The rise of RCM operating partners in private equity: what it means for value creation

As hold cycles lengthen and competition increases, private equity firms are exploring new strategies to maintain and enhance portfolio company value. For those operating in healthcare, the clear answer is improved revenue cycle management (RCM) leadership.

RCM has undergone remarkable transformation over the past decade. What was once handled by office managers collecting payments at the time of visit has evolved into a sophisticated system of insurance claims processing, billing optimization and data analytics.

Our healthcare-focused private equity clients have increasingly recognized that effective RCM leaders are table stakes at the portfolio-company level. The next evolution, however, is happening at the fund level.

We’re now seeing a marked increase in private equity firms (both healthcare-exclusive and general investors with growing healthcare portfolios) bringing in fund-level, RCM-focused operating partners.

Why RCM matters at the fund level

A dedicated fund-level RCM resource allows private equity firms to align their portfolio companies around three critical pillars of value: portfolio company rapid response / interim support; reporting standardization; and talent development / mentorship.

When an RCM leader at the company level resigns or revenue leakage starts to surface, a fund-level expert can step in immediately. This approach minimizes disruption and ensures best practices are applied uniformly across the portfolio.

Many firms have learned the hard way that a few weeks of unaddressed billing inefficiencies can have outsized financial consequences. Having a fund-level RCM partner ready to respond allows for swift corrective action and protects against compounding impact.

Equally important is reporting standardization. Data is one of the most powerful assets a fund can have, as long as it’s consistent and accurate.

For instance, one portfolio company may define “denial rate” as a percentage of total claims submitted, while another measures it as a percentage of total dollars billed. The result? Two completely different pictures of revenue performance and no reliable baseline for comparison.

Without consistent definitions, whether for denial rates, net collection efficiency or bad debt, the investment team is left comparing apples to oranges across the portfolio.

A fund-level RCM leader brings discipline to how performance is measured, enabling more confident decision-making. Standardized reporting also strengthens board presentations, lender discussions and exit narratives, as investors can point to portfolio-wide performance metrics with clarity and confidence.

Building stronger RCM talent pipelines

Talent development is another area where fund-level RCM leadership adds measurable value.

Many portfolio companies have strong finance or operations leaders who understand the basics of revenue management but may not have deep RCM experience. A centralized operating partner can assess gaps, mentor key staff and provide targeted training to ensure each company’s RCM function runs efficiently and strategically.

This approach elevates the entire portfolio. Instead of isolated RCM teams operating in silos, a fund-level partner creates a network of professionals who share best practices and align with the fund’s overarching strategy.

Over time, this builds institutional knowledge and operational resilience. Even as leaders turn over and companies expand, the portfolio retains a consistent RCM philosophy and playbook.

Unlocking hidden value through diligence

The value of a fund-level RCM operating partner doesn’t stop at portfolio oversight. These professionals also play an increasingly important role in diligence and deal sourcing.

During diligence, a fund-level RCM partner can help determine whether a target company’s processes are strong enough to support growth or if strong topline metrics are masking deeper issues like vendor dependence, unsustainable collection practices or weak payor contracting that could erode margin post-close.

This insight helps investment teams avoid overpaying for businesses that appear operationally sound but lack sustainable revenue infrastructure. Conversely, they can identify targets with room for improvement where operational interventions could generate meaningful upside.

The future of RCM value creation

Firms that integrate RCM expertise at the fund level can move faster during diligence, standardize performance across diverse assets and identify early indicators of revenue risk before they become material issues.

As private equity continues to evolve, the most successful firms will be those that treat RCM as a strategic growth engine, and as we move toward 2026, we expect fund-level RCM expertise to become as standard as operating partners in finance, transformation or tech enablement—roles primed to be a true differentiator for funds competing on operational excellence.

To learn more, contact Jacob Sattler at (336) 217-9112 or jacob.sattler@charlesaris.com.