McKinsey Survey: Hospitals Face RCM Squeeze, Shift AI and Outsourcing Strategies
A 2025 survey of U.S. healthcare leaders by McKinsey found that revenue cycle management (RCM) is under significant pressure from regulatory changes and payer dynamics. According to the report, published in April 2026, 45% of respondents indicated their cost to collect is rising, while 78% attributed at least 10% of their aging accounts receivable to payer-related causes. More than 65% of surveyed leaders anticipated a negative financial impact from the H.R.1 legislation.
In response, providers are adjusting their operating models, with a growing focus on technology and outsourcing. While 51% of leaders identified AI and advanced technologies as a priority—up from 33% in a 2024 survey—expectations for near-term returns have moderated. For instance, only one-third of 2025 respondents believe 30% of outpatient coding volume can be automated, suggesting a more pragmatic view of implementation timelines and ROI.
Outsourcing strategies are also evolving, with 60% of respondents planning to change their vendor approach within the next two years. Of that group, three-quarters intend to expand their outsourcing efforts. The survey noted a trend where organizations that exceeded performance goals were more likely to expand with existing vendors (59%), while underperforming organizations showed a higher tendency to seek new partners (68%). Denial management and coding accuracy were the top functions prioritized for both automation and outsourcing.