RCM 2030 Reality Check: What the Kaufman Hall Performance Outlook Reveals About the Next Decade

Healthcare leaders do not need another report telling them things are hard.

What they need is clarity about what has changed.

The 2025 Health System Performance Outlook from Kaufman Hall offers that clarity. Not because it introduces new problems, but because it confirms a shift many leaders already feel.

Healthcare performance is no longer about growth.
It is about resilience.

Here is what RCM leaders should take from this report and why it matters for the next decade.

1. Financial pressure is now the baseline

Nearly 60 percent of organizations reported non labor expense increases between 6 and 10 percent.
Only 30 percent expect cash balances to improve in the next year.

This means financial pressure is no longer episodic. It is structural.

RCM strategy can no longer assume stability. It must be designed for volatility.

2. Denials are created upstream, not downstream

The report is clear.

At hospitals, denials are driven primarily by front end failures.
At physician practices, they are driven by documentation gaps.

This reframes denial management.

Appeals matter, but prevention matters more.
RCM leaders need authority and alignment across access, clinical documentation, and utilization management.

3. Workforce constraints shape every RCM decision

More than half of health systems are outsourcing revenue cycle functions.
At the same time, 44 percent cite lack of resources as the biggest barrier to improvement.

This is not a staffing problem alone.
It is a design problem.

RCM 2030 requires workflows that assume turnover, hybrid teams, and automation from the start.

4. Access and throughput are now revenue drivers

ED holds, delayed discharges, and insurance related delays are among the most common constraints reported.

These issues increase cost and suppress revenue at the same time.

RCM leaders who stay focused only on claims and payments will miss where the real leakage is occurring.

5. Performance improvement is stalling under its own weight

Most organizations report having formal performance improvement structures.
Many also report lacking time, resources, and accountability to execute.

This is the gap RCM leaders are being pulled into.

RCM teams are expected to fix structural problems without structural authority. That is not sustainable.

What this means for RCM 2030

This report does not point to a single fix.
It points to a new operating reality.

RCM must evolve from a reactive function into an integrated operating system that connects access, care delivery, documentation, utilization, and payment.

That is what RCM 2030 actually means.

And the organizations that recognize that now will be the ones still standing later.

Source: Kaufman Hall 2025 Health System Performance Outlook