R1 RCM (RCM) Status Update summary

Technology Platform and Data Ecosystem

• Unmatched breadth and depth of healthcare data, covering over 550 million patient encounters annually and 60% of the acute care market, with over 95% payer connectivity.

• Deep integration into customer workflows enables precise automation and actionable insights at critical points.

• Proprietary knowledge, best practices, and workflow orchestration are embedded in standard operating procedures, rules, and algorithms.

• Cloudmed acquisition enhanced data scale and machine learning capabilities, now fully integrated into the platform.

• Migration to Microsoft Azure Cloud completed on time and under budget, improving scalability, cost control, resiliency, and cybersecurity, with ~2 petabytes of data migrated.

AI, Automation, and Innovation

• Automation-first, AI-enabled platform automates over 200 million tasks annually, impacting work equivalent to 5,000+ FTEs, with ongoing expansion using RPA, machine learning, and generative AI.

• AI-driven solutions include automated clinical appeals, physician coding quality assurance, and call quality insights, with recent applications reducing clinical appeal creation time by 75% and enabling 100% QA of calls.

• AI and automation are deployed incrementally, with a four-phase approach from human-in-the-loop to full autonomy.

• Generative AI is used to streamline complex processes like prior authorizations and clinical appeals, reducing manual effort, increasing accuracy, and expected to reduce costs by 40%.

• Continuous feedback loops from user interactions drive ongoing process and technology improvements.

New Modular Solutions and Client Impact

• Insurance Discovery solution increases annual recoveries by over 10% compared to competitors, leveraging proprietary data and automation.

• Modular Coding relieves staffing constraints, improves capacity by 2-3x, and reduces charging lag by ~30%.

• Patient Receivables solution improves patient payments by up to 10% and achieves over 90% patient satisfaction.

• New solutions are designed to be scalable and reusable across multiple business lines, accelerating cash collection and improving patient satisfaction.

• Return on investment for new initiatives averages less than 24 months, with rapid deployment and iteration.