Outlook for 2026: Experian Health Releases Revenue Cycle Management Predictions

Core Insights - The healthcare industry is entering a pivotal year characterized by new regulations, financial pressures, and a shift from AI awareness to adoption [3] Group 1: Predictions for Healthcare - The revenue cycle will become increasingly complex, necessitating healthcare organizations to leverage technology to enhance human expertise by 2026 [1] - AI adoption is expected to grow, with 53% of respondents believing it will be widely adopted but requiring oversight, while over a third view it as essential for operational efficiency [2] Group 2: Challenges and Opportunities - Claim denials will continue to be a significant challenge, with over one-third of providers reporting that 10% or more of claims are denied; only 14% currently use AI to address this issue [4] - The One Big Beautiful Bill Act (OBBBA) will lead to a rise in self-pay patients, with the Congressional Budget Office projecting an increase of 10 million uninsured Americans by 2034, prompting providers to optimize systems and workflows [4] - AI is expected to be rapidly adopted in the next six months, with top use cases including insurance eligibility verification (52%), patient scheduling (45%), and patient registration (44%) [4] Group 3: Regulatory Changes and Their Impact - The Interoperability and Prior Authorization Final Rule, effective January 2026, aims to streamline prior authorizations, reducing administrative burdens and improving patient care access [4] - Rural hospitals face significant risks, with up to 700 potentially shutting down due to financial strains, necessitating diversification of revenue streams and partnerships with larger health systems to remain solvent [4]