What You Should Know
Technology-enabled revenue cycle management (RCM) platform Med-Metrix, LLC has signed a definitive agreement to acquire front-end automation specialist CanAide, Inc. from HCAP Partners.This marks Med-Metrix's second major acquisition agreement within a single week, arriving immediately on the heels of its $147 million acquisition of Health Catalyst’s mid-revenue cycle software business, Vitalware.Backed by private equity heavyweights Harvest Partners and A&M Capital
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
AGS Health Launches InnovationWorks™ Center of Excellence to Scale Revenue Cycle AI
What You Should Know
Tech-enabled revenue cycle management (RCM) pioneer AGS Health has launched AGS Health InnovationWorks™, a dedicated center of excellence purpose-built to deliver pragmatic, ROI-driven RCM AI solutions.The center addresses severe operational barriers by engineering AI tools to adapt natively to a health system's specific payer mix, localized workflows, and rigid compliance mandates.Backed by global tech and investment leaders including Blackstone and Amazon Web Services
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Surescripts Expands Prior Authorization Automation: Slashing Prescription Approval Times as New CMS Interoperability Rules Loom
What You Should Know
Surescripts has expanded its Prior Authorization Automation solution, increasing the number of enabled clinicians by 50% since December 2025 to reach 68,000 prescribers across 42 major health systems.Automated prior authorization systems achieved a median approval time of just 18 seconds when clinical determination criteria were met, bypassing traditional manual forms, faxes, and telephone calls.Real-Time Prescription Benefit tools saved patients $19.7 million from
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Commure Secures $70M to Drive 85% Autonomous Revenue Cycle Execution
What You Should Know
Commure, an AI platform for healthcare operations, secured a $70M financing round at a $7 billion post-money valuation led by General Catalyst, with participation from Sequoia Capital, Morgan Stanley, and Kirkland & Ellis.Tackling the $1 Trillion Problem: The company’s agentic AI infrastructure targets administrative waste—a sector that consumes an estimated $1 trillion annually in the U.S. alone.Proven Operational Automation: Commure’s end-to-end revenue cycle
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The $262B “Acceptance”: Why It’s Time to Stop Treating Denials as an Unavoidable Cost
I want to be direct about something: the denial problem in U.S. healthcare is not complicated to understand. It is complicated to fix, but the basic dynamic is straightforward. Hospitals deliver medically appropriate care, submit claims, and then watch a meaningful portion of those claims get denied. Most of those denials are never challenged. Revenue disappears. And somewhere along the way, we collectively decided this was just how things work.
It isn’t. And we need to stop treating it like
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Transforming Medical Coding Operations Through Hybrid Intelligence Design
Healthcare revenue cycle management is bending under the strain of evolving payer policies, complex documentation, and higher demands for accuracy and cost control. Exacerbating these challenges are rising coding assignment volumes, which are forcing HIM departments to address continued workforce shortages.
These problems are interconnected and systemic. They cannot be solved by simply adding staff or deploying standalone automation tools. Instead, a more structured approach is emerging:
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Carlyle Acquires Knack RCM and EqualizeRCM to Build Global AI-Native Healthcare RCM Platform
What You Should Know
Carlyle has acquired a majority stake in Knack RCM and EqualizeRCM, merging them to create a global, multi-specialty, AI-native revenue cycle management (RCM) platform.The combined platform targets high-complexity segments, including rural hospitals, behavioral health, anesthesia, and durable medical equipment (DME).EqualizeRCM contributes proprietary AI tools like Bill Smart for denial prediction and an AI-native platform built on large language models (LLMs) and
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Fathom Secures Strategic Investment from CVS Health Ventures to Scale Autonomous Medical Coding
What You Should Know
Fathom, a leader in autonomous medical coding, has announced a strategic investment from CVS Health Ventures.The funding follows a period where revenue cycle management (RCM) has become the top priority for health IT investment, according to a 2025 Bain & Company/KLAS report.Fathom’s platform achieves 90%+ automation rates across multiple specialties, providing an alternative to slow, department-by-department AI rollouts.The company was recognized as the #1 solution
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RevSpring Report: 50% of Consumers Cut Back on Care Due to Financial Confusion and Cost
What You Should Know
RevSpring has released a national survey of 2,024 U.S. adults revealing that 94% of consumers agree healthcare needs to be made easier to navigate.Friction begins at the point of entry: 38% of consumers struggle to find an in-network provider.Financial uncertainty is a primary driver of disengagement, with 79% of patients reporting they have been surprised by the price of a medical bill.50% of respondents admitted to cutting back on medical care due to cost and confusion
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Availity Abrasion Index 2026: Denials and Prior Authorization Top Payer-Provider Friction Points
What You Should Know
Availity has launched the 2026 Abrasion Index, a dual-sided research report quantifying administrative friction between U.S. health plans and healthcare providers.Denials emerged as the most severe abrasion point, with the report finding that ~70% of denials are ultimately overturned and paid, creating significant administrative "churn".Prior authorization remains a critical burden, with physicians averaging 13 hours per week on the process and 89% reporting it
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