory
cases that can be denied for particular reason codes

Not disclosed

Proprietary

Solution name

Processes servedYear launched

Denials dashboard

Claims management

Denial management
analytical model

Claims management

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Cognizant profile (page 6 of 6)Everest Group assessment – Leader
Measure of capability:

Market impact
Market adoption

Portfolio mix

Value delivered

Low

High

Vision & capability
Overall

Vision andstrategy

Scope ofservices offered

Innovation andinvestments

Deliveryfootprint

OverallStrengths

Limitations⚫ Cognizant is one of the few IT/BPO providers well adept to deliver the full suite of RCM⚫ Cognizant’s buyer size spread continues to be pivoted toward small to midsize healthcare

processes by leveraging its technological prowess, healthcare industry experience, strong
partner ecosystem, and clearinghouse capabilities. The firm has also carved out a providerfocused business unit which is a testament to its focus on the RCM space⚫ Cognizant takes the digital-first approach and delivers efficiencies by leveraging its proprietary

solutions such as TriZetto and Cognizant Neuro. It also has multiple automation solutions forprocesses such as charge entry and payment posting and has entered a partnership to deliver
an enhanced digital patient experience

providers, this is likely to raise apprehensions with large providers on Cognizant’s ability toserve a diverse client base
⚫ Given its scale and market presence, Cognizant has a relatively small pool of medical coders

predominantly focused on outpatient coding work. With coding being the most outsourced
function in the RCM value chain, limited depth in this area presents a roadblock in its ability
to serve enterprises in this segment⚫ The firm offers flexibility in its delivery and pricing models. Its multi-shore presence allows forbetter business continuity, and its ability to offer contingency-based pricing constructs is morein line with evolving customer expectations⚫ Referenced clients highlighted the ability to take feedback and course correct as well as

operational agility as strengths of the firm

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11Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Everest Group PEAK Matrix® is a proprietary framework for assessment ofmarket impact and vision & capability
Everest Group PEAK Matrix
High

Market impact
Measures impact created in the market

Leaders
Major Contenders

Aspirants

Low
Low

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Vision & capability
Measures ability to deliver services successfully

High

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Services PEAK Matrix® evaluation dimensions

Measures impact created in the market –captured through three subdimensions
Leaders

Market adoption

Portfolio mix
Diversity of client/revenue base acrossgeographies and type of engagements

Market impact

Number of clients, revenue base,
YoY growth, and deal value/volume

Major Contenders

Aspirants

Value delivered
Value delivered to the client basedon customer feedback andtransformational impact

Vision & capability
Measures ability to deliver services successfully.
This is captured through four subdimensions

Vision and strategy

Scope of services offered

Innovation and investments

Delivery footprint

Vision for the client and itself; future
roadmap and strategy

Depth and breadth of services portfolio
across service subsegments/processes

Innovation and investment in the enablingareas, e.g., technology IP, industry/domain
knowledge, innovative commercial
constructs, alliances, M&A, etc.

Delivery footprint and global sourcing mix

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023

Everest Group confers the Star Performers title on providers that demonstrate
the most improvement over time on the PEAK Matrix®
Methodology
Everest Group selects Star Performers based on the relative YoY improvement on the PEAK Matrix

Market impact

Year 1
In order to assess advances on market impact,
we evaluate each provider’s performance acrossa number of parameters including:⚫ Yearly ACV/YoY revenue growth⚫ # of new contract signings and extensions⚫ Value of new contract signings⚫ Improvement in portfolio mix⚫ Improvement in value delivered

Year 0Vision & capability
In order to assess advances on vision and capability,
we evaluate each provider’s performance acrossa number of parameters including:⚫ Innovation⚫ Increase in scope of services offered⚫ Expansion of delivery footprint⚫ Technology/domain specific investments

We identify the providers whose improvement ranks in the
top quartile and award the Star Performer rating to those
providers with:⚫ The maximum number of top-quartile performance
improvements across all of the above parameters
AND⚫ At least one area of top-quartile improvement performancein both market success and capability advancement

The Star Performers title relates to YoY performance for a given vendor and does not reflect the overall market leadership position, which is identified as Leader, Major Contender, or Aspirant.
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FAQs

Does the PEAK Matrix® assessment incorporate any subjective criteria?
Everest Group’s PEAK Matrix assessment takes an unbiased and fact-based approach that leverages provider / technology vendor RFIs and Everest Group’s proprietary databases containing providers’ deals
and operational capability information. In addition, we validate/fine-tune these results based on our market experience, buyer interaction, and provider/vendor briefings.
Is being a Major Contender or Aspirant on the PEAK Matrix, an unfavorable outcome?
No. The PEAK Matrix highlights and positions only the best-in-class providers / technology vendors in a particular space. There are a number of providers from the broader universe that are assessed and do
not make it to the PEAK Matrix at all. Therefore, being represented on the PEAK Matrix is itself a favorable recognition.
What other aspects of the PEAK Matrix assessment are relevant to buyers and providers other than the PEAK Matrix positioning?
A PEAK Matrix positioning is only one aspect of Everest Group’s overall assessment. In addition to assigning a Leader, Major Contender, or Aspirant label, Everest Group highlights the distinctive capabilities
and unique attributes of all the providers assessed on the PEAK Matrix. The detailed metric-level assessment and associated commentary are helpful for buyers in selecting providers/vendors for their specificrequirements. They also help providers/vendors demonstrate their strengths in specific areas.

What are the incentives for buyers and providers to participate/provide input to PEAK Matrix research?
⚫ Enterprise participants receive summary of key findings from the PEAK Matrix assessment⚫ For providers– The RFI process is a vital way to help us keep current on capabilities; it forms the basis for our database – without participation, it is difficult to effectively match capabilities to buyer inquiries– In addition, it helps the provider/vendor organization gain brand visibility through being in included in our research reports
What is the process for a provider / technology vendor to leverage its PEAK Matrix positioning?
⚫ Providers/vendors can use their PEAK Matrix positioning or Star Performer rating in multiple ways including:– Issue a press release declaring positioning; see our citation policies– Purchase a customized PEAK Matrix profile for circulation with clients, prospects, etc. The package includes the profile as well as quotes from Everest Group analysts, which can be used in PR– Use PEAK Matrix badges for branding across communications (e-mail signatures, marketing brochures, credential packs, client presentations, etc.)⚫ The provider must obtain the requisite licensing and distribution rights for the above activities through an agreement with Everest Group; please contact your CD or contact us
Does the PEAK Matrix evaluation criteria change over a period of time?
PEAK Matrix assessments are designed to serve enterprises’ current and future needs. Given the dynamic nature of the global services market and rampant disruption, the assessment criteria
are realigned as and when needed to reflect the current market reality and to serve enterprises’ future expectations.

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Revenue Cycle Management (RCM) Operations PEAK Matrix® Assessment 2023
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