Healthcare professionals converged at HFMA RCC 2025, where the spotlight was on advancing revenue cycle management (RCM) through cutting-edge technologies, patient-centered care and strategic governance. With over 550 attendees, the event delivered valuable insights into the forces reshaping the healthcare financial landscape.
What stood out most were the unifying themes across the sessions. Topics like AI advancements, price transparency, payer accountability and team development weren’t just theoretical frameworks; they revealed practical paths forward for healthcare organizations to thrive. This post distills the most impactful insights from the conference into actionable takeaways for professionals poised to transform their RCM practices.
The Power and Perils of AI in Revenue Cycle Management
Artificial intelligence dominated HFMA RCC 2025 as attendees debated the balance between AI's potential and associated risks. In my session, “AI Alignments in Revenue Cycle,” with Andreea Bodnari, Founder and CEO of ALIGNMT AI, we underscored the skyrocketing adoption of AI, with discussions ranging from increasing efficiencies to controversies like auto-denials. Confidence in AI is on the rise, yet so are lawsuits stemming from its misuse.
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Key Takeaways:
- Risk vs. Reward
AI implementation can reduce manual workloads, such as saving $5 per chart in coding, equating to potentially $50K in monthly savings. However, errors, like a 20% implementation misstep, can result in millions of compliance penalties.
- Governance Is Crucial
Establishing AI governance charters, compliance committees and bias-monitoring protocols is critical to ensure ethical and effective adoption. Tools like fairness audits and red team testing have become indispensable.
- Adaptability Improves Results
AI thrives with ongoing learning and dynamic workflows. Success came down to aligning teams, operationalizing clear standards and using robust data policies to measure real-world ROI.
AI might be here to stay, but governance and education will determine whether it’s the game-changer we hope it to be.
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Building Relationships with Payers to Drive Accountability
Healthcare providers are navigating an uphill battle with payers armed with increasingly stringent denials and prior authorization practices, particularly within Medicare Advantage plans. "We owe it to our patients to ensure we remain financially viable," one speaker noted, emphasizing the need to sharpen collaboration between providers and payers.
Key Takeaways:
- Data-Driven Conversations
Sharing proprietary payer scorecards with underperforming payers led to optimized relationships and streamlined processes. Outliers were addressed collaboratively to target specific pain points like appeal success rates or denied claims.
- Proactive Measures
Leveraging advanced analytics tools such as denial dashboards in systems like Epic made it easier for organizations to identify payer-specific patterns and drive improvements.
- Transparency from Day One
Improved price transparency and upfront cost-sharing estimates enhanced patient trust and reduced uncollectables. Simple workflows, like ensuring half of all estimates were within $2 of EOBs, set benchmarks for accountability.
The message was clear: you can’t simply confront payers with inefficiencies; evidence-based solutions open the door for a collaborative improvement.
Redefining Price Transparency in 2025 and Beyond
New regulations are intensifying the focus on price transparency, forcing providers to comply with growing technical and qualitative standards. Penalties are steep and now enforced across all hospital sizes. Shawn Stack of HFMA highlighted how the latest executive orders are pushing hospitals toward proactive compliance.
Key Takeaways:
- Compliance is Evolving
Audit metrics have shifted from basic technical requirements (posting machine-readable files) to qualitative data reviews, focusing on clear, accessible pricing information.
- Automating Monitoring
Several systems showcased how robotic process automation (RPA) ensures files meet formatting rules, detect missing price modifiers and maintain operational links in hospital databases.
- Future Focus
Transparency isn’t going away. With federal oversight tightening, organizations need systems in place to ensure continuous compliance with both current and upcoming guidelines, including GFEs for both self-pay and insured patients.
Providers who treat compliance as a technical one-off task will struggle. Building seamless operational workflows and ongoing audits are the only way to keep pace.
Patient-Centered Care Needs Beyond the Bill
Revenue cycle is no longer just about balancing the books; it’s about genuinely improving the patient experience while maintaining financial stability in healthcare. Speakers repeatedly acknowledged the growing public frustration with overwhelming medical bills and the industry's failure to deliver upfront clarity around costs.
Key Takeaways:
- Holistic Communication
Every touchpoint, from scheduling to collections, must be clear and patient-friendly. Organizations that fail to create straightforward cost-sharing conversations risk alienating long-term patients.
- Affordability Assistance
Studies revealed vast discrepancies in financial assistance policies across hospitals. Standardizing these guidelines and communicating them transparently can lower tensions while maintaining regulatory integrity.
- Payer Accountability
Providers need to build systems that hold insurers accountable for excessively delaying or underpaying for patient care, ensuring insurance remains a safeguard rather than a barrier.
Healthcare sits at the intersection of care and commerce, but rethinking RCM processes around compassion and trust could turn patient satisfaction into an asset.
Technology Can’t Replace Strong Teams
Finally, the conference served an important reminder that technology is only as effective as the people behind it. Cultivating leadership, cross-collaboration and continuous learning were key priorities shared by RCM leaders.
Key Takeaways:
- Upskilling Matters
Allow employees to expand their skills across functions. For example, evolving billers into certified coders or transforming analysts into automation leads helps retain and empower top talent.
- Vulnerable Leadership
A recurring theme was the importance of vulnerability in leadership. Admitting, “I don’t have all the answers,” builds trust and encourages staff to take ownership of outcomes.
- Balanced Delegation
Effective leaders delegate tasks not just to ease their own workloads, but to fuel team growth and long-term job satisfaction.
RCM teams positioned for success are those where siloed roles dissolve into shared goals.
A Look Ahead
HFMA RCC 2025 provided compelling evidence that the future of revenue cycle management lies in striking a balance between innovation and accountability. From AI adoption to payer accountability, patient-centered care and transparent processes, organizations must be willing to adapt and evolve.
For those looking to elevate their RCM practices, the call to action is clear. Invest in the right technologies, empower your teams and prioritize patient trust to achieve end-to-end efficiency.
The key question isn’t, “Will we adopt these changes?” It’s, “How fast can we adapt to lead the way?”
About the Author
Jonathan G. Wiik, MSHA, MBA, CHFP
Vice President, Health Insights
Jonathan Wiik, VP of Health Insights at FinThrive, has over 25 years of healthcare experience in acute care, health IT and insurance settings. He started his career as a hospital transporter and served in clinical operations, patient access, billing, case management and many other roles at a large not-for-profit acute care hospital and prominent commercial payer before serving as Chief Revenue Officer. Wiik works closely with the market and hospitals on industry best practices for revenue management. He is considered an expert in the industry for healthcare finance, legislation, revenue management and strategic transformation.
