Delray Beach, Fla. – – September 15, 2026 -- The global Revenue Cycle Management market is projected to reach USD 132.06 billion by 2031, up from USD 73.61 billion in 2026, expanding at a compound annual growth rate of 12.4%, according to MarketsandMarkets.
North America controls 40% of the RCM market as denial rates push AI adoption
North America held a 40.0% share of the global RCM market in 2025, driven by a fragmented US payer landscape and rising claim denial rates that are pushing hospital networks toward AI-assisted coding and predictive denial analytics. Small and medium-sized enterprises are the fastest-growing enterprise segment, expanding at a 13.0% CAGR, while on-premises deployment still commands 56.4% of the market despite the shift toward cloud platforms.
Healthcare providers anchor the market as CMS documentation mandates tighten
Healthcare providers represent the largest end-user segment, as hospital networks and integrated delivery systems consolidate fragmented billing systems to manage multi-payer coordination and denials across specialties. Regulatory pressure from the No Surprises Act and evolving CMS reimbursement models is compelling providers to adopt robotic claims processing and predictive denial tools to protect revenue integrity.
AI-enabled solutions post the fastest technology growth as vendors embed machine learning
AI-enabled RCM solutions are the fastest-growing technology segment, with vendors including Optum, Oracle Health, Infinix Healthcare, Plutus Health, Advanced Data Systems and R1 RCM embedding machine learning and natural language processing for predictive denial management, automated coding and payment forecasting. Nearly two-thirds of providers already use AI somewhere in their revenue cycle, according to Experian Health's 2026 State of Claims survey.
Candid Health triples valuation in $120 million Series D as capital chases claims automation
Investment activity is concentrating on platforms automating coding, prior authorization and denial prevention rather than single-task billing tools. Candid Health raised USD 120 million in a July 2026 Series D round, tripling its valuation from its February 2025 Series C, to scale its AI-driven claims automation platform. Adonis raised USD 40 million in a March 2026 Series C, lifting total funding to more than USD 95 million for its AI orchestration platform.
Innovaccer acquires CaduceusHealth to build full-stack revenue cycle automation
In May 2026, Innovaccer acquired CaduceusHealth to extend its Flow platform into full-stack, AI-native revenue cycle management for ambulatory care providers, reflecting broader M&A activity targeting mid-cycle clinical intelligence, patient access and payment analytics capabilities.
Optum Insight generates $19.4 billion as Waystar revenue climbs 17% year-over-year
Optum Insight reported USD 19.4 billion in full-year 2025 revenue, according to UnitedHealth Group, while Waystar posted USD 1.1 billion in full-year 2025 revenue, up 17% year-over-year. Solventum's Health Information Systems segment, covering coding and RCM technology, accounted for 16.3% of the company's USD 8.33 billion in 2025 net sales, though these figures span broader business units rather than standalone RCM software shares.