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

Rivet-Health

Identity

• Name: Rivet Health (Rivet Health, Inc.). Acquired by Zelis on January 12, 2026 - brand and rivethealth.com surface still live as of research date; Ted Ferrin continues as CEO inside Zelis. [VENDOR-CLAIMED + THIRD-PARTY - https://www.rivethealth.com/news/zelis-acquires-rivet, https://www.zelis.com/news/zelis-acquires-rivet/]
• Founded: 2018. [THIRD-PARTY - https://www.crunchbase.com/organization/rivethealth, https://rocketreach.co/rivet-profile_b45c94a0fc6ef3d5]
• HQ: Salt Lake City, Utah (50 W Broadway per RocketReach + LinkedIn; Dun and Bradstreet lists a secondary Holladay, UT address; LinkedIn footprint names Lehi). [THIRD-PARTY discrepancy - https://rocketreach.co/rivet-profile_b45c94a0fc6ef3d5, https://www.dnb.com/business-directory/company-profiles.rivet_health_inc.07b8c7f30380e691ab3ebf87f283d698.html]
• Funding (pre-acquisition): ~$31.5M total across Seed, Series A ($8.25M led by Menlo Ventures), Series B ($20.5M led by Catalyst Investors, June 2022). Acquisition terms not disclosed. [THIRD-PARTY - https://www.crunchbase.com/organization/rivethealth, https://www.prnewswire.com/news-releases/rivet-raises-20-5-million-series-b-led-by-catalyst-investors-301571448.html]
• Headcount: ~67 (RocketReach); LinkedIn-band-consistent with 51-200. [THIRD-PARTY - https://rocketreach.co/rivet-profile_b45c94a0fc6ef3d5]
• Founders / leadership: Ted Ferrin (CEO and Co-Founder), Andrew Harding (VP Customer Success and Co-Founder), Alex Pratt (VP Engineering), Alissa Boddie (VP Product), Marcus Jackman (VP Sales), Nathan Moon (Chief Architect). [VENDOR-CLAIMED - https://www.rivethealth.com/about]
• Archetype: Mid-market provider-side revenue-cycle analytics SaaS - three-product platform combining Revenue Diagnostics (forecasting + denials prevention), Payer Performance (contract benchmarking + variance detection), and Patient Pricing (No Surprises Act-native good-faith estimates).

Total score: 50.9 / 100

(56.9 raw weighted - 6 pricing-transparency hard penalty)

• Stage fit:
• Foundation (<40 readiness): no - sales-led only, no free tier, no self-serve trial; quote-only pricing means a Foundation-stage buyer cannot self-size the spend.
• Pilot (40-59): conditional - yes for a 5-25-provider specialty ambulatory group (orthopedics, oncology, ophthalmology, GI, urology, OB-GYN) with a measurable denial-rate or patient-pre-collection pain. No for larger or enterprise-hospital pilots.
• Scale (60-79): yes (in the specialty-ambulatory mid-market scope) - this is Rivet's sweet spot. 5-100-provider single- and multi-location specialty groups on mid-tier EHRs (athenahealth, eClinicalWorks, AdvancedMD, ModMed, NextGen, Nextech, Greenway, Veradigm, Intergy). Named-customer outcomes (Boulder Centre $1.7M pre-collection, Resurgens $1.2M denied-claim recovery, Salem Gastro $653K contract-variance recovery, Generations $90K + $250K) anchor this segment.
• Optimization (80+): conditional - mid-market hospitals with no dedicated RCM team get value from the three-product bundle; mature RCM organizations with best-of-breed point tools (Iodine CDI + Waystar denials + standalone payer-contract software) likely beat Rivet on per-surface depth.
• One-line verdict: The mid-market specialty-ambulatory choice in the cohort - integrated three-product bundle, credible named-customer outcomes, recent Zelis acquisition - whose tear-sheet score is bounded by classical-ML AI architecture (no GenAI / agentic depth), no HITRUST, deceptive /pricing → /patient-pricing routing, and acquisition-integration uncertainty four months in.

Headline numbers

Dimension scores

Integration + scale penalty verdict

• Integration penalty: SOFT. Native EHR/PM coverage across ~11-12 mid-tier platforms (athenahealth, eClinicalWorks, AdvancedMD, Dr Chrono, Epic, Veradigm, ModMed, Greenway, Nextech, Intergy, NextGen PM) plus Waystar / Availity / Change Healthcare / Optum / Clearwave on the clearinghouse / patient-engagement layer. Gaps: no Cerner / Oracle Health integration, no Epic App Orchard / App Market certified tier confirmed, no public FHIR R4 / SMART on FHIR conformance statement, Athena integration friction surfaced in customer reviews. Soft applies to Dim 2 ceiling.
• Scale penalty: NONE. Mid-market ambulatory scale is credibly demonstrated (1.4T+ contracted rates modeled, 500M+ claims and remits audited, 5.5M+ patient cost estimates, $1.6B+ patient out-of-pocket tracked, 99.9%+ uptime, ~16 named specialty groups). Zelis acquisition corroborates strategic-acquirable scale signal. No academic-medical-center-named customer, but at the segment Rivet actually serves there is no gap to flag.

Pricing detail

• Public list pricing: None on /pricing (CTA-only page). Existing D1 record notes the URL 301-redirects to /patient-pricing, a product page rather than a SaaS-pricing page - a Yardstick-tracked dark-pattern. [VENDOR-CLAIMED - https://www.rivethealth.com/pricing]
• Third-party anchor: Starting at $6,000 per year, subscription model. Free-trial language present in the GetApp listing is not corroborated on the vendor's own site. [THIRD-PARTY - https://www.getapp.com/healthcare-pharmaceuticals-software/a/rivet/reviews/]
• Pricing model description: Volume-based, tied to patient-encounter volume - "larger practices paying more than smaller ones." [THIRD-PARTY (competitor source - weight accordingly) - https://www.mdclarity.com/reviews/rivet-health]
• Sales-led discovery only: Every CTA across the site is "Schedule a demo," "Request a demo," or "See How." No free tier, no public sandbox, no published trial-seat policy. [VENDOR-CLAIMED - https://www.rivethealth.com]
• Captured-ROI claims (vendor-authored case studies; cost-context anchors): Generations Family Practice ~$90K denial recovery + $250K underpayment discovery; Salem Gastro $653K contract-variance recovery; Boulder Centre for Orthopedics $1.7M surgery pre-collection (3.5x prior performance); Resurgens Orthopaedics $1.2M+ in denied claims recovered; Austin Retina $250K+ pre-collected via Rivet estimates in 2024; Clearview Cancer Institute "tens of thousands per patient recovered, 10x ROI." [VENDOR-CLAIMED - https://www.rivethealth.com/success-stories, https://www.rivethealth.com/customer-stories/austin-retina]

Integrations

Source: https://www.rivethealth.com/partners-and-integrations + GetApp corroborated list.

• EHR / PM (vendor partners page): athenahealth, eClinicalWorks, AdvancedMD, Dr Chrono (by EverHealth), Epic, Veradigm, Exscribe (orthopedic-focused), ModMed, Greenway Health, Nextech. [VENDOR-CLAIMED]
• EHR / PM (GetApp corroborated list, 11 total): Adds NextGen Healthcare Practice Management, Intergy, athenaOne (also listed by vendor as athenahealth). [THIRD-PARTY - https://www.getapp.com/healthcare-pharmaceuticals-software/a/rivet/reviews/]
• Cerner / Oracle Health: Not listed. [UNKNOWN]
• Epic App Orchard / App Market certified tier: [UNKNOWN] Epic listed as integration partner; certified-marketplace tier not confirmed in our pull.
• FHIR R4 / SMART on FHIR conformance: [UNKNOWN] No public conformance statement.
• HIE / TEFCA QHIN: [UNKNOWN] Not surfaced.
• Clearinghouses / EDI: Availity (real-time eligibility), Change Healthcare / Optum, Waystar. [VENDOR-CLAIMED + THIRD-PARTY]
• Patient-engagement / billing / patient-payments: Clearwave (patient engagement), Twilio (communications), GlobalPayments, Rectangle Health. [VENDOR-CLAIMED]
• Payor direct relationships: Blue Cross Blue Shield (BCBS Federation), CMS (Medicare / Medicaid). [VENDOR-CLAIMED]
• Referral / RCM-services partners: BillingParadise, Health e Practices, OneHealth Nebraska (IPA), Physicians' Choice, Unislink, WVP Health Authority. [VENDOR-CLAIMED]

Editorial assessment

Rivet Health is a credible mid-market specialty-ambulatory RCM analytics platform that solves a clean three-part problem - revenue-cycle forecasting and denials prevention (Revenue Diagnostics), payer-contract benchmarking and underpayment recovery (Payer Performance), and No Surprises Act-compliant patient cost estimation (Patient Pricing) - for a defined buyer: a 5-100-provider single- or multi-location specialty practice running a mid-tier EHR/PM stack. The named-customer outcomes are concrete and consistent across the roster: low-to-mid six figures of recovered or pre-collected revenue per customer per year, with the orthopedic-specialty concentration (Boulder Centre, Resurgens, Chatham, Northwest, Bluegrass, Vero) being the clearest pattern of repeat product-market fit. The Zelis acquisition on January 12, 2026 ratifies the asset to a strategic acquirer in the healthcare-payments space.

The cohort-fit honest framing is that Rivet sits in the middle of the healthcare-rcm cohort, not at the top. AKASA wins on enterprise scale (Cleveland Clinic Epic deployment, $205M+ raised, Black Book #1, HITRUST r2). Adonis wins on AI-native architecture marketing and recent growth velocity (Mount Sinai / Baptist Health / AdventHealth hospital roster, $95M+ raised through Series C, 4x revenue growth 2025). Cohere wins on payor-side prior-auth depth. Tennr wins on DME / specialty intake automation with a published proprietary model. Rivet wins on the integrated three-product bundle for the specialty ambulatory practice that does not need any of those leaders' surfaces - and does not want to manage four separate vendors and four separate BAAs.

The bounded weak spots are real. First, AI architecture: the product is marketed as "AI-powered" but the public architecture is classical-ML in description (forecasting models, variance detection, denials-prevention rules, claim X-ray pre-submission scrubbing). A buyer comparing Rivet's "AI" copy to AKASA's GenAI architecture or Adonis's agentic-AI framing will find Rivet's claims thinner. The ai_native_score of 75 is the right floor (AI is a meaningful addition, marketed as primary, but 2018-founded heritage means the product functioned recognizably without the AI layer). Second, post-acquisition contract uncertainty: the Zelis deal is recent enough that integration impact on Rivet's product roadmap, pricing structure, BAA / DPA, and customer-success staffing is not yet visible. Third, the deceptive /pricing → /patient-pricing routing is a dark-pattern the Yardstick rubric explicitly penalizes. Fourth, compliance posture is at the cohort floor (SOC 2 Type 2 + HIPAA + pen test) rather than at the HITRUST-r2 leaders' bar - mid-market hospital procurement will sometimes ask for HITRUST and Rivet does not currently clear that hurdle.

Relative to the cohort: Rivet is the mid-market specialty-ambulatory choice when AKASA / Adonis are too heavy and DIY Excel is too thin. The Yardstick-distinct value to the buyer is the comparability check - is Rivet's bundle of three products at this price the right call versus picking a best-of-breed leader per surface (e.g., Tebra patient cost estimates + Iodine CDI + Waystar denials + standalone payer-contract tooling)? For a 5-50-provider specialty practice with no dedicated RCM team, Rivet's integrated bundle reduces vendor count and contract overhead and the published outcomes are credible. For a 100+ provider group with a real RCM organization, the best-of-breed leaders likely win on per-surface depth and the comparison gets harder for Rivet.

Revisit if: (a) Zelis publishes the post-acquisition Rivet product roadmap and pricing structure, (b) Rivet publishes HITRUST CSF certification status (e1 / i1 / r2), (c) an Epic App Orchard / App Market certified listing appears versus the current generic integration-partner listing, (d) Rivet publishes the foundation-model architecture for its AI features and a held-out accuracy benchmark, (e) a Cerner / Oracle Health integration ships, (f) KLAS / Black Book / Forrester / Gartner coverage lands, (g) peer-reviewed validation or independent third-party measurement of any outcome currently anchored on vendor-authored case studies appears.

Right-of-reply gaps

The following [UNKNOWN] items should be sent to Rivet (and to Zelis, given the recent acquisition) during the factcheck pipeline:

• Post-acquisition product continuity. Will Revenue Diagnostics, Payer Performance, and Patient Pricing remain as three distinct products under the Rivet brand, or be folded into Zelis-branded SKUs? Pricing structure change date, if any?
• Post-acquisition BAA / DPA. Which legal entity (Rivet Health, Inc. or Zelis) is the contracting party on the BAA effective post-close for new and existing customers? Is the DPA changing?
• HITRUST CSF certification status. Tier (e1 / i1 / r2), audit date, target certification date if not yet certified.
• Foundation-model architecture for the AI features. Which LLM(s), if any, power Revenue Diagnostics forecasting, AI denials prevention engine, and AI Claim X-ray? Is it classical-ML only, or is there a generative-AI layer? Model vendor (OpenAI / Anthropic / Google / proprietary)?
• Customer PHI training-data opt-out default. Is customer PHI included in or excluded from Rivet model training by default in the standard BAA / DPA? Configurable?
• Sub-processor list. Public sub-processor list location, if any.
• Data residency. Where is PHI processed and stored? Multi-region options? AWS / GCP / Azure region commitments?
• Pen-test cadence. Annual? Continuous? Report availability under NDA?
• Encryption algorithms. Specific at-rest algorithm (e.g. AES-256-GCM) and key-management posture (KMS / HSM).
• Epic App Orchard / App Market certified-tier listing status. Currently listed as integration partner; certified-marketplace tier not confirmed.
• Cerner / Oracle Health integration. Roadmap, if any.
• FHIR R4 / SMART on FHIR conformance statement and resource scope.
• Direct customer count. Vendor's own customer count, distinct from the "36,000 practices" Rectangle-Health-partner aggregate language. Total active customer count by stage (specialty practice, multispecialty, hospital).
• KLAS / Black Book / Forrester / Gartner coverage. Any analyst-tracked rankings or scorecards held?
• Published pricing band at 5-, 25-, 100-provider deployment sizes. Per-encounter or per-provider anchor, even directional.
• HQ canonical address. RocketReach lists 50 W Broadway Salt Lake City; Dun and Bradstreet lists 1579 E Ventnor Ave Holladay; LinkedIn footprint also names Lehi. Confirm canonical primary HQ.
• Athena integration friction resolution detail. Capterra reviewers cited initial integration trouble that was later resolved - what was the root cause and how was it addressed?
• Customer-net-retention figures. Any disclosable NRR / GRR data, pre or post acquisition.
• Independent third-party measurement of any captured-ROI outcome. All published outcomes are vendor-authored case studies; is there any KLAS / peer-reviewed measurement, or an independent buyer-side audit of any deployment?