Realizing the Promise of Tech-Enabled, AI-Driven Revenue Cycle Management (RCM): Outsourcing in the New Era

The evolving landscape of Revenue Cycle Management (RCM) highlights how AI, automation, and outsourcing are transforming financial and operational efficiencies for healthcare providers. Despite persistent challenges such as billing complexities and staffing shortages, healthcare leaders are increasingly prioritizing advanced automation, AI-driven decision-making, and cybersecurity to modernize RCM processes. Generative AI is expected to play a vital role in this modernization, with 85% of RCM leaders believing it will enhance efficiency within the next five years. Key applications include real-time eligibility verification, AI-driven chatbots, and automated medical coding, though organizations must address challenges such as data accuracy, compliance risks, and integration with legacy systems. As RCM continues to evolve, technology-enabled outsourcing models are becoming essential for sustainable growth, enabling providers to optimize workflows, reduce costs, and enhance patient experiences.

This report underscores that AI-driven RCM is no longer an option but a necessity for healthcare providers seeking financial resilience and operational excellence. Additionally, it highlights key considerations for selecting the right RCM partner and outlines how third-party providers can enhance RCM workflows for greater efficiency and compliance.