Proven revenue cycle outcomes, engineered through best in KLAS transformation and end-to-end managed services
Revenue Cycle Transformation
Overview
PwC’s Revenue Cycle professionals help healthcare organizations bend the cost-to-collect curve, safeguard net revenue from payer pressure, and stabilize margins in a risk-based world. We enable confident AI adoption and regulatory resilience through a modern operating model that turns insight into action—backed by 30+ years of experience and billions in value delivered.
Revenue Cycle Managed Services
Market trends
Capabilities
- Operating Model and Data-Driven Insights
- EHR / RCM Transformation
- Clinical Alignment and Optimization
- Intelligent Automation and AI
- Digital Patient Engagement
- Strategic Access
- Revenue Cycle Managed Services
- Revenue Cycle Strategic Reimbursement
- Join PwC’s Revenue Cycle Consortium
Operating Model and Data-Driven Insights
PwC redesigns revenue cycle operating models grounded in data, automation, and predictive insight to enable faster, smarter decision-making across RCM functions.
Key Solutions Delivered
- AI-enabled operating model design that translates insight into action
- Predictive and prescriptive analytics embedded into workflows to drive real-time decisions and measurable performance improvement
EHR / RCM Transformation
PwC enables organizations to maximize the value of their EHR and RCM platforms by optimizing native capabilities, improving configuration, and integrating complementary technologies.
Key Solutions Delivered
- EHR optimization and integration with payer and third-party systems
- Workflow standardization and orchestration for clinical-financial alignment
Clinical Alignment and Optimization
PwC bridges clinical and financial workflows and incentives to improve revenue capture while maintaining high standards of quality and compliance.
Key Solutions Delivered
- Technology-enabled coding quality platform to strengthen revenue integrity and compliance
- Automated coding workflows for accelerated billing cycles
- Market-based strategic pricing and value-based care reporting capabilities and analysis
Intelligent Automation and AI
PwC embeds AI and intelligent automation across the revenue cycle to eliminate manual work, deliver real-time decision support, and unlock capacity at scale.
Key Solutions Delivered
- End-to-end process automation
- Generative and agentic AI enablement
- Denials prevention and next-best-action analytics
Digital Patient Engagement
PwC scales consumer-first experiences that improve access, financial transparency, and patient satisfaction.
Key Solutions Delivered
- Omni-channel patient engagement
- Proactive, personalized outreach for care continuity
Strategic Access
PwC drives revenue growth and margin improvement by aligning patient access strategies with demand, capacity, and reimbursement realities.
Key Solutions Delivered
- Access growth strategy and capacity alignment
- Demand forecasting and utilization insights
Revenue Cycle Managed Services
PwC provides revenue cycle managed services that stabilize performance, address workforce constraints, and continuously improve revenue cycle outcomes.
Key Solutions Delivered
- AI-enabled end-to-end RCM business process outsourcing services with a proven track record of improving financial performance
- Exception-based workflow leadership, managing $40BN+ in AR
Revenue Cycle Strategic Reimbursement
PwC strengthens reimbursement performance by optimizing payer strategies and improving contract outcomes, delivering sustainable margin improvement while navigating increasing payer and regulatory complexity.
Key Solutions Delivered
- Contract strategy and intelligence platforms
- Reimbursement performance predictive analytics
Join PwC’s Revenue Cycle Consortium
Connect with revenue cycle leaders from health systems across the country to exchange insights, explore timely industry topics, and benchmark key financial and operational metrics. PwC’s Revenue Cycle Consortium helps members surface leading practices, strengthen performance, and drive continuous improvement in a rapidly evolving healthcare landscape.
Insights
Case studies
Recognition and awards
