8 Stats That Will Make You Rethink Your RCM Strategy

Hi and happy Tuesday,

Denials are rising faster than manual teams can adapt. Clean-claim submission is getting harder. Most leaders agree AI helps, yet very few are using it. 

Eight numbers stood out, not because they're surprising but because the gap between knowing and doing has never been wider.

Stat 1: Denials are accelerating

41% of providers now face denial rates of 10% or higher

That's not a plateau. It's a compounding problem. If you're sitting at 8% denials today and thinking "we're fine," the data says you won't be for long.

Stat 2:Clean claims are getting harder

68% of providers say submitting a clean claim is more challenging than a year ago. 

Payer rules are changing faster than your team can keep up with. What worked last quarter doesn't work this quarter.

Meanwhile, 54% report that claim errors are increasing, not holding steady but increasing.

Stat 3: Everyone believes AI works

67% of providers believe AI can improve the claims process. That's the consensus.

62% of leaders are well-versed in AI, automation, and machine learning. That's up from 28% in 2024.

So awareness, confidence, and understanding are high.

Stat 4: Almost nobody is using it

67% believe AI is an effective RCM strategy. However, only 14% use it.

That's a 53-point gap between conviction and action.

Why? 

1. Concerns about accuracy, 

2. Health Insurance Portability and Accountability Act (HIPAA) compliance, 

3. Staff training complexity, and 

4. Skepticism that AI can understand payer-specific rules.

Stat 5: The ones using AI are winning

69% of AI adopters report fewer denials and/or better resubmission success, not marginal gains, but measurable improvements in outcomes.

This is outcome data from practices that made the leap.

Stat 6: Your current tech isn't cutting it anymore

That's a 21-point drop in satisfaction in three years.

The tools that felt adequate in 2022 aren't keeping pace with 2025 complexity. This is a consequence of changing payer rules. 

In other words, denial patterns shifted, but your technology didn't.

Stat 7: Practices are upgrading anyway

41% of providers upgraded or replaced their claims management technology in the past year

This one matters. Despite economic pressure, despite staff shortages, despite everything, 41% made a technology investment.

There is no waiting for perfect conditions; it is time to act.

Stat 8: More are planning to move now

59% plan to invest in denial-reduction or claims-processing technology within six months. Decisions reflect the urgency, not "someday," or "when we have budget." Six months.

The practices that wait a year won't be comparing themselves to 2025 benchmarks. They'll be competing against practices running 2026 systems.

What it means for RCM leaders

The demand for smarter, AI‑enabled claims workflows is rising rapidly, but adoption remains cautious and slow. If the right tools and assurances emerge, many are poised to switch.

Next week, I'm uncovering silent revenue streams you never knew you had (beyond denials).

See you next Tuesday,
Dino Gane-Palmer