The volatility moment: why “solo navigation” breaks down

Healthcare’s operating environment is defined by persistent margin pressure, workforce constraints, payer complexity, and policy uncertainty—conditions that make RCM too critical (and too dynamic) for any organization to steer alone. Recent industry analyses show hospitals stabilized modestly in late 2024 and 2025, but margins remain below pre‑pandemic norms and the range of performance is widening across systems according to HFMA.

CFOs and finance leaders consistently flag revenue cycle pain points. Denials, prior authorizations, and payer relations are the top stressors. In HFMA’s multi‑year research and the Guidehouse/HFMA 2024 survey of 134 executives, payer challenges were cited as the No. 1 source of stress; leaders also prioritized automation and managed services to close capacity gaps. [hfma.org]

Broader market forces amplify the need for partnership. McKinsey’s 2025 outlook warns of four forces (policy changes, tariffs, supply‑demand shifts, and accelerating medical/technology innovation) that could compress health‑system margins by up to 13 percentage points over the next five years without productivity gains. This underscores why governance, technology, and collaboration must move in lockstep in uncertain waters. [mckinsey.com], [hfma.org]

Bottom line: If volatility is the weather, then collaboration is needed at the helm of the ship to get in front of the storm. In today’s RCM, independence often translates into inefficiency.

Beyond vendor relationships: Accountability is the differentiator

The difference between a vendor and a true partner is accountability. Vendors fill gaps; partners fill goals. True partners operate with co‑governed structures, shared KPIs, and transparent dashboards that connect people, process, and technology into one operating model. That’s the essence of the co‑governed approach Currance takes with our clients: aligning performance outcomes under shared accountability, executive visibility, and real‑time reporting. 

This move from “outsourcing” to co‑navigation mirrors what leading finance groups advocate: governance frameworks that are data‑driven, transparent, and integrated across clinical and financial workflows. HFMA’s resources on standardizing denial metrics and aligning revenue cycle value streams emphasize common definitions, shared measures, and clear visibility into performance, so that stakeholders can act on one version of the truth.[hfma.org]

At the same time, external conditions (labor shortages, payer practices, and uneven reimbursement) demand more sophisticated collaboration than transactional vendor management. The American Hospital Association notes hospitals absorbed $130B in underpayments from Medicare and Medicaid in 2023, while workforce costs remain the largest expense category—context that makes joint performance management essential, not optional. [aha.org]

Key concept: Co‑governance creates structural accountability and a culture of collaboration. It replaces “outsourced tasks” with shared goals, shared data, and shared results. CFOs need precision when margins hinge on denials, yield, and cost‑to‑collect.

Why partnerships outperform: data, governance, and transparency

1) Denials and prior authorization demands require coordinated execution. Initial claim denials have risen year over year, driven by commercial plans and Medicare Advantage. Healthcare Finance News reports initial denials reached 11.8% in 2024, with leaders turning to data‑driven strategies, stronger payer contracts, and clinical‑financial integration to blunt the impact. [healthcare…cenews.com]

HFMA’s survey summary and 2024 detailed report quantified the pain: more than 86% of executives cite payer challenges as their top stressor and over 41% report denial rates above 3.1%, with automation/AI and managed services ranking as priority investments. Partnerships that align the analytics, workflows, and escalation paths, rather than scattering ownership across departments, consistently deliver faster resolution and lower rework. [hfma.org]

2) Workforce and process variability demand shared standards. AHA’s 2025 analysis highlights workforce costs at 56% of hospital expenses and continued underpayment trends—conditions that magnify the cost of inefficient RCM. Co‑managed operating models standardize work, elevate skill mix, and reduce variation across patient access, coding, and denial management. [aha.org]

3) Transparent dashboards and co‑owned KPIs drive behavioral change. HFMA and industry forums increasingly stress governance for AI/automation, payer accountability, and team development; data‑backed payer scorecards and shared KPIs help align incentives and improve outcomes. When partners co‑author the scorecard and commit to real‑time visibility, teams mobilize faster around root causes from authorization defects to documentation gaps.

4) Policy and market shocks require adaptable, multi‑disciplinary teams. McKinsey and PwC anticipate continued cost inflation, utilization shifts, and policy volatility across 2025, illustrating conditions that reward agile, cross‑functional teams versus siloed departmental fixes. Co-navigation creates surge capacity and collective problem‑solving when rules change or volumes swing. [mckinsey.com], [virtuealliance.com]

Co‑navigation governance models: 

A proven, patented approach that embeds partnership at every level

• Shared KPIs and executive dashboards: Revenue yield, net collection rate, denial rate by type and payer, POS collections, aging, and avoidable rework tracked against baseline and targeted lift, and clearly visible to both parties.
  • Why it matters: Shared transparency is associated with faster correction cycles and lower rework, a theme reinforced by HFMA’s standardization guidance. 
• Integrated people, process, technology: Joint teams align patient access accuracy, clinical documentation, coding integrity, and payer management so denial root causes are addressed upstream (not just appealed downstream).
  • Why it matters: HFMA findings show nearly half of leaders report net collection yield ≤93%, presenting an opportunity unlocked by upstream prevention plus downstream precision.
• Transparent reporting and governance cadences: Weekly operational huddles; monthly executive reviews with payer scorecards; quarterly value realization audits linking ROI to measurable improvements: collections lift, denial reduction, and cost‑to‑collect.
  • Why it matters: Governance charters and compliance/quality monitoring are widely cited as critical to safe, effective AI/automation and sustained performance.

Not outsourcing—it’s co‑navigation. Currance transforms revenue cycle differently, with co‑management under shared accountability, so your finance team remains at the helm with better instrumentation, more capacity, and a stronger course offering sustainable performance.

Shared accountability = Measurable results

When a partnership is built on co‑governance and transparency, results become quantifiable and attributable—not anecdotal.

Improved collections and yield

Finance leaders continue to prioritize yield and cash acceleration. Strata Decision’s CFO outlooks show cautious optimism tied to margin management and payer negotiations; in parallel, HFMA/Guidehouse survey data reveal substantial room to improve net collection yield for nearly half of organizations. Co‑governed partnerships that target registration accuracy, authorization rates, clinical documentation, and payer compliance can lift net yield while reducing days in A/R. 

• Related:Currance Announces Expanded Strategic Partnership with CNOS to Transform Healthcare Revenue Cycle Operations

Reduced denials

Standardized metrics plus integrated workflows reduce front‑end and medical necessity denials. HFMA’s Claim Integrity Task Force emphasizes common measures and root‑cause analytics across the patient‑centric revenue cycle—exactly the kind of playbook a partner can help institutionalize. 

Further, reforms and scrutiny around prior authorization heighten the value of coordinated appeals and payer engagement. AMA surveys document the clinical and operational burdens: 93% of physicians report care delays and roughly one quarter report adverse events linked to PA—evidence that structured, data‑driven collaboration with payers is vital. [aha.org]

ROI tied to performance metrics

A well‑designed RCM partnership documents ROI through shared KPIs: incremental cash collected, denial rate reduction (by type), avoided write‑offs, cost‑to‑collect improvements, and staffing efficiency. As policy headwinds mount (site neutrality, MA practices, tariffs), McKinsey’s analysis argues for productivity gains via technology and operating model redesign—exactly what co‑managed partnerships are organized to achieve. [mckinsey.com]

What CFOs should demand in an RCM partner

1. Co‑governance charter and shared KPI stack: Insist on a written governance framework: decision rights, data access, cadence, and KPI definitions that align to HFMA’s standard measures (e.g., denial types, net collection yield, cost‑to‑collect).
2. Executive dashboards and payer scorecards: Require real‑time visibility into performance and payer behavior; leverage scorecards to drive transparency and accountability in contracts and operations—a theme highlighted in HFMA conference takeaways.
3. Upstream prevention + downstream precision: Confirm your partner’s ability to fix sources of denials (eligibility, authorization, documentation) and also execute high‑win appeals, integrating clinical and financial teams. Survey and benchmark data show that prevention delivers the largest sustainable gains.
4. Technology road map with governance: Automation and analytics are essential—but they must be governed. CFOs should look for AI/automation capabilities paired with compliance, bias monitoring, and quality controls to ensure safe adoption and measurable ROI. 
5. Policy literacy and adaptability: Partners should proactively interpret and operationalize new rules (e.g., prior‑auth reforms, site‑neutral payment changes) and tune workflows accordingly. Staying ahead of these shifts is a strategic lever in a margin‑constrained world.

Key takeaway

No organization can navigate today’s healthcare currents alone. Strategic RCM partnerships—grounded in co‑governance, transparent reporting, and shared accountability—are the compass guiding CFOs toward lasting financial health. As volatility persists and payer dynamics evolve, the systems that outperform will be those that replace fragmented vendor oversight with authentic partnership and measurable, data‑driven execution.

Additional related resources for finance leaders:

• Currance Announces Expanded Strategic Partnership with CNOS to Transform Healthcare Revenue Cycle Operations. Press release.

• HFMA Research Summary — Top stressors in revenue cycle and executive perspectives. Survey summary.

• AHA Financial Headwinds Report — Labor costs, underpayments, and macro headwinds affecting hospitals. Press release.

• McKinsey “Gathering Storm” — Margin pressures and productivity opportunities for providers. Article.

• Healthcare Finance News — Denial dynamics and collection‑rate trends. Coverage.