What Revenue Cycle Leaders Are Actually Worried About
Last week, the Healthfuse team attended Becker’s Annual Health IT + Revenue Cycle Conference. The takeaway was clear: health systems are in the middle of real transformation, and the pain points are getting harder to ignore.
Our own Jonathan Wiik came back with five themes that kept surfacing — in sessions and in conversations with revenue cycle leaders from all over the industry. What struck us wasn’t just how much was changing, but how consistent the challenges were: too many vendors with no way to govern them, AI tools rolling out faster than teams can absorb them, staffing models being rebuilt from scratch, and payer-provider tension that keeps escalating instead of settling down.
Put together, these five themes describe an industry with more technology than it can evaluate, more automation than it can manage, and higher stakes than ever in getting both right. Here’s what Jonathan heard — and what it means for health systems trying to make sense of it all.
Common Pain Points Echoed at Becker's
Too many vendors, not enough oversight.
Leaders at UW Medicine, MD Anderson, THR, and Lake Regional all described the same problem: vendors calling nonstop, with no consistent way to evaluate them, compare them, or cut the ones that aren't performing. Lake Regional found $1.8M in savings in a single year just by auditing its existing vendor contracts for duplicates — exactly the kind of gap Healthfuse's vendor-profile and benchmarking database is built to close.
AI is moving faster than the governance around it.
Leaders from UPMC, Stanford, Sentara, Abridge, and Rochester all made the same point: rolling out an AI tool isn't the same as getting people to actually use it. Rochester closed that gap with a formal AI Center of Excellence — complete with a gating and review process — and tied it to a $16M net revenue improvement. Abridge saw a similar pattern: a 14% jump in RVUs, but only once usage passed the 50% mark. The lesson: measure AI by how fast people adopt it, not how fast you can roll it out.
Staffing is shifting from headcount to skillset.
Automation is already changing the math on cost-to-collect. At UW Medicine, manual pre-authorization and claims work now accounts for less than 80% of the workflow — down from over 90% a decade ago. Across nearly every session, the message on staffing was the same: billing experience alone won't get you hired anymore. What health systems want now is data literacy, analytics skills, and critical thinking. That changes the vendor conversation too — it's less about replacing headcount and more about redesigning how the work gets done.
Payers and providers are locked in an AI arms race.
Cleveland Clinic, Schneider Regional, and Temple all described the same escalation: providers automate to get claims paid, payers automate to deny them. Even shared-risk and value-based contracts haven't fixed the misaligned incentives. On the practical side, leaders pointed to payer transparency data and negotiated price glide-paths (like phased 1%-a-year increases) as real leverage in these fights.
Slow EHR platforms are opening the door for niche vendors.
Maryland Medical System and others said their pace of innovation is held back by their EHR platform (largely Epic). That's pushing health systems toward smaller, more agile point solutions instead of waiting 2–3 years for a platform roadmap to catch up. One leader compared Epic to an oil tanker: it powers the whole hospital, but it disappears out to sea for a year or two before it's back in port with new features — especially in AI and automation for RCM.
Change management is the tough part. The tech works. But the teams need time and space for AI to work, and then time and space for the change itself. Adoption is slower. – Revenue Cycle Executive
Outsourcers, Payers, and EHR Vendors are All Repositioning. What does that Mean for Healthfuse?
Outsourcers are circling. Optum, Ensemble, and Xtend all came up as vendors “knocking on every door” for full RCM outsourcing — a real alternative to the VMO model wherever trust has broken down. For Healthfuse, that reinforces the message we lead with: we’re a partner, not a replacement for your team.
Payers are investing in AI too. Every automation win on the provider side is being matched by payers automating denials and prior authorizations. That tug-of-war over the same dollar keeps demand high for Healthfuse’s payer-contract analytics and denials benchmarking.
EHR vendors are falling behind. Slow roadmaps from Epic and other major EHR players give smaller, faster vendors room to get in the door — which plays directly into Healthfuse’s vendor-sourcing and RFP-acceleration work.
The Two Loudest Pain Points at This Conference Are Exactly Where Healthfuse Already Delivers
What we heard maps directly onto Healthfuse’s strengths. Two pain points came up again and again: (a) no one has a reliable way to evaluate or govern the flood of RCM and AI vendors in the market, and (b) payer friction is outpacing most systems’ internal analytics. Both are openings we should be raising in every HPO and payer-facing conversation.