In April, The Health Management Academy hosted revenue cycle leaders during the 2025 Revenue Cycle Officer Forum. Across the three-day forum, one session stood out.
During the session “AI, Automation, and Cybersecurity: Lessons Learned and Future Innovation in Revenue Cycle Management,” THMA’s Thomas Seay discussed the potential for AI and compared RCO’s opinions to those of CEOs.
Attendees began with a broad discussion of AI usage in healthcare. AI is largely considered the future of healthcare. There is already promise with the kind of sophisticated analytic thinking capabilities of consumer technology like ChatGPT. But, AI algorithms that are actually built for healthcare are solving much more specific problems: generating appeals letters, imagining diagnostics, and clinical documentation are the most widely adopted capabilities and claims coding, nurse scheduling, patient navigation agents are the least adopted.
Attendees spent the bulk of the session discussing their common challenges with AI implementation. Value creation vs value capture quickly emerged as the top dilemma.
Value capture: making immediate wins in the ‘AI arms race’ with payers; in other words, how many dollars can be captured with AI (e.g. better appeal letter or coding to get slice of the existing pie).
Value creation: transforming healthcare to see compounding gains over time (e.g., call patient who might not otherwise hear from provider).
When queried about which avenue they leaned toward, RCOs were almost evenly split (51% value creation and 44% value capture). RCOs see creating and capturing value as a two-way street. One executive said that there is merit in doing both, creating a third category—value preservation. Though that is the goal, most attendees acknowledged being more attuned to zero-sum, value capture use cases. Why? Because of the growing “revenue cycle arms race,” executives have been put on the defensive as they traverse the aggressive deployment of AI by payers.
How do CEO’s opinions compare with their RCO’s? Most CEOs (86%) lean almost entirely toward value creation. Attendees debated two reasons for this: CEOs buy into the AI “hype” and they can think about the long-term value.
Attendees believed that their CEOs are more comfortable with AI in revenue cycle than in clinical areas. As one RCO put it, “In RCM, mistakes aren’t catastrophic, and returns are easy to measure.”
Another pain point many attendees mentioned was the broader vendor market. An overcrowded market has resulted in systems using tools from multiple vendors throughout the rev cycle process—of which some tools are mislabeled as AI—and still need extra support. “We can’t pick 50 vendors and implement them and manage that. I’m looking at it more like a marriage.” - New England system RCO.
RCOs want vendors who will adapt with them and the changing market and need partners who can show candor about accurate costs and benefits. “When you do land on vendor, you want them to be proactive and drive improvement. That’s the other thing we’re looking for, we don’t want the solution for just today, it will evolve tomorrow and the next day.” – West Coast system RCO.
So What?
While Revenue Cycle Officers acknowledge the promise of AI in revenue cycle management (RCM), they are primarily focused on overcoming practical implementation barriers and achieving measurable ROI. Their emphasis on value capture reflects the immediate pressure to compete with payers, who are aggressively deploying AI to optimize their own outcomes. RCOs, positioned on the front lines of this “AI arms race,” are tasked with defending health systems’ revenue, which places greater importance on tools that can deliver quick, tangible improvements—particularly in appeals, coding, and reimbursement. To succeed, AI strategies must balance long-term transformation with short-term financial defensibility.
Adding to this complexity is an overcrowded and often confusing vendor landscape. RCOs express growing frustration with adopting multiple tools—some inaccurately labeled as AI—that require intensive support and fail to integrate seamlessly. They are not looking for short-term fixes but for long-term, adaptable partners who can evolve with their needs. There’s a clear opportunity for vendors to stand out by being proactive collaborators, offering transparent ROI, and consistently delivering meaningful improvements. Above all, RCOs are calling for honesty, practicality, and flexibility. Health systems that pursue grounded, evolving AI implementations—rather than overhyped, one-size-fits-all solutions—will be better equipped to meet today’s financial demands while building toward future innovation.