Hospital finance leaders don’t need a report to tell them things are difficult, but the American Hospital Association’s latest “Costs of Caring” report does something extremely useful: it puts concrete numbers behind pressures that have been building for years and shows just how much they’ve compounded.
The picture the report paints is one of mounting strain across the industry. Total hospital expenses grew 7.5% in 2025, more than twice the rate of growth in hospital
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Revenue Cycle Management | News, Analysis, Insights - HIT Consultant
Thoreau Enters Definitive Agreement for Strategic Growth Investment in Ensemble Health Partners
What You Should Know
Revenue cycle managed services leader Ensemble Health Partners has announced a definitive agreement for a strategic growth investment from Thoreau, the healthcare investment platform founded by veteran private equity executive Matt Holt.The transaction values Ensemble at an estimated $12 billion, positioning the newly launched, Apollo Global Management-backed Thoreau platform at the epicenter of scaled healthcare administrative outsourcing.Legacy institutional
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Prior Authorization Technology Is the Weakest Link in the GLP-1 Revolution
The clinical case for GLP-1 receptor agonists in obesity management is no longer a debate. Randomized controlled trials have demonstrated sustained weight reduction of 15 to 22 percent of body weight, meaningful improvements in cardiovascular outcomes, and reductions in obesity related comorbidities including type 2 diabetes and sleep apnea. The American Association of Clinical Endocrinology, the American Gastroenterological Association, and major cardiology societies have all updated their
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M&A: Med-Metrix Acquires CanAide to Automate Patient Access
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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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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