More than two-thirds of health systems outsource AR, collections
ILLINOIS, UNITED STATES — More than two-thirds of United States health systems outsource accounts receivable (AR) follow-up and collections to external partners, making it the most commonly outsourced revenue cycle function, according to a 2026 survey by Guidehouse and the Healthcare Financial Management Association (HFMA).
AR and collections lead RCM outsourcing
The 2026 Guidehouse and HFMA Revenue Cycle Trends report found that 67 percent of health systems outsource AR follow-up and collections, followed by coding at 50 percent, denials management at 39 percent, and billing and claims editing at 29 percent, according to Becker’s Hospital Review.
The survey found that 69 percent of health systems are outsourcing all or part of their revenue cycle management (RCM) to managed services vendors. Seventy-eight percent are also using automation and artificial intelligence (AI) to expedite manual RCM processes.
Andrew Hancock, Partner and Payer/Provider Financial Solutions leader at Guidehouse, said technology investment and vendor partnerships are evolving in parallel.
“As AI continues to mature, providers will benefit from access to intelligent revenue cycle platforms that power and scale their operations. But these technologies still need sound governance and human oversight,” Hancock said.
Accounts receivable is the most commonly outsourced RCM function at 67 percent, ahead of coding at 50 percent, denials management at 39 percent, and billing and claims editing at 29 percent.
Payer friction, denials compound outsourcing pressure
Payer relationships are the central pressure point in the report. Eighty-eight percent of providers cite claims disagreements as a barrier to timely, full payment, 81 percent report increased denial rates, and 74 percent flag increased prior authorization delays.
Denial rates exceeding five percent are now reported by 20 percent of respondents, nearly double the share in the previous survey period. These conditions are compounding demand for external RCM support, where managed services vendors absorb the administrative burden of contested and unpaid claims.
Ian Stewart, Partner and Health Managed Services leader at Guidehouse, said health systems are seeking partners who can deliver results at scale.
“Our managed services team is on the frontlines of the revenue cycle, helping the nation’s leading health systems get paid faster and in full,” Stewart said.
Despite broad interest in AI, 60 percent of respondents have not yet implemented AI or automation in their revenue cycle operations, leaving a workflow gap that managed services vendors are positioned to fill.
For health systems navigating payer complexity and staffing shortages, the Guidehouse and HFMA findings reflect a market well past early adoption. Managed services vendors now handle the revenue cycle functions most exposed to payer variability, including AR follow-up, denials, and coding, while health systems retain oversight of clinical and financial strategy.
Health systems evaluating RCM vendor options can review the top healthcare outsourcing companies in the U.S., where business process outsourcing (BPO) providers specializing in AR management and coding services are listed alongside broader administrative outsourcing options.
Related news
- Denials top the list of RCM challenges in 2026 · 5 Aug
- Revenue cycle management hits its boardroom moment · 8 Jul
- U.S. hospitals rethink offshore RCM as AI matures · 21 Jul
Disclosure: Outsource Accelerator uses AI tools in the backend of its editorial workflow. Every article is reviewed and verified by a human editor before publication.
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