Yardstick Research tear-sheet / healthcare RCM cohort

Methodology · how we score · rubric weights in plain sight · vendors received this sheet seven days before publication and could flag factual errors, never rankings

Fathom-Health

Identity

Total score: 71.6 / 100

Headline numbers

Metric Value Evidence URL
Automation rate (KLAS-validated, multi-customer) 90%+ across specialties https://www.businesswire.com/news/home/20251002716056/en/Fathom-Achieves-95.5-Overall-Performance-Score-in-KLAS-Research-Autonomous-Coding-Report-With-Customers-Validating-90-Automation-Rates
KLAS Autonomous Coding 2025 overall performance score 95.5/100 https://www.businesswire.com/news/home/20251002716056/en/Fathom-Achieves-95.5-Overall-Performance-Score-in-KLAS-Research-Autonomous-Coding-Report-With-Customers-Validating-90-Automation-Rates
Your Health single-customer outcome 95.5% automation, 98.3% accuracy, $35M benchmarking revenue impact https://hitconsultant.net/2026/03/19/fathom-autonomous-medical-coding-your-health-35m-revenue-ai/
Lifetime encounter volume (vendor claim) 63M+ https://fathomhealth.com/
Provider sites (vendor claim) 3K+ https://fathomhealth.com/
HITRUST certification tier i1 (moderate-assurance) https://fathomhealth.com/insights/fathom-advances-data-protection-and-privacy-in-autonomous-medical-coding-with-hitrust-i1-certification
Total funding (pre-CVS 2026) ~$60.1M https://www.crunchbase.com/organization/fathom-4
Latest strategic investor CVS Health Ventures (May 2026) https://hitconsultant.net/2026/05/06/fathom-cvs-health-ventures-autonomous-coding-investment/

Dimension scores

Dimension Score (raw/max) Weight Weighted Evidence URL
AI capability depth 3/4 15 11.25 [VENDOR-CLAIMED + THIRD-PARTY] KLAS-validated 90%+ automation across customers and 95.5/100 overall KLAS Autonomous Coding 2025 score; outpatient breadth (ED, radiology, primary care, anesthesia) plus E/M + HCC capture; capped at 3 (not 4) because the foundation-model / LLM provider is undisclosed and no published arXiv paper or model card exists, which is a meaningful disclosure gap vs Hippocratic Polaris / Tennr RaeLM. Inpatient DRG still in development. - https://fathomhealth.com/insights/fathom-achieves-95-5-overall-performance-score-in-klas-research-autonomous-coding-report-with-customers-validating-90-automation-rates
Workflow integration depth 3/4 25 18.75 [VENDOR-CLAIMED + THIRD-PARTY] Native Epic Toolbox listing (Fully Autonomous Coding category, August 2024) + athenahealth Data View Marketplace presence - the strongest dual-EHR-marketplace posture in the cohort. Customer-validated end-to-end at Your Health on athenahealth. Capped at 3 (not 4) because Cerner / Meditech / Allscripts / NextGen / eClinicalWorks are cited only by third-party teardowns, not by native marketplace cards; FHIR R4 / SMART on FHIR conformance not stated. - https://www.fathomhealth.com/insights/fathom-autonomous-medical-coding-available-in-epic-toolbox, https://athenaconnect.athenahealth.com/marketplace/product/fathom-inc, https://hitconsultant.net/2026/03/19/fathom-autonomous-medical-coding-your-health-35m-revenue-ai/
Vertical specialization 4/4 15 15.0 [VENDOR-CLAIMED + THIRD-PARTY] 100% healthcare-only product company. Distinct product pages by buyer segment (health system, physician group, health plan, RCM vendor) and by specialty (primary care, emergency medicine, radiology, anesthesia, E/M). Strategic healthcare investor base (Cedars-Sinai, Vituity Inflect Health, ApolloMD, CVS Health Ventures). No horizontal NLP or adjacent revenue. - https://fathomhealth.com/, https://hitconsultant.net/2026/05/06/fathom-cvs-health-ventures-autonomous-coding-investment/
Implementation + time-to-value 3/4 10 7.5 [VENDOR-CLAIMED contradicted by THIRD-PARTY] Vendor says "4-6 weeks" full deployment (2022 Series B). RevCycleAI / PPLE Labs say "4-6 months" implementation, 12-18 months to average ROI. Your Health trajectory (October 2025 go-live → March 2026 all-service-lines disclosure) consistent with 4-6 months full enterprise rollout. Score 3 (not 4) because the contradiction is real and the published 4-6 weeks is misleading for multi-service-line buyers, but 5-month all-lines rollout with $35M revenue impact is still excellent for the cohort. - https://www.fathomhealth.com/insights/fathom-secures-46m-series-b-financing, https://revcycleai.com/blog/fathom-vendor-deep-dive/, https://hitconsultant.net/2026/03/19/fathom-autonomous-medical-coding-your-health-35m-revenue-ai/
Data + compliance posture (HIPAA/HITRUST) 2/4 20 10.0 [VENDOR-CLAIMED + THIRD-PARTY] HITRUST i1 (December 2024 - moderate-assurance tier, below Cohere Health's r2 in the same cohort) + SOC 2 Type 2 (audit firm + date not published) + HIPAA. ISO 27001 / 27701 / 42001 not claimed. Penetration test reports not published. AI safety / training-data posture not addressed on trust page. PHI-training opt-out default in standard BAA undocumented - a meaningful gap given the autonomous-coding category. Score 2 (not 3) because the lack of model-governance + PHI-training-default disclosure compounds the i1-vs-r2 tier gap; the buyer-side procurement story is materially weaker than Cohere Health's. - https://fathomhealth.com/security, https://fathomhealth.com/insights/fathom-advances-data-protection-and-privacy-in-autonomous-medical-coding-with-hitrust-i1-certification
Pricing + scalability 1/4 5 1.25 [VENDOR-CLAIMED] Fully quote-only; /pricing returns HTTP 404; never indexed by Wayback. Homepage CTAs are "GET STARTED" / "REQUEST A CALL" / "SCHEDULE A CALL". The "up to 50%" / "up to 70%" cost-reduction framing is an outcome claim, not a price. ROI calculator gates results behind a contact form. No per-encounter or per-chart anchor. Scalability itself is strong (90%+ automation at health-system volume; "code millions of charts per day" demonstrated), but the rubric reads pricing transparency as the gating signal here. - https://www.fathomhealth.com/, https://www.fathomhealth.com/services, https://www.fathomhealth.com/roi-calculator
Vendor strength + named-customer evidence 4/4 10 10.0 [VENDOR-CLAIMED + THIRD-PARTY] CVS Health Ventures (May 2026) + Cedars-Sinai + Vituity Inflect Health + ApolloMD + GV + 8VC + Lightspeed + Alkeon strategic-investor stack. Named-customer roster includes One Medical, Assembly Health, Community Health Network, ApolloMD (1,500+ physicians, 2.5M+ patients, 88 hospitals), Hoag, UCI Health, Your Health, Cedars-Sinai. KLAS 100% satisfaction in 6-customer Spotlight (2024); KLAS 95.5/100 overall in Autonomous Coding 2025 with 100% recommend rate; KLAS #1 for Reducing Cost of Care in 2025 Emerging Solutions Top 20; 2025 NY Digital Health 100. Strongest single-customer quantified outcome in the cohort (Your Health). - https://fathomhealth.com/, https://www.fathomhealth.com/insights/apollomd-leverages-fathom-autonomous-medical-coding-to-save-costs-and-accelerate-revenue-cycle-for-1-500-physician-group, https://www.businesswire.com/news/home/20251022748915/en/Fathom-Named-1-Solution-for-Reducing-Cost-of-Care-in-KLAS-2025-Emerging-Solutions-Top-20-Report

Total weighted: 11.25 + 18.75 + 15.0 + 7.5 + 10.0 + 1.25 + 10.0 = 73.75 → minus 2.0 soft integration penalty + 0 scale penalty + soft pricing-transparency penalty applied per the cohort scoring code = headline_score ~71.6.

Pricing detail

Integrations

Editorial assessment

Fathom is the operating standard for outpatient autonomous medical coding. Where most healthcare-rcm vendors paste marketing language about automation, Fathom has KLAS-validated 90%+ automation across customers, a 95.5/100 overall performance score in the KLAS Autonomous Coding 2025 report, and a falsifiable single-customer outcome at Your Health (95.5% automation across all service lines, 98.3% accuracy, $35M benchmarking revenue impact, October 2025 go-live to March 2026 disclosure). That outcome is rare in the cohort - most peers publish range claims or single-line testimonials, not multi-metric multi-service-line numbers tied to a named customer with a verifiable EHR.

Best fit is the mid-sized to enterprise outpatient health system or physician group with consolidated emergency-department / radiology / primary-care / E/M-heavy volume, Epic or athenahealth as the EHR of record, and an existing coding operation that can absorb partial-to-full displacement. The CVS Health Ventures investment in May 2026 signals payor-side risk-adjustment coding (HCC capture for Medicare Advantage and ACA marketplace populations) as the second wedge.

Where Fathom is bounded: inpatient DRG is in development, not in production - for academic medical centers with DRG-heavy volume, CodaMetrix's inpatient-first positioning is the differentiated alternative. HITRUST tier is i1 (moderate-assurance), not r2 (the highest tier Cohere Health holds) - for payor-side buyers comparing Fathom vs Cohere on risk-adjustment, this gap surfaces in procurement. The model architecture is undisclosed (no foundation-model attribution, no arXiv paper). The PHI-training opt-out default is not in any published DPA-level statement. Pricing is fully quote-only.

Compared to CodaMetrix, Fathom wins on outpatient breadth, KLAS-validated automation rate, EHR-marketplace presence, and quantified customer outcomes; CodaMetrix wins on inpatient DRG. Both are similarly opaque on pricing. Buyers should make the call on inpatient-vs-outpatient mix.

Revisit when: inpatient DRG goes GA with a named customer outcome; Fathom publishes a model card or names a foundation-model provider; Fathom publishes a per-encounter / per-chart price anchor; HITRUST tier upgrades from i1 to r2; CVS-Ventures-strategic deployment lands with a named payor-side customer outcome.

Right-of-reply gaps

The following items are tagged [UNKNOWN] or are vendor / third-party contradictions in the dossier and should be sent to Fathom in the right-of-reply email: