7 Questions to Help You Optimize Your Healthcare Revenue Cycle Management for 2026

Having a strong revenue cycle management (RCM) process is important for all healthcare practices since it’s what streamlines your billing process so that your practice can be financially sustainable.¹ 

As you head into the new year, it’s a good opportunity to evaluate how your RCM processes can be enhanced to boost efficiency. Here are some key evaluation questions to get you started, along with proactive strategies to help you optimize incoming payment flow while helping reduce debt and expenses. 

Evaluating Your Healthcare Revenue Cycle

Every practice’s RCM might look a bit different because billing processes, levels of insurance acceptance and patient financing options can vary. That’s why it’s important to identify your key metrics for evaluating your specific revenue cycle. Start off with this one central question:

1. What are the key metrics to track in your healthcare revenue cycle?

One of the most important metrics to focus on as a health and wellness provider is point-of-service (POS) and collections, since such payments can equate to cash flow.² Your practice can try to improve this metric by giving your patients or clients a variety of financing options to help them move forward with the care they may want or need.

Other common metrics your practice may want to track (as applicable) could include:³ 

• Medical coding accuracy. This is important for practices that make insurance claims since it can help avoid claim denials or payment delays.
• Days in receivables outstanding. This is the average number of days it takes your practice to collect payments. The fewer days it takes, the better it can be for your revenue management cycle.
• Claim denial rate. This is the percentage of insurance claims that are denied. If you find that your percentage is higher than you’d like, it might warrant a deeper look into the reasons why.
• Net collection rate. This represents the percentage of expected revenue collected from bills more than 120 days old. If your practice has a lot of outstanding bills, it could be throwing off your revenue cycle.

Optimizing Healthcare Revenue Cycle Management for 2026

Digging into your data can help you spot trends and diagnose potential issues with your RCM. From there, you can formulate a plan of care to make improvements going into 2026. Here are a few additional questions to consider as you work on optimizing your revenue cycle management:

2. Are you leveraging technology to enhance your healthcare revenue cycle management?

Healthcare can be complex. Because patient care is often delivered in multiple visits, account balances and claims may pile up and be unresolved even while clients move forward with new services.³ To help manage such complexities, many practices are incorporating new layers of technology to streamline workflows and reduce errors, which can help the RCM overall. Some of these tools include automation, electronic health records (EHR) integration, analytics tools, etc. One survey found that 63% of healthcare organizations surveyed have already integrated AI-powered automation solutions, and of those, 15% have already seen a positive ROI.⁴

Think about your own health and wellness practice. Have you encountered challenges that have made managing payments a bit tricky at times? If so, it could be a good time to explore new technology solutions to better manage your revenue cycle.

3. How often do you train teams on revenue cycle best practices? 

Keeping your office staff up to speed on medical billing and coding updates and compliance is also important for maintaining optimal revenue cycle performance. Continuous improvement activities, such as training for staff, can help ensure that operations run smoothly, reduce human error and make processes involving accounts receivable and payments more efficient.⁵

Whether you conduct training once per quarter or bring the staff together whenever something new is introduced is up to you. The key is to strive for consistency and give everyone on your team the resources and support they need to do their jobs well.

Strengthening Healthcare Billing and Collection Processes

Coding errors are the most common reason that claims are denied by insurance companies.⁶ With a better process in place, you may be able to help increase accuracy and experience fewer payment delays. Ask yourself these questions:

4. Are your healthcare billing and collection methods aligned with industry standards?

You want to ensure that your current billing processes stay updated for accuracy, timeliness and compliance in order to maximize collections. It’s also important to help your staff fully understand HIPAA compliance, for example, including adhering to the Privacy Rule for oral and written communications and the Security Rule for electronic transactions.⁷

5. What strategies are in place to help manage patient balances?

Having a well-thought-out patient communication plan, offering flexible payment options and standardizing a follow-up procedure can help create a positive experience for your patients or clients, all of which can help encourage repeat visits.⁸ 

For instance, working with a prospective patient or client to identify financial assistance or payment plans pre-appointment can help them get the care they want or need.

It’s also important to have a follow-up plan for payment owed after an appointment. Collecting copays and the patients’ portion of the bill may require regular follow-up via automated payment reminders, email or text.³

Reviewing Financing and Payment Terms

As patients assume a greater share of out-of-pocket healthcare costs, it’s increasingly common for practices to collect payments directly from them.³ With this in mind, consider whether your payment policies help make care accessible and attainable for patients or clients in your community.

Ask yourself:

6. Do your financing and payment practices meet patient needs while supporting practice revenue?

When considering your existing payment plans and financing options, focus on two key goals: encouraging timely payments and helping minimize barriers to care. Think about whether your current solutions support these goals. If not, consider introducing new payment options that might make it easier for your patients or clients to follow through with their care plans.

7. How can you adjust payment practices to better support patients’ changing wants, needs and economic circumstances?

Flexible payment options and financing solutions like the CareCredit credit card can help patients manage out-of-pocket healthcare expenses over time. Spreading a larger bill into smaller payments may make it easy for patients and clients to incorporate the cost of care into their budgets.

Optimizing Your Healthcare Revenue Cycle in 2026

Putting some thought into your RCM now can help you put better processes in place for a more successful 2026. After assessing the health of your RCM, you can create a game plan to work on areas that need improvement.

Whether it’s strengthening your billing and collections processing, improving patient communications, implementing regular staff training or adding more financing solutions, each small improvement to your revenue management cycle can have a big impact on your practice’s overall financial well-being.

A Patient Financing Solution for Health and Wellness Providers

If you are looking for a way to connect your patients with flexible financing that empowers them to pay for the care they want and need, consider offering the CareCredit credit card as a financing solution. CareCredit allows cardholders to pay for out-of-pocket health and wellness expenses over time while helping enhance the payments process for your practice or business.

When you accept CareCredit, patients can see if they prequalify with no impact to their credit score, and those who apply, if approved, can take advantage of special financing on qualifying purchases.* Additionally, your practice or business will be paid directly within two business days.

Learn more about the CareCredit credit card as a patient financing solution or start the provider enrollment process by filling out this form.

Author Bio

Dawn Papandrea is a journalist with more than two decades of experience covering personal finance and consumer issues. She has written for leading financial publications and organizations, including U.S. News & World Report, Investopedia, BankRate and others.

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