Revenue Cycle Management: Future Trends to Keep an Eye On

The latest revenue cycle management (RCM) advancements are helping providers thrive. Stronger RCM means better financial performance and, ultimately, better patient care.

Some providers shake off trends as just that, a passing fad. But in this industry, trends tend to have lasting power. If you aren’t keeping up with them, rest assured, competitors are. Staying ahead of the latest trends in revenue cycle management helps position your organization for future success.

Here are some of the biggest things the Office Ally team has seen brewing in the RCM space lately.

How Technology Will Evolve RCM

Healthcare organizations have vast amounts of data to analyze, parse through and protect. Most organizations have realized it’s impossible to efficiently manage the sheer quantity of available data without assistance from technology. Many providers have already gone digital, but technology is still evolving in ways that will significantly impact the revenue cycle. 

AI & Automation Can Revolutionize Workflow Efficiency

According to one report, around 80% of healthcare executives are increasing their IT budget to meet the rise in AI technologies. Around 70% of healthcare professionals (a group encompassing providers and payers) have already implemented or actively considered implementing some sort of AI capability into their processes. 

AI and automation help improve efficiency, optimize workflows, and minimize errors. Providers have long used robotic process automation (RPA) for less complex tasks, but natural language processing (NLP) has allowed providers to automate more complicated, mult-step tasks. NLP continually analyzes available data to learn and adapt for maximum efficiency.

All parts of the revenue cycle have the potential to benefit from AI and automation. AI can already flag and correct claims likely to be denied, identify denials most likely to benefit from an appeal, and even help patients with payment questions via automated chatbots. Shortly, expect AI capabilities to expand even further into pre-certification and coding.

The Use of Cloud-Based RCM Platforms

Many organizations were initially hesitant to go cloud-based due to security reasons. Robust security, encryption, and legal regulations have made adoption widespread. Cloud-based software is quickly becoming less of a trend and more of a necessity. Expect small providers to migrate to the cloud in 2026 as technology officially becomes the norm. 

Improved Payment Security & Verification Through Blockchain

Blockchain is one of the most secure payment options available. It’s decentralized and immutable, and once placed, the payment cannot be changed or altered without consensus across the network. This heightened security protects patient data and reduces the risk of fraud. Expect to see more hospitals allowing blockchain technology as a payment option.

Patient-Centric Financial Engagement

Factors like Medicaid redetermination, the One Big Beautiful Bill Act and an increase in high-deductible health plans are leading to greater out-of-pocket costs for patients, which, in turn, means there is a higher risk of providers not receiving payment.

To combat this, the entire billing and payment process is becoming more patient-centric. The Healthcare Financial Management Association found that over 50% of patients prefer online interactions, and one-third of medical payments already happen online. Outdated payment systems tend to prompt confusion, late payments, and annoyance from frustrated patients.

Like cloud-based technology, expect digital financial engagement to become the norm. Flexibility, transparency, and convenience are key, meaning providers must invest in tools like patient portals, online payment processing, and mobile apps to keep up with the competition.

Personalizing the Billing Process & Providing Transparency

Providers of all sizes are reviewing and adapting more flexible policies as patient-first financials take hold. Patients want clear billing statements with no surprise charges, flexible payment plans, and multiple payment options. Expect to see providers cater to these desires in the coming year to boost collections.

Mobile Apps for Payments

Mobile apps are a significant trend to watch. They’re like a patient portal in your pocket, allowing for payments on the go. Text messages have an extremely high open rate of 98%. Providers can send a text with a link that opens their mobile app, where patients can store existing preferred payment methods. It’s the ultimate self-service, no-friction collection method, and more providers will adopt it shortly.

Shifts in Regulatory Requirements & Compliance

Constant changes at the federal, state, and payer levels make it hard for providers to remain compliant with regulations. New laws can impact patient billing, patient data, coding methodology, reimbursement rates, and more. Providers need advanced RCM tools that can keep up with these regulatory changes.

The Ever-Changing Impact of Federal & State Policies

Whatever legislation is passed, leadership must stay informed and adequately train staff. Sometimes, it’s appropriate to seek legal guidance to avoid penalties. 

Policies are constantly changing. Currently, providers are mobilizing to prepare for the impacts of the One Big Beautiful Bill Act on Medicaid coverage. In the future, healthcare professionals expect regulations on AI and patient privacy. It’s unlikely providers will ever know exactly what’s in store.

Cybersecurity Mandates & the Need for Data Privacy

An increasingly digital world comes with risks, especially with patient data at stake. Protecting patient data is a top priority as cyberattacks continue. 

High-performing providers are investing in staff training and equipping robust IT teams with tools like:

• Multi-factor authentication
• Encryption
• Real-time threat detection
• Regular system audits and updates

No provider, no matter the size, is safe from cyberattacks. Cybersecurity started as a trend, but it’s become its area of focus. Investing in security measures is the only way to keep patient data as safe as possible and comply with privacy regulations.

Analytics & Data Driving Decisions

Tracking relevant analytics optimizes RCM at every stage of the revenue cycle. With appropriate analytics tools, providers can identify bottlenecks, forecast case flow, and make data-backed, strategic decisions.

Analytics have been around for a long time, but there’s been a recent shift to put them to work. Expect constant, real-time monitoring to become the norm as data analysis is critical for provider performance.

The Implementation of Real-Time Dashboards

Instead of generating reports after the fact, real-time data dashboards allow for proactive changes and better decision-making. Real-time analytics are often more helpful than analyzing past performance and will become a necessity very soon.

Rising Claim Denials & Using Data to Reduce 

Claim denials are a significant challenge right now and are on the rise. According to an AKASA survey, half of the providers reported their denial rates increased in the past year. Denials can occur due to incorrect coding, missing documentation, noncompliance with payer contracts, prior authorization issues, etc. 

Maintaining and tracking a robust database of relevant metrics is the best tool to prevent rising denials and is becoming hugely popular among providers. Analytics help identify the root cause of denials and prevent future issues. AI can also analyze available data to predict claim denials and prioritize appeals. 

The Need to Adapt to New Care Models & Workflows

Value-based care (VBC) is a big buzzword in the healthcare industry. It’s a payment model that financially rewards providers for good patient outcomes, leading to lower patient costs. Value-based care quickly outpaces the traditional fee-for-service approach as patients seek the best outcomes and best service for the price they’re paying. The rise of VBC is likely to continue over the next five years.

To adapt, provider tools must adequately track and report quality care metrics to comply with value-based contracts. Payers are less likely to provide reimbursement if they don’t clearly see a desired outcome. 

How to Fit Within New Value-Based Reimbursement Models

More value-based contracts mean new payment structures. Your RCM must support:

• Bundled payments
• Risk-sharing contracts
• Chronic condition management

Providers must also have the infrastructure for quality reporting. They must be able to collect, document, and code the right data and report requested data quickly to justify reimbursement claims.

Remote Patient Monitoring & Hybrid-Based Care

The COVID-19 pandemic made telehealth a regular part of patients’ lives. Telehealth differs from in-person visits and requires specialized virtual care billing and reimbursement processes. These include telehealth and RPM-specific CPT codes, payer-specific policies, and licensing and billing compliance for virtual and/or hybrid care.

Expect to see telehealth and remote patient processes worked into existing RCM workflows. Telehealth isn’t going anywhere, and its integration will be a significant focus for RCM professionals moving forward.

How to Prepare for the Future With Strategic Planning

Successful healthcare revenue cycle management starts with strong people, processes and technology. Providers need:

• People: Well-trained staff prepared to do their jobs.
• Processes: Standardized workflows prioritizing consistency and efficiency.
• Technology: Tools to support success and drive results.

Standard RCM teams have the people and the processes, but often lack the technology required to capitalize on these trends. Scalable RCM software solutions are ready and waiting to give your team a boost.

Office Ally is dedicated to helping you find the best solutions to meet your needs. Whether you're interested in learning more about our products, need a personalized demo or have specific questions, we're ready to help. Let’s talk!