Healthcare provider revenue cycle management (RCM) is entering a period of unprecedented transformation as artificial intelligence, agentic automation and new operating models reshape how work is performed across the revenue cycle. Traditional RCM delivery models built on labor-intensive processes, offshore staffing and scale-based economics are increasingly being challenged by AI-enabled approaches that automate complex workflows, augment decision-making and drive measurable business outcomes.
As healthcare provider organizations seek greater efficiency, accuracy and financial performance, both suppliers (service providers) and Healthcare Providers must rethink how revenue cycle services are designed, delivered and contracted.
This session examines the transformation forces driving disruption across front-office, middle-office and back-office revenue cycle operations and explores how AI agents are transforming activities ranging from patient access and eligibility verification to coding, claims management, denials and collections. Attendees will gain insight into how leading organizations are moving beyond task automation to redesign end-to-end workflows, establish AI-ready operating foundations and prepare for human-plus-AI delivery models. The discussion will highlight emerging best practices for building intelligent revenue cycle operations that combine healthcare domain expertise, data and AI/automation to improve performance at scale.
The session will also explore the implications for service providers and sourcing strategies as AI reshapes the economics of RCM delivery. Participants will learn how competitive dynamics are evolving, why traditional FTE-based commercial models are becoming increasingly misaligned with AI-enabled operations and how outcome-based, risk-sharing and performance-driven contracting structures are emerging. Drawing on ISG market observations, client experiences and industry trends, the presentation/discussion will provide a forward-looking perspective on the path the future of healthcare RCM sourcing through 2028 and beyond.
