6 health systems outsourcing RCM functions
- Six U.S. health systems outsourced RCM functions in first-half 2026
- 69% of health systems now outsource all or part of RCM
- Knox Community Hospital moved all 42 billing staff to Ovation
- 78% of finance executives cite payer friction as a top stressor
CHICAGO, UNITED STATES — Six hospital and health systems across the United States moved revenue cycle management (RCM) functions to outside vendors in the first half of 2026, as mounting margin pressure and payer friction push hospital finance leaders toward managed service partnerships with performance accountability.
The outsourced functions span accounts receivable (AR) follow-up, medical billing, coding, and claims management, with several deals transferring entire hospital billing departments directly to vendor payrolls.
Health systems transfer entire billing teams
According to Becker’s Hospital Review, Knox Community Hospital in Mount Vernon, Ohio, signed a three-year agreement with Ovation Healthcare to outsource all billing services effective Feb. 1, with all 42 of its hospital and physician billing staff offered employment transfer to Ovation.
IU Health entered a revenue cycle partnership with Ensemble Health Partners on June 9, with IU Health retaining accountability for patient experience and financial outcomes while Ensemble manages operating model design and revenue cycle performance.
Margaret Mary Health transferred 53 employees to Revology as part of a similar arrangement, a model where RCM vendors absorb existing staff and institutional billing knowledge alongside the workflow rather than rebuilding from outside.
RCM outsourcing now a sector standard
UnityPoint Health announced April 15 that it is transitioning revenue cycle functions to Omega Healthcare, joining a wave of regional systems that restructured RCM operations in 2026 following sustained operating pressure and federal reimbursement volatility.
Sixty-nine percent of health systems are now outsourcing all or part of their RCM to managed services vendors, according to the 2026 Guidehouse and Healthcare Financial Management Association (HFMA) Revenue Cycle Trends report.
AR follow-up and collections lead at 67 percent of health systems, ahead of coding at 50 percent, denials management at 39 percent, and billing and claims editing at 29 percent.
Seventy-eight percent of health system finance executives cite payer friction as one of their top three RCM technology stressors, according to Black Book Research’s 2026 Hospital and Health System RCM Trends Report based on surveys of 882 provider-side executives.
Top healthcare outsourcing companies in the RCM space have shifted their value proposition from billing labor hours to performance accountability, committing to collection rates, denial reversal rates, and cash realization timelines that health systems can report at the board level.
Business process outsourcing (BPO) providers in healthcare now handle core financial functions for a growing share of U.S. hospitals, offering the workforce scale and payer intelligence that in-house billing teams cannot replicate cost-effectively under current margin conditions.
Related news
- Revenue cycle management hits its boardroom moment · 7 Jul
- More than two-thirds of health systems outsource AR, collections · 29 Aug
- Health systems lean into outsourcing to cut costs · 5 Sep
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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