Tips for healthcare leaders on choosing the right RCM partner

How do you help healthcare organizations navigate the biggest challenges in healthcare?

Healthcare organizations face mounting challenges that threaten sustainable quality care: relentless cost pressures, shrinking margins, talent shortages, regulatory complexity and payer-provider friction. Fragmented revenue cycle processes across patient access, coding, billing and accounts receivable follow-up create operational silos that exacerbate these issues, slowing cash flow, increasing administrative burden and eroding financial resilience.

Payer-provider friction is also increasing due to shifting coverage rules, ambiguous contract terms and opaque denial policies, making it difficult for providers to secure timely, accurate reimbursement.

Ensemble addresses these challenges by unifying and managing the revenue cycle end-to-end. We streamline processes, embed expert operators, and leverage advanced AI to connect payers and providers more effectively and provide a better experience for patients. By synthesizing two petabytes of claims and clinical data from 80 million annual transactions, we’re able to surface actionable insights and enable early interventions that anticipate payer requirements, reduce preventable denials and resolve accounts faster.

Ensemble works within existing client systems, strengthening the technology that already exists and filling gaps where needed. Embedded teams work side-by-side with provider staff and payer representatives, standardizing workflows and building trust through transparency and accountability. By breaking down silos, strengthening payer-provider collaboration and delivering operational excellence, Ensemble enables healthcare leaders to focus on strategic priorities — expanding access to care, improving patient experience and sustaining financial health.

What advice would you offer to healthcare leaders when choosing among vendors?

Don’t settle for a vendor. Choose a partner who is accountable, transparent and proven. The most effective RCM partners embed with your teams, align on values and commit to clear, auditable KPIs. Look for evidence of operational excellence, technology orchestration and partnership accountability. Ask for measurable outcomes like net revenue improvement, denial reduction, cash flow acceleration and patient satisfaction. Evaluate their ability to integrate with your systems and support transitions, such as EHR migrations, without disruption. True partners also demonstrate their value in crisis, like rapid disaster recovery, and in ongoing performance. Prioritize those who offer disciplined innovation, holistic insight and collective strength, not just technology. A true partner should deliver sustainable performance, not short-term fixes.

What is some advice you can give providers for a successful implementation of a new product or service?

Success starts with alignment and clarity. Define goals, metrics and governance before launching, and engage stakeholders across clinical, financial and operational teams to avoid silos. Prioritize data quality and interoperability, as fragmented or incomplete data can be a barrier to success. Choose a partner who invests in thorough onboarding, transparent communication and ongoing collaboration. Leverage automation and AI where it fits, but ensure expert teams are in place to address exceptions and drive innovation. The right partner will unify operations, eliminate inefficiencies and deliver sustained results with transparency and accountability.

Ensemble’s approach includes establishing baselines, setting clear KPIs and providing embedded support for continuous improvement.

Quick Facts

• 3 years on the Short List
• 94% of peer reviewers agree or strongly agree that they would recommend Ensemble’s services to colleagues

About Ensemble

Ensemble is the nation’s leading end-to-end revenue cycle management partner, serving hundreds of hospitals and managing more than $45 billion in net patient revenue. Founded in 2014, Ensemble combines certified operators, advanced AI and data-driven insights to optimize every aspect of the revenue cycle — from patient engagement to account resolution. Our approach delivers consistent financial results, elevates patient experience and reduces administrative burden. Recognized as Best in KLAS for end-to-end RCM outsourcing, Ensemble is committed to helping providers thrive and ensuring patients receive the care they deserve.

To learn more about HFMA’s Peer Review program, visit hfma.org/peerreview