R1 RCM INC. Unless the context indicates otherwise, references in this Quarterly Report on
Form 10-Q to "R1," "the Company," "we," "our," and "us" mean
This Quarterly Report on Form 10-Q contains "forward-looking statements" within the meaning of the federal securities laws, that involve substantial risks and uncertainties. These statements are often identified by the use of words such as "anticipate," "believe," "estimate," "expect," "intend," "designed," "may," "plan," "predict," "project," "would," and similar expressions or variations. These forward-looking statements include, among other things, statements about the potential impacts of the COVID-19 pandemic, our strategic initiatives, our capital plans, our costs, our ability to successfully deliver on our commitments to our customers, our ability to deploy new business as planned, our ability to successfully implement new technologies, our future financial performance, and our liquidity. Such forward-looking statements are subject to risks, uncertainties, and other factors that could cause actual results and the timing of certain events to differ materially from future results expressed or implied by such forward-looking statements. Factors that could cause or contribute to such differences include, but are not limited to, our ability to retain existing customers or acquire new customers; our ability to manage our operations effectively; competition within the market; the severity, magnitude, and duration of the COVID-19 pandemic; responses to the pandemic by the government and healthcare providers and the direct and indirect impacts of the pandemic on our customers and personnel; the disruption of national, state, and local economies as a result of the pandemic (including as a result of supply chain interruptions, labor shortages, and inflationary pressures); the impact of the pandemic on our financial results, including possible lost revenue and increased expenses; as well as those discussed elsewhere in this Report, and those set forth in Part I, Item 1A of the 2020 Form 10-K and our other filings with theSEC . The forward-looking statements in this Quarterly Report on Form 10-Q represent our views as of the date of this Quarterly Report on Form 10-Q. Subsequent events and developments may cause our views to change. While we may elect to update these forward-looking statements at some point in the future, we have no current intention of doing so except to the extent required by applicable law. You should, therefore, not rely on these forward-looking statements as representing our views as of any date subsequent to the date of this Quarterly Report on Form 10-Q. Overview Our Business We are a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. Our services help healthcare providers generate sustainable improvements in their operating margins and cash flows while also enhancing patient, physician, and staff satisfaction for our customers. We achieve these results for our customers by managing healthcare providers' revenue cycle operations, which encompass processes including patient registration, insurance and benefit verification, medical treatment documentation and coding, bill preparation, and collections from patients and payers. We do so by deploying a unique operating model that leverages our extensive healthcare site experience, innovative technology, and process excellence. We assist our revenue cycle management ("RCM") customers in managing their revenue cycle operating costs while simultaneously increasing the portion of the maximum potential services revenue they receive. Together, these benefits can generate significant and sustainable improvements in operating margins and cash flows for our customers. 27 --------------------------------------------------------------------------------
Our primary service offering consists of end-to-end RCM services for health
systems, hospitals, and physician groups, which we deploy through an operating
partner relationship or a co-managed relationship. Under an operating partner
relationship, we provide comprehensive revenue cycle infrastructure to
providers, including all revenue cycle personnel, technology solutions, and
process workflow. Under a co-managed relationship, we leverage our customers'
existing RCM staff and processes, and supplement them with our infused
management, subject matter specialists, proprietary technology solutions, and
other resources. Under the operating partner model, we record higher revenue and
expenses due to the fact that almost all of the revenue cycle personnel are our
employees and more third-party vendor contracts are controlled by us. Under the
co-managed model, the majority of the revenue cycle personnel and more
third-party vendor contracts remain with the customer and those costs are netted
against our co-managed revenue. For the nine months ended
We also offer modular services, allowing customers to engage us for only specific components of our end-to-end RCM service offering, such as physician advisory services ("PAS"), practice management ("PM"), revenue integrity solutions ("RIS"), patient experience ("PX"), coding management, and business office services. Our PAS offering assists healthcare organizations in complying with payer requirements regarding whether to classify a hospital visit as an in-patient or an out-patient observation case for billing purposes. Our PM services offer administrative and operational support to allow healthcare providers to focus on delivering high quality patient care and outsource non-core functions to us. Our RIS offering includes charge capture, charge description master ("CDM") maintenance, and pricing services that help providers ensure they are capturing the maximum net compliant revenue for services delivered. Our PX offering helps patients manage their data in one easy-to-use environment, enabling eligibility validation and insurance plan attribution, demographic accuracy, meeting authorization and referral requirements, medical necessity validation, and patient out-of-pocket cost estimation. Our coding management offering drives performance, quality, and consistent results via business intelligence and analysis, human capital management, an accountability framework, and a quality management program. Our business office services can help providers with the entire billing function or to specifically recoup revenue that may otherwise be lost by focusing skilled resources in lower priority areas with significant revenue potential.
Once implemented, our technology solutions, processes, and services are deeply embedded in our customers' day-to-day revenue cycle operations. We believe our service offerings are adaptable to meet an evolving healthcare regulatory environment, technology standards, and market trends. We operate our business as a single segment configured with our significant operations and offerings organized around the business of providing revenue cycle operations for healthcare providers. VisitPay Acquisition
On
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On
Given the ongoing challenges associated with efforts to contain the spread of
COVID-19 and related business impact for our customers, we initiated a number of
actions in 2020 that have continued throughout 2021 to ensure (1) the health,
safety, and well-being of our workforce; (2) uninterrupted and, in many
respects, expanded support for our customers and the patients and communities
they serve; and (3) business and operational continuity. Among our specific
actions to support our workforce, we have maintained our work-from-home model
for more than 15,000 global employees, offered zero out-of-pocket cost for
COVID-19 testing and telemedicine visits, offered mental wellness programming,
and continued the R1 Cares vaccination support program for our
Patient volumes have continued to recover over the last 12 months and are
largely in line with pre-COVID levels. Given the continued uncertainty of the
pandemic, we cannot reasonably predict when volumes will return to their
pre-COVID levels. The impact of the COVID-19 pandemic is fluid and continues to
evolve. We cannot predict the extent to which our business, results of
operations, financial condition or liquidity will ultimately be impacted,
including as a result of macro-economic impacts to the global supply chain,
labor shortages, and inflationary pressures. However, we continue to assess its
impact on our business and continue to actively manage our response. For further
details on the potential impact of COVID-19 on our business, refer to "Risk
Factors," in Part II, Item 1A of our Annual Report on Form 10-K for the fiscal
year ended
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