6 Healthcare Finance and RCM Trends to Watch in 2027

Here are the healthcare finance and RCM trends we’re watching heading into 2027:

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1. Agentic AI Moves From Pilot to Production
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“While other sectors are also adopting [agentic AI], the healthcare vertical is seeing the fastest growth, with some projections citing a CAGR of 48.4% due to the massive volume of data and the complexity of its decision-making processes.”

Grand View Research, Agentic AI In Healthcare Market 2025-2030

Agentic AI represents the shift from passive systems that can share and summarize data to proactive systems that can reason and act autonomously. To meet specific operational goals, agentic AI can remember tasks, sequence project steps, gather relevant data, coordinate with other systems, and adapt to changes.
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With its capacity for high-level reasoning and sophisticated system integrations, agentic AI has transformational potential. And this capability — plus the expected surge in uninsured patients and uncompensated care — is driving record levels of investment. AI already accounts for 46% of all healthcare investment, and the global market for agentic AI in healthcare is projected to reach $4.96 billion by 2030.
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In 2027 and beyond, healthcare providers expect agentic AI to help automate repetitive tasks, increase revenue capture, optimize overhead costs, and improve the patient financial experience. In two key areas, agentic AI is moving from pilot phase to production-scale deployment:
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Prior Authorization: This is a major growth area where AI agents first determine if an authorization is necessary — ruling it out in roughly 40% of cases. When required, agents can pull clinical data directly from the EHR and submit it to payer portals, reducing admin time and improving first-pass resolution rate.
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Patient Billing Support: AI has an increasingly important role as the “first stop” for patient billing inquiries. AI agents can provide always-on, contextually informed support: helping patients understand complex medical bills, navigate insurance coverage, and identify financial assistance programs relevant to their situation. As a result, providers can reduce DSO and cost-to-collect — organizations using the Billie AI Voice Agent report that Billie resolves 75% of patient billing inquiries and cuts cost-to-collect by 66%.
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“To navigate these uncertain times, health system executives have made enabling growth through improved operations and financial performance their top priorities. Areas of focus include lowering operating costs, improving access, improving revenue cycle performance, and increasing provider capacity.”

Chartis, Pressures and promise: US health system priorities 2025–2030

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2. A/R Shifting to Patient Accounts & Escalating Patient Financial Risk

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Rising patient financial responsibility is now a defining economic reality of healthcare finance. As payers and employers steadily shift costs downstream — through higher deductibles, growing premium contributions, and leaner plan designs — patients represent an increasingly crucial and unpredictable source of provider revenue. For medical groups and hospitals, that means collections success no longer hinges on payer contracts alone — it hinges on the patient financial experience itself.
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Underinsurance is a primary driver of this financial risk. A new inflection point in 2026: the average ACA Marketplace deductible saw its steepest increase in history, jumping 37% as enrollees migrated to lower-premium, higher-deductible plans, while employer-plan deductibles now sit 47% higher than a decade ago, per KFF. The practical effect: a growing share of insured patients function as self-pay until their deductible is met.
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The insurance affordability crisis is affecting patients across the income spectrum; patients earning $100k+ per year and patients with commercial insurance — both considered high-capacity patients in the traditional payment risk model — report struggling to pay their insurance and medical bills.
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“The 2026 outlook is cautious at best, and organizations anticipate little relief from financial constraints on their strategies. Over eight in ten CFOs view business conditions as their primary concern. 84% of administrative and clinical leaders cite financial pressures as their greatest threat for the coming year. Cost discipline is essential. Healthcare consulting firms report fastest expansion from helping organizations achieve operational and financial improvement.”

Becker’s Hospital Review, Healthcare finance trends for 2026

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3. Policy-Driven Coverage Volatility

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Policy-driven coverage volatility is also responsible for this financial instability. Federal Medicaid funding to states will be cut by $664 billion between now and 2034. New work requirements and eligibility checks are expected to cause a 10% decline in enrollment — approximately 7.6 million people losing Medicaid coverage. The expiration of enhanced ACA subsidies caused average monthly premiums to jump from $113 to $178. Rising costs, declining enrollment, and higher cost-sharing for those who remain insured — all these factors represent increased financial risk among the patient population.

With a new level of volatility and financial risk, simple billing reminders aren’t enough for providers to collect patient revenue. Going forward, providers need mature patient billing solutions that deliver easy-to-understand statements and personalized interventions, like flexible payment plans for large and longstanding balances.

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4. Industry Shift Toward Outpatient Care

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Healthcare labor costs are high and growing, now representing 60% of total hospital expenses. This puts more pressure on margins already strained by rising operational costs and declining reimbursements.
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To preserve margins — and compete with growing retail clinics and telehealth offerings — many health systems see non-acute care as a key growth opportunity.

• Outpatient care: Outpatient care volume is projected to increase 18% through 2035 — much higher than the 5% projected growth for inpatient care.
• Ambulatory care: The Ambulatory Surgery Center segment is steadily expanding. Over half of eligible surgeries were performed at ASCs in 2024, and service volume is expected to rise 9% by 2028.
• Urgent care: Health systems are expanding their footprints into new markets through urgent care centers: of the more than 400 urgent care centers opened in the first half of 2025, 40% were affiliated with established hospitals.
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With the expansion of laboratory services and durable medical equipment offered in urgent care settings, the revenue per visit has even more significant growth potential.

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5. Growth of Same-Day and Digital Payment Rails

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Healthcare is catching up with other industries by adopting same-day and digital payment rails to enhance operational efficiency and improve the patient billing experience.
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The industry logged 141 million healthcare claim payments via ACH in the third quarter of 2025, a 6.8% increase over the same period in 2024. The acceptance of virtual cards and instant payment networks is also growing fast.
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Businesses are motivated to adopt these digital wallets and instant networks primarily to reduce costs (48%), provide flexibility to customers (39%), and provide 24/7 instant payment services (35%).
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To further streamline the revenue cycle, providers are using AI solutions to achieve payment precision, i.e., analyzing claims to detect coding and billing errors prior to submission, significantly reducing claim denials and payment delays.

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6. Emerging Cybersecurity Threats: Deepfakes and Shadow AI

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Unfortunately, new technologies bring new security threats, and these are particularly costly in healthcare. The average cost of a healthcare data breach was $7.42 million in 2025 — and the most expensive of any industry.
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Security experts are particularly concerned about the rise of deepfakes — highly realistic AI-generated images, audio, or video — and their use for identity theft and payment fraud. AI deepfake tools are more and more common, and they’re getting easier to use; the average time for creating a deepfake photo or video is now 27 seconds or less.
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Simultaneously, the unauthorized employee use of AI tools, known as shadow AI, has become a major risk for HIPAA compliance. Shadow AI may go undetected by an organization, and attackers can exploit vulnerabilities that the company is not fully aware of. Shadow AI was involved in 20% of security breaches in 2025, and security incidents involving shadow AI take, on average, a week longer and $200k more to resolve.
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In 2027 and beyond, mitigating cybersecurity risks requires a sociotechnical approach: redesigning workflows, ensuring effective human oversight, and preventing "agent sprawl" to ensure all autonomous actions remain transparent and within controlled guardrails.

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Healthcare Finance for the Future

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Healthcare is contending with major financial pressures, and providers need margin relief and efficiency improvements.
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Looking to build an economy of scale ready for the future of healthcare? We built a guide to doing just that for the patient side of RCM: take the 7 Stages of Patient Billing Maturity self-assessment.