The healthcare industry is modernising as artificial intelligence (AI) and strategic outsourcing reshape revenue cycle management (RCM).
A recent report from Everest Group highlights a growing consensus among senior healthcare executives, with 85% believing AI will improve RCM performance over the next five years, and even greater advancements are anticipated by 2030.
AI’s Expanding Role in Revenue Cycle Management
The healthcare sector is turning to a combination of AI and outsourcing to improve revenue cycle management (RCM). The Everest Group report highlights that 51% of healthcare leaders expect RCM outsourcing budgets to increase by 2030.
Healthcare providers can access AI-driven solutions without the need to build in-house expertise by working with specialised firms.
This trend is driven by the operational and financial challenges healthcare organisations face as they seek to optimise revenue collection while minimising administrative costs. The synergy between AI automation and outsourcing is seen as pivotal in enhancing financial outcomes.
A Surge in Strategic Outsourcing Partnerships
The Everest Group report highlights that 51% of healthcare leaders anticipate an increase in RCM outsourcing budgets by 2030. By partnering with specialised firms, providers can access AI-driven expertise without having to build in-house capabilities from the ground up.
This trend is driven by operational challenges and financial pressures, as providers seek to optimise revenue collection while minimising administrative costs. The combination of AI-powered automation and strategic outsourcing is seen as a game-changer for improving financial performance.
Generative AI Gains Traction—But Challenges Remain
Generative AI (Gen AI) is emerging as a key player in RCM, with 51% of healthcare providers already integrating it into their workflows. AI-driven tools are being used for real-time eligibility verification, claims data analysis, and chatbot-assisted patient interactions.
These technologies have the potential to enhance accuracy and speed up processes that have traditionally been slow and labour-intensive.
However, the report reveals that 80% of providers are facing difficulties in implementing AI solutions.
The primary challenges include a lack of in-house expertise and difficulties integrating AI with existing electronic health record (EHR) systems.
Vijayashree Natarajan, SVP & Head of Technology at Omega Healthcare, notes that organisations that successfully implement AI are already seeing tangible benefits,
“Clients are already getting real value from their Gen AI spending, which includes better collections and lower balances of Aged Accounts Receivable.”
The Future of AI in Healthcare Revenue Cycle Management
The rapid adoption of AI in healthcare is accompanied by a heightened focus on cybersecurity, payer collaboration, and automation. With AI at the core of revenue cycle management (RCM) strategies, 66% of healthcare executives predict that AI and machine learning (ML) will dominate the sector by 2030.
This shift toward AI is set to transform financial operations, making RCM more efficient and effective. While challenges persist in its implementation, the combination of AI automation and strategic partnerships is paving the way for a new era in healthcare financial management.