Top RCM Trends We’re Tracking Heading Into 2026: Challenges, Trends, and Expert Strategies to Stay Competitive

Healthcare revenue cycle management has reached a pivotal moment. As providers grapple with new challenges and pressures, managing financial operations grows more complex than ever.

As we travel to industry events and speak with prospects, we hear similar themes from healthcare finance leaders discussing their biggest challenges. CFOs and RCM leaders are concerned about operational efficiency and financial sustainability in four critical areas:

• Workforce bottlenecks - the challenge to recruit and retain highly skilled staff, as well as train and upskill staff to handle advanced RCM workflows, has left many finance and A/R teams understaffed and scrambling to maintain basic operations
• Interoperability inefficiencies - a lack of communication and shared systems among departments creates bottlenecks that compromise patient care and financial performance
• Financial pressures - stagnant reimbursement rates and rising claim denial rates shift more financial responsibility to patients, which creates collection challenges that further strain resources
• Technology gaps - current tech infrastructure (like EHR-based RCM features) limits many providers in terms of how they can streamline and automate RCM processes and reduce manual workload

These challenges add up to staggering amounts of lost revenue: for example, claim denials alone cost hospitals as much as $262 billion annually. To reduce avoidable denials and delays, healthcare leaders are seeking new approaches and technology to streamline, automate, and optimize RCM for better revenue capture.

Read on to learn more about RCM trends and how organizations can improve RCM operations and the patient financial experience — a key factor in patient loyalty.

The Top Healthcare Revenue Cycle Trends 
in 2026

Several industry trends are accelerating change across healthcare. Some originate externally, like the development of new technologies and changes in government policy. Others live squarely within the healthcare ecosystem, like labor shortages and changes in insurer policy.

Key trends shaping the healthcare revenue cycle in 2026 include:

AI and Automation

Artificial intelligence (AI) and automation technologies are transforming RCM operations across the healthcare industry: almost half of healthcare organizations use some form of AI in revenue cycle operations, and nearly three-quarters use some form of automation.

Healthcare organizations are using AI to:

• Answer common patient billing questions and assist with payment
• Generate accurate price estimates
• Direct patients to financial counseling resources
• Automate billing notices and payment reminders
• Predict patient payments and forecast cash flow
• Proactively offer flexible payment plans
• Claims management
• Eligibility and insurance verification
• Diagnosis, patient care, coding
• A/R prioritization and recovery
• Financial analysis

Research indicates that AI and automation could eliminate as much as $360 billion in excess U.S. healthcare spending, specifically wasteful costs associated with scheduling, basic communications, data analysis, and documentation of patient care. The applications for AI in revenue cycle management continue to expand, from predictive analytics that estimate patient payments to automated patient billing systems that reduce administrative overhead.

With AI-powered tools that improve accuracy and reduce manual effort, organizations can optimize medical coding, eligibility verification, claims processing, data analysis, patient communication, denial management, and other essential operations.

The right AI-powered tools help RCM and A/R teams improve payment collections, accelerate cash flow, and improve the patient billing experience.

The Practical Frontier of Agentic AI in Healthcare

While much of the conversation around AI in healthcare focuses on breakthrough applications like diagnostic imaging or predictive analytics, some of the most valuable use cases are far less glamorous — and far more immediately impactful.

Agentic AI, which refers to autonomous tools capable of completing tasks and interacting across systems without constant human oversight, is proving especially useful in areas burdened by repetitive, manual work. Think of common workflows like responding to billing questions, verifying insurance, or following up on patient payments — tasks that are critical, but often monotonous and time-consuming.

This is where agentic AI delivers real operational value. By taking on these high-volume, burdensome tasks, AI systems can reduce the administrative load, accelerate routine processes, and free up staff to focus on more complex or human-centered challenges. An example is Collectly’s AI agent for RCM and patient billing, Billie.

As healthcare organizations face continued staffing shortages and margin pressure, these practical applications of AI — not just the futuristic ones — are driving measurable impact today.

Policy Shifts

Healthcare organizations are navigating a complex landscape of evolving policies that directly impact revenue cycle operations. Leaders are facing complex changes in areas like:

• Value-based care: The ongoing transition from traditional fee-for-service models to more complex value-based care models with quality-and outcome-based reimbursements requires fundamental changes to an organization’s RCM processes.
• Price transparency: The No Surprises Act and similar price transparency legislation require hospitals and other providers to share accurate, timely estimates of the cost of scheduled services for uninsured and self-pay patients. Without automation and advanced RCM tools, creating and communicating these good faith estimates can burden administrative staff and prevent further organizational growth.
• Telehealth: The expiration of COVID-era telehealth reimbursement policies and uncertainty about their possible extension after fall 2025 creates planning challenges for organizations seeking to balance investment in virtual care with the need for long-term financial stability.
• Security: Patients expect a seamless, user-friendly digital billing experience on par with the modern retail experience, but healthcare providers and third-party vendors must comply with laws related to patient privacy, protected health information (PHI), and data security: HIPAA, HITECH, PCI DSS, FTC regulations, and state-level privacy requirements.

Staying up-to-date on local, state, national, and professional standards — and choosing technologies that enable compliance alongside growth — is a key priority for healthcare leaders going into 2026.

Financial Pressures

The financial landscape for healthcare organizations has become increasingly challenging. On the backdrop of accelerating inflation in the US, operational costs and administrative workloads continue to rise for healthcare providers. Meanwhile, revenue - particularly from payer reimbursements - fails to keep pace.

Moreover, patients are seeing their financial responsibility continue to increase: average spending per patient has more than doubled since 1970 when adjusted for inflation, and the rise in out-of-pocket costs has been driving down patient collection rates.

Rising claim denials only add to the patient financial responsibility — and to the administrative workload. This creates a cascading effect throughout the revenue cycle and puts pressure on already strained financial operations. This pressure is particularly acute for private practices, which often lack the scale and resources to absorb these mounting costs effectively.

Going forward, healthcare CFOs and revenue teams are looking for new ways to respond to 
these financial pressures — for example, improving net collections by simplifying the patient billing journey.

Healthcare Workforce Shortages

Recruiting and retaining skilled workers is a challenge across healthcare roles, specialties, and regions. By 2030, the American healthcare system could be understaffed by more than 100,000 physicians, and almost half of all providers already feel the financial and operational strain of staffing shortages.

A lack of experienced workers in key revenue cycle roles — from medical coders to patient financial counselors — creates operational bottlenecks and drives up labor costs. The situation is compounded by an aging workforce, increased burnout and attrition post-COVID, and a growing chronic disease burden among patient populations. Healthcare organizations find themselves caught between the need to maintain adequate staffing levels and the challenge of recruiting qualified professionals in an increasingly competitive labor market — often resulting in higher compensation costs and reliance on temporary staffing solutions that put further strain on organizational budgets.

Strategies for Healthcare CFOs and RCM Professionals

With providers now collecting over 30% of revenue directly from patients, healthcare leaders are rethinking RCM strategies. Here are the biggest strategies we hear from industry leaders heading into 2026:

1. Prioritize Staff Retention

The market for skilled, experienced healthcare workers in all roles is challengingly competitive; the National Healthcare Retention & RN Staffing Report found that the average hospital turned over over 106.6% of its workforce in the past five years. Revenue teams, unfortunately, are no exception. RCM teams report turnover as high as 40%, more than ten times the national average across all industries.

When experienced staff leave, organizations lose institutional knowledge and mentorship and incur increased costs for recruiting, training, and onboarding new workers, as well as a (hopefully temporary) loss of productivity.

Not all employee departures are preventable, but leaders can maximize retention by creating an environment that fosters professional growth, efficiency, and job satisfaction. This requires thoughtful changes to employee workflows and internal operations, ideally based on staff feedback. Sometimes a relatively small optimization — like automating a frustrating, repetitive data entry task— can go a long way toward improving the staff experience for those managing the revenue cycle.

• Reduce frustrating manual work: Use AI, automation, and EHR integrations to reduce the frustrating manual work that drives employee dissatisfaction and burnout.
• Provide high-quality technology: Implement digital billing and advanced (EHR-agnostic) RCM software to streamline workflows and improve the staff experience.
• Train and coach staff: Provide upfront and ongoing training on RCM workflows — to not only finance and A/R teams, but also clinical staff — to ensure highly accurate documentation of patient services for timely billing to occur. Offer engaging training and continuing education programs to help staff stay current with evolving regulations and technologies.
• Encourage professional development and advancement: Allocate budget and time for staff development opportunities like mentorship programs, specialized training, and cross-functional skill-building to demonstrate organizational investment in employee growth. Reduce attrition by offering career ladder programs that demonstrate clear pathways for professional advancement.
• Offer competitive compensation: Create competitive compensation structures and incentive programs to align with an increasingly competitive labor market.
• Focus on the employee experience: Regularly collect staff feedback from multiple channels and act upon the feedback received. Improve employee engagement with peer recognition programs and flexible work arrangements, where feasible.

2. Improve Cross-Department Collaboration and Coordination

Revenue cycle efficiency depends heavily on seamless collaboration between departments that have traditionally operated in silos. Poor communication between revenue cycle management, health information management (HIM), and clinical teams creates bottlenecks that compromise both financial performance and patient satisfaction.

Organizations that break down these silos see measurable improvements in denial rates, collection efficiency, and overall operational effectiveness.

• Involve HIM teams early: Get HIM experts at the table early in strategic discussions —especially when it comes to mergers, acquisitions, and policy changes. HIM experts can share critical knowledge about coding requirements, documentation standards, and regulatory compliance that directly impact revenue cycle performance — and prevent documentation and compliance issues that create costly problems later on.
• Engage clinicians in the revenue cycle: Physicians, nurses, and other clinical staff who understand the financial implications of their documentation and coding decisions become active partners in revenue optimization. When clinicians understand how incomplete documentation leads to claim denials or delayed payments, they become more engaged in providing the detailed information upfront that is necessary for accurate billing. This clinical engagement directly translates to lower claim denial rates and improved cash flow — a huge priority when payers are initially denying almost 12% of hospital-based claims.
• Build in intentional collaboration: Schedule regular cross - departmental meetings and leadership check-ins. Share performance metrics and review revenue cycle KPIs that matter most to HIM and clinical teams on a regular basis. Hold collaborative problem-solving sessions to maintain alignment between teams. Create joint training programs, cross-training opportunities, and formal communication channels to help all teams understand their role in the broader revenue cycle ecosystem.

3. Use AI and Automation to Optimize RCM

AI and automation represent the most significant opportunity for revenue cycle transformation. These technologies can address multiple challenges simultaneously, from workforce shortages to process inefficiencies to data accuracy issues. The applications span the entire revenue cycle, including coding automation, payment posting, patient communication, denial prevention and management, and comprehensive auditing capabilities.

However, successful AI implementation requires addressing several key challenges. Many EHR vendors' native AI capabilities remain limited, forcing organizations to seek third-party solutions or develop custom integrations. Inconsistency among payers in claim processing requirements creates complexity that even sophisticated AI systems struggle to navigate. Legacy technology systems often lack the infrastructure necessary to support advanced automation tools.

Identify the best use cases for automation: Revenue cycle automations use technology to perform routine RCM tasks with minimal human involvement. Typically with today’s technology, automations are based on predefined workflows. This rule-based and task-oriented technology is ideal for taking on rote administrative tasks like eligibility verification.

Identify the best use cases for AI: Revenue cycle AI learns and adapts in real-time to assist in complex decision making. It’s better suited for generating actionable insights, such as analyzing current and historical data to predict patient payments and flag outliers in claims submissions.

Types of healthcare RCM automation:

• Coding automation can significantly reduce the manual effort required for claim preparation while improving accuracy and consistency — which improves the downstream via fewer denials and more reimbursements.
• Payment automation eliminates manual posting and indexing processes, reducing staff workload while accelerating cash application.
• Automated patient communication systems handle routine follow-ups and payment reminders, freeing staff to focus on complex patient interactions that require human judgment.
• Denial prevention systems use predictive analytics to identify potential claim issues before submission, allowing organizations to address problems proactively rather than reactively.
• Digital self-service patient tools enable patients to handle routine tasks independently, giving patients instant gratification while reducing admin burden.

Streamline billing workflows: Use AI to reduce manual entry, automate recurring tasks, and personalize patient communications. AI agents like Billie blend AI and automation to pull together key data points from EHR/PM, insurance, and billing systems, and intelligently deliver personalized patient billing support 24/7/365. As a result, Billie users report their staff spend 85% less time on billing inquiries, and payment delays due to billing confusion decreased 70%.

Resolve revenue leakage and reduce bad debt: With robust analytics that synthesize millions of data points in real-time, AI can proactively identify potential issues or patterns contributing to lost revenue. From there, the system can curate solutions like payment plans to improve patient collection rates, as well as identify costly errors and indicators of fraud before they escalate into bigger problems.

Find flexible and adaptable software: Shifting payer requirements can render automated processes obsolete overnight. For long-term consistency, providers should invest in flexible AI-powered solutions that adapt to changing requirements while maintaining easy connections to any EHR, PM, and other system in use. Customized demos and feedback from different staff groups can help thoroughly vet software solutions before full deployment.

4. Improve Cybersecurity Protections and Procedures

Recent headlines show how much of a priority information security needs to be for healthcare organizations - especially as we increasingly rely on digital billing systems and automation technologies. Revenue cycle systems contain massive amounts of sensitive patient and financial data, making them attractive targets for cybercriminals, and the introduction of new platforms and processes creates new complexities and potential vulnerabilities.

The investment in comprehensive cybersecurity protection pays dividends through reduced risk of costly data breaches, the diminished threat of noncompliance, high levels of patient trust, and uninterrupted revenue cycle operations. Leading healthcare organizations are creating proactive cybersecurity strategies that extend throughout every stage of the revenue cycle and across HIM, 
A/R, clinical, and leadership teams.

• Deliver clear, consistent staff training: Conducting staff training programs (during onboarding and on a recurring basis) helps employees recognize the specific risks associated with digital billing processes and automations. Training materials should be updated and new training sessions delivered as requirements and processes evolve. Reference documents and other resources that employees can easily find from their workstation provide a refresher when needed.
• Implement an audit and assessment program: Recurring security assessments help identify vulnerabilities before they can be exploited, and incident response planning ensures rapid response to and containment of any security breaches. Reviewing third-party applications and integrations is an important part of security assessments and preventing new vulnerabilities.
• Review security procedures regularly: Data security procedures require regular review and updating to address new types of cyberthreats and evolving legal requirements regarding consumer privacy and data security. Ensure vendors are building and testing products according to the latest standards.
• Address internal vulnerabilities: In-house security best practices like multi-factor authentication and role-based access controls provide an essential security layer for system access. Providers should also reduce reliance on single clearinghouse vendors to prevent catastrophic disruption from security incidents originating from a specific vendor.
• Use AI-assisted analysis of security data: AI-powered fraud detection and anomaly monitoring systems can identify suspicious activity patterns that human oversight might miss. These systems learn from new information over time, becoming increasingly sophisticated and learning to recognize new threats and attack patterns.

Prepare for the Future of RCM with Collectly

Automation, AI, and policy shifts are transforming healthcare revenue cycles, so it’s up to industry leaders to make sure their organizations keep pace to achieve greater financial stability, secure and sustain an adequate workforce, and deliver optimal patient experiences. If they intend to stay competitive for the long term, they must empower and engage their staff, optimize RCM processes, and enhance cybersecurity protections.

Billie is the 24/7 AI billing agent built for the future of RCM. Billie can instantly resolve patient questions, reduce call volume, and accelerate payment.

These downstream impacts make it essential for revenue cycle leaders to treat the billing experience as a strategic priority. Investing in a patient-centric RCM approach doesn’t just build trust — it drives higher satisfaction-linked reimbursement and stronger long-term financial performance.

Billie users:

• Spend 85% less staff time resolving billing questions
• Boost cash flow up to 32% by reducing delays/resolving issues faster
• Reduce cost to collect by 20-30%
• Miss zero billing questions from their patients

Using real-time data from EHR, PM systems, insurance, and billing systems, Billie can understand and communicate the full financial picture for each patient. This enables instant, personalized support — even when your office is closed.

Ready to see what Billie can do for your RCM team? Request a demo today!