KLAS names top global vendors in 2025 RCM outsourcing report
UTAH, UNITED STATES — Hospitals and healthcare organizations are increasingly turning to outsourcing to manage complex revenue cycle operations, with a new KLAS Research report showing which vendors are winning trust in the market.
RCM outsourcing surges as healthcare cuts costs
End-to-end revenue cycle management (RCM) outsourcing is gaining traction as health systems struggle with rising costs and operational inefficiencies.
According to market research firm KLAS Research, outsourcing agreements typically last at least five years and often involve rebadging, “in which people are transferred to another organization.”
The report assessed client satisfaction with major vendors, including Ensemble, Guidehouse, Optum, and R1 RCM.
Demand for outsourcing has surged, with “most major outsourcing vendors gaining new contracts between July 2023 and May 2025,” the study noted.
The report found that healthcare providers typically opt for outsourcing when internal performance is lagging, costs are high, or quick improvements require additional resources.
For many organizations, outsourcing offers access to advanced technology, including artificial intelligence, that would otherwise be too costly to implement independently.
Healthcare RCM rankings and client feedbacks
Ensemble emerged as the top-performing vendor, earning the 2025 Best in KLAS award with a score of 95.1. Clients highlighted “deep partnerships” extending from sales to post-implementation, as well as a “structured governance process, collaborative leadership, and frequent, structured communication channels.” Ensemble also drew praise for investing in advanced technology and expanding its presence in payer relations.
Guidehouse followed with 93.8 points, supported by positive client remarks about its “knowledgeable, flexible staff” and “achieved outcomes.” While data was more limited, smaller healthcare organizations reported optimism about the vendor’s ability to deliver.
Optum scored 61.9, with clients appreciating access to its technology but voicing concerns over “staff turnover, slow progress on key initiatives, and persistent backend challenges.” Outcomes in cash collections, denial rates, and patient experience left many dissatisfied.
R1 RCM ranked lowest with 55.6 points, with clients citing challenges with staff turnover, lack of strategic coordination across teams, and poor follow-through on targets and commitments. Despite these issues, recent leadership changes and investments, including a partnership with Palantir, sparked cautious optimism about its future.
Healthcare providers seek resilient long-term RCM partners
As healthcare organizations weigh whether to keep their revenue cycle functions in-house or outsource, factors such as vendor reputation, technology capabilities, and partnership quality are becoming increasingly decisive.
KLAS emphasized that performance on quantifiable financial and operational metrics clearly defines success; however, fostering strong cultures, relationships, satisfaction, and collaboration were also key.
With outsourcing now a strategic lifeline, providers are looking beyond short-term fixes and prioritizing long-term partnerships that can deliver both financial and operational resilience.
