AI and Automation: The Top Priority for RCM Leaders in 2025

In the rapidly evolving landscape of revenue cycle management (RCM), healthcare leaders are increasingly turning to artificial intelligence (AI) and advanced automation to tackle industry challenges. According to a comprehensive Qualtrics market survey conducted by Waystar, 92% of RCM, finance, and technology leaders rank AI and advanced automation as a top priority for 2025. This article explores the key trends and strategic focus areas driving this shift, as well as the primary challenges and solutions for implementing AI and automation technologies.



Expanding AI and Generative AI Investments

The top priority for RCM leaders in 2025 is to invest in AI and advanced automation to streamline RCM operations. Key focus areas for investment include:

1. Patient access (70% of leaders)
2. Claim management (65% of leaders)
3. Revenue integrity (60% of leaders)
4. Patient financial care (55% of leaders)
5. Denial prevention (50% of leaders)
6. Denial management (45% of leaders)



Ensuring Strong ROI from RCM Software Investments

Leaders emphasize return on investment (ROI) as a critical factor in their RCM purchasing decisions. Many providers consider alternative vendors when their current solutions underperform, citing low ROI as a core reason for switching platforms. To measure the ROI of AI and automation initiatives, RCM leaders plan to track specific key performance indicators (KPIs) such as:

1. Claim denial reduction
2. Cost savings
3. Cash flow improvement
4. Payer mix and contract optimization
5. Patient access and satisfaction
6. Cybersecurity and data protection



Safeguarding Data Against Cybersecurity Breaches

Data security concerns with an existing vendor rank as the second most important factor in switching RCM software, following negative client support experiences. A strong focus on data security also ranks as a top factor when evaluating new revenue cycle software. To address these concerns, RCM leaders must prioritize data security measures and consider the following solutions:

1. Implementing robust encryption and access controls
2. Regularly updating and patching software
3. Conducting thorough vendor evaluations and audits
4. Establishing clear data governance policies and procedures

Adopting End-to-End Software Platforms Over Point Solutions

In contrast to the historical reliance on multiple siloed, non-integrated point solutions, more than 70% of providers now work with one to two software partners for all RCM needs. A 2024 study shows that 100% of leaders with end-to-end software platforms see a positive return on investment, which explains the industry's shift from point solutions toward a single platform. By consolidating vendors, RCM leaders aim to reduce vendor management overhead and improve data consistency.



Primary Challenges and Solutions

RCM leaders anticipate several challenges in implementing AI and automation technologies, including data security concerns, integration with existing systems, cost and ROI, and workforce development. To address these obstacles, they plan to:

1. Strengthen data security measures
2. Consolidate vendors and adopt end-to-end software platforms
3. Focus on ROI and consider alternative vendors when current solutions underperform
4. Invest in workforce development and address potential resistance to change

By prioritizing AI and advanced automation investments, RCM leaders aim to improve operational efficiency, reduce costs, enhance patient satisfaction, and ensure data security. As the healthcare landscape continues to evolve, embracing these technologies will be crucial for staying competitive and driving success in the revenue cycle management arena.