RCM Outsourcing for Community Healthcare Facilities

What Conventional Wisdom Gets Wrong—and How to Challenge Assumptions for a More Empowered Approach

Hospitals, outpatient clinics, and other healthcare facilities are in a critical moment, facing operational and financial strain, evolving reimbursement models, and labor shortages. While these pressures have always existed, they’re especially timely now, given new developments such as the One Big Beautiful Bill Act. But if these concerns are problematic everywhere, they’re particularly challenging among smaller, independent facilities. There, resources are far less plentiful than at large centers.

At these organizations, there’s a certain accepted norm: Do everything leanly, and when possible, do it in-house. That mantra seems like a good enough idea; it’s resourceful, after all. But is it efficient? Or effective? Or in the best interest of patients and staff?

In some contexts, not very. Revenue cycle management (RCM) is a classic example of that conventional wisdom gone wrong. Even though outsourcing RCM can liberate teams from the costs, risks, and complexities of work they have no time to do, many leaders of small- to mid-sized organizations are reluctant to outsource that work, being motivated by myths that limit their success.

However, a strategic outsourcing plan can indeed help address both short- and long-term needs, relieving operational stress, improving financial performance, and empowering teams to do their best work. A flexible partnership helps drive that value even further while removing barriers that hold organizations back.

Fact: With the right partner, outsourcing involves a flexible setup. There’s help where you need it.

Far from an all-or-nothing commitment, outsourcing provides options. Organizations can plug in specific services based on their internal strengths, technologies, and needs across coding, claims management, denial management, and more.

That flexibility extends to small portions of larger workflows—such as outsourcing coding for one specialty and keeping another in-house.

“RCM outsourcing is incredibly flexible,” said Merideth Wilson, General Manager of the Financial Health business unit at TruBridge. “A modular approach allows organizations to test partnerships, alleviate pressure on internal teams, and scale up as needed. An outside perspective often uncovers additional opportunities for improvement, helping to create a continuous cycle of growth and optimization.”

What are some best practices for healthcare organizations that aren’t sure which functions they should outsource and which ones they should handle in-house?

Factors to consider

A hybrid model—where some tasks are outsourced and others retained—often works best.

Fact: Control is never lost—rather, freedom is gained.

Outsourcing RCM doesn’t write off a hospital’s ability to stay in control of their billing—quite the opposite: It helps hospitals get their head above water so that they can focus on core patient care priorities, while still having total insight and transparency into billing activities.

Further, having access to more operationalized RCM data can provide details about the facility’s financial health, billing trends, and opportunities for expansion and improvement. And, with those
operational components better orchestrated, patient care stands to be as well.

“The right RCM partner should provide the same level of transparency as if the work were done internally—through dashboards, real-time reporting, and open communication,” Wilson said.

“Outsourcing isn’t about losing control; it’s about gaining visibility into the data and KPIs that truly matter. Leaders should remain actively engaged, provide strategic direction, and foster a collaborative culture that keeps both internal teams and outsourcing partners aligned on shared outcomes.”

What must-haves should you expect from your RCM partner to ensure you don’t feel out of the loop and still in control of an outsourced RCM model?

To maintain transparency and control in an outsourced model, look for a partner who offers:

Fact: Outsourcing can help hospitals mitigate burdens so that they can better maintain their independence.

When a hospital chooses to outsource RCM workflows, it can start to achieve things it couldn’t before—from eschewing labor, software, and training costs of a full in-house billing department to improving revenue collections. It can also optimize cash flow when partners can devote their total attention to reimbursement capture, not just in batches as allowed by internal staff bandwidth.

With these capabilities unlocked, staff can gradually take on more meaningful priorities. Further, the organization can itself better address and insulate against financial challenges that often put mergers and acquisitions on the table in the first place. For example, TruBridge clients have seen a 13% increase in cash collection and a 24% reduction in accounts receivable days.

“Hospitals often worry that outsourcing means surrendering their identity or autonomy, but that’s simply not true,” Wilson said. “Outsourcing doesn’t compromise a company’s independence when
managed correctly. Strategy and decision-making remain internal, while clear governance, data ownership, flexible contracts, and internal innovation ensure control is maintained.

“Outsourcing should be a partnership—not a takeover,” she added. “A quality partner will operate as an extension of your team, honoring your mission, culture, and local values. In fact, smart outsourcing supports independence by making the organization more financially sustainable.”

How can outsourcing your RCM result in not just a consistent patient experience, but a potentially improved one as well?

Patients notice when things are easy. When you outsource to the right partner, you can:

All of this adds up to greater trust and satisfaction.

Fact: Onramps can be fast and agile with the right support.

Leaders often feel daunted by the implementation and change management of a newly outsourced RCM model—but they shouldn’t be, Wilson advises. Rather than a drawn-out process, transitions are fast if the right partner is involved. Many hospitals tend to be transitioned within a month or two, sometimes three in the most complex cases.

“The transition process doesn’t have to be painful,” she said. “A strong RCM partner will manage the heavy lifting—conducting assessments, onboarding staff, and configuring technology—so that your internal team isn’t overwhelmed.”

Some organizations may even want to pursue a stepstone model, which might involve an initial path for quick results followed by a longer plan to build on that foundation with additional outsourced services. In any case, experienced partners have the knowledge to make transitions more seamless and less labor-intensive across finance, IT, billing, and other areas, Willson added.

“You’re not hiring a task-doer; you’re partnering with a results-driven expert who brings operational excellence to the table.”

How long does it take to transition to an outsourced RCM model?

While timelines vary, many hospitals begin to see traction within 30 to 60 days. The full implementation may take 90 days, depending on complexity, but a skilled partner will have a dedicated onboarding team, proven workflows, and change management support to ease the transition.

Fact: Experienced partners take the time to become deeply aligned with your diverse needs.

Your community, teams, patients, and payers are unique—and the right partner should show that they’re able to adapt accordingly. This involves taking the time to learn the nuances of the hospital’s current operations and providing innovative solutions to build upon those strengths for improved operations and patient care.

“This assumption overlooks the fact that specialized vendors often serve many hospitals with similar characteristics and payer complexities,” Wilson said. “They offer tailored solutions, dedicated teams, and deep industry expertise that complement and enhance your internal operations.

“Experienced RCM partners understand how to incorporate nuance and needs specific to the organization because they work with these organizations every day. From customizing workflows to hiring regional staff, they can be deeply aligned with your environment.”

How can an RCM partner demonstrate their commitment to a hospital’s local needs, patients, and the community overall?

A good partner doesn’t just plug in a generic model. We’ve seen success with:

Fact: Outsourcing is a proactive choice.

Rather than a rescue mission when in-house workflows fail, RCM outsourcing is a strategic, preemptive decision that makes operations more efficient and less stressful for your patients, your payers, and you. It’s also a way to future-proof against staff turnover and recruiting challenges.

“Many top-performing hospitals have outsourced select RCM functions by design, not desperation,” Wilson said. “Strong RCM partners take time to understand your organization and act as an extension of your team, bringing expertise, continuity, and customized support to enhance performance.”

A key benefit of that support is the economy of scale. RCM organizations like TruBridge have the resources and reach to offer a combination of enterprise technology and highly trained, hard-to-recruit talent, for example.

Through their RCM partners, organizations can also tap into artificial intelligence and machine learning tools that they might not have otherwise with an in-house model. This helps organizations capture the value of accuracy and error reduction that might have previously been out of reach.

Using AI for denial management has reduced rejection rates by up to 40%. Outsourcing helps organizations access these critical tools.

How can RCM outsourcing enable healthcare organizations to access innovative technologies like AI/ML that can transform their billing processes?

AI and machine learning are transforming RCM—but they’re hard to adopt alone. People and technology work best when they enable each other. Outsourcing gives hospitals access to:

These tools are expensive and complex to build in-house. With the right partner, you can plug into them immediately.

It’s time to reframe the conversation: Outsourcing billing activities empowers organizations to do their best and most meaningful work—it’s not a surrender of control or a plea of desperation.

But there is one caveat: You need an effective RCM partner who will collaborate with you throughout that outsourcing journey.

The best outsourced support enables organizations to maintain visibility, control, and independence while efficiently and effectively mitigating burdens. Like TruBridge, they’re also well informed about industry trends and policies, such as No Surprises Act compliance, telehealth coding, and payer-specific nuances.

“Outsourcing RCM isn’t about giving up control—it’s about gaining the right support. When done right, it strengthens your financial health, improves staff satisfaction, and gives patients a better experience. It’s not a fallback. It’s a forward step.”

Outsourcing helps hospitals: