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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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
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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IKS Health Acquires TruBridge for Rural EHR and RCM Solutions Expansion
What You Should Know
IKS Health will acquire TruBridge for $26.25 per share (up to $565M) in an all-cash transaction, with the deal expected to close in the third calendar quarter of 2026.The combined organization will support over 2,000 healthcare organizations and more than 150,000 clinicians across the ambulatory and acute care continuum.The acquisition integrates TruBridge’s Electronic Health Record (EHR) and Revenue Cycle Management (RCM) solutions with IKS Health’s agentic AI care
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Amperos Health Raises $16M for Agentic AI Denial Management and Revenue Recovery Platform
What You Should Know:
The Funding: Amperos Health has closed a $16M Series A funding round led by Bessemer Venture Partners, with participation from Uncork Capital and Neo. This follows a $4.2M seed round in June 2025.The Core Technology: Amperos has launched the industry’s first AI-native, end-to-end denial management platform. Unlike fragmented tools that only draft appeal letters or offer predictive scoring, Amperos uses agentic AI (state-of-the-art LLMs with computer and voice
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KLAS Releases 2026 Patient Financing Services Report Examining Recourse vs. Nonrecourse Offerings
What You Should Know:
- KLAS Report: According to the newly released Patient Financing Services 2026 report by KLAS, the industry is undergoing a critical structural shift in how these third-party programs are modeled—and one startup is capitalizing on the transition better than anyone else.
- The Market Shift: Patient financing services are third-party solutions that give patients flexibility to pay their healthcare costs over time, simultaneously shifting long-term receivables and
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Joyful Health Secures $17M for AI-Powered Healthcare Financial Operations
What You Should Know
The Raise: Joyful Health, an AI financial infrastructure company, has announced a $17M Series A funding round led by CRV, bringing its total funding to $22M. Existing seed investors, including XYZ Venture Capital and Designer Fund, also participated.The Infrastructure Fix: Instead of trying to layer AI on top of fragmented, messy data, Joyful Health is building a unified financial system of record. It maps the relationships between clinical encounters, payer rules, and
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Automating Behavioral Health Utilization Review to Reduce Denials
Nearly 1 in 10 adults in the U.S. experienced a mental health crisis in 2025, according to a John Hopkins study. Individuals in crisis require access to the full spectrum of care they need. However, this isn’t always the reality.
Historically, manual utilization review (UR) has been the standard for ensuring patients receive care when they need it most. Many behavioral health facilities now face UR challenges driven by tedious manual processes that can no longer handle growing volumes of
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Keebler Health Secures $16M to Scale LLM-Native Risk Adjustment Platform
What You Should Know
The Raise: Keebler Health, an LLM-native risk adjustment platform, has raised a $16M Series A funding round led by Flare Capital Partners, with participation from Sands Capital and a syndicate of venture funds. The company has raised $23M since its founding in 2023.The Technology: Unlike legacy platforms that use retrofitted Natural Language Processing (NLP) to scan for keywords, Keebler is built entirely on Large Language Models (LLMs). It processes the raw clinical
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