In today’s healthcare landscape, private equity (PE) ownership is no longer an outlier – it’s the norm. From physician groups and hospitals to revenue cycle firms and technology vendors, PE firms are driving unprecedented consolidation and capital investment across the industry, with potential hidden risks to revenue cycle performance.
But as ownership models shift, so do the dynamics of partnership. And nowhere is that more apparent – or more consequential – than in the realm of revenue cycle management (RCM).
Private equity brings undeniable benefits: speed, scale, and access to capital. But when multiple healthcare entities — a provider group, a staffing company, and an RCM vendor — fall under the same PE umbrella, clinical and operational decisions often take a back seat to portfolio alignment. What looks efficient on paper can create hidden tradeoffs in performance and service delivery.
For example, a PE firm with ownership in both a physician services organization and an RCM company may drive those entities into partnership — not because of fit, but because of financial strategy. The result? The RCM vendor may not be selected based on its service model, technology stack, or results — but because it shares a parent company.
This raises critical questions:
RCM is not a plug-and-play function. Especially in emergency medicine, anesthesia, radiology, and hospitalist workflows, it demands a high degree of customization, local insight, and real-time responsiveness. When RCM partners are chosen for platform alignment rather than performance alignment, healthcare groups often experience:
These are not theoretical concerns. We’ve heard them repeatedly from healthcare leaders navigating transitions between RCM partners in a PE-backed environment.
None of this is to say that PE involvement is inherently negative — in fact, many PE-backed RCM and physician services companies perform exceptionally well. But the critical distinction is intentionality. In any PE-backed setting, leaders must ask:
In an industry where revenue cycle performance directly impacts patient care, provider satisfaction, and financial viability, these questions are too important to ignore.
The best RCM outcomes happen when service models are tailored, analytics are transparent, and partnership is real. Whether or not a PE firm is involved, healthcare leaders deserve a partner who prioritizes performance over portfolio alignment — one who is chosen because they deliver results, not because they check a box.
As consolidation continues across healthcare, the smart organizations will be those that recognize the difference — and choose deliberately.
