A new PE-backed RCM company plans to fix “American healthcare deal gut”
Hospitals find it harder than ever to collect payments for care they provide, one of many factors that contribute to the widespread economic pressure among providers nationwide. Many hospitals have invested heavily in revenue cycle optimization techniques, whether stand-alone or integrated with EHR systems — but the situation has not improved.
This week, New Mountain Capital set up a new company that will compete with established revenue cycle management companies and try to beat them in its own game. The private equity firm formed a new entity by combining three independent platforms that have been acquired, called Smarter Technologies: SmarterDX, Inspedful.AI and Access Healthcare.
With prominent players like EPIC, Change Healthcare and R1 RCM already competing for customers, one might wonder: Does healthcare really need another revenue cycle management company?
Smarter Technologies CEO Jeremy Dekinsky believes the answer is yes – he explains why when chatting with Arundhati Parmar on Tuesday, why Medcity News'Editor in Chief, at the investment conference for Chicago Publications.
Dekinsky's company promises to improve payment accuracy and reduce measurable costs through AI-powered automation.
He noted that health care accounts for nearly 20% of national GDP, but it brings frustrating opaque experiences to patients – often involving surprise bills and indexes between providers and payers.
“We have deep fears about how care in this country is delivered,” Dejinsky declared.
He describes what happens every day in the United States: Despite insurance, patients receive confusing surprise bills a few months after receiving care and are forced to navigate between providers and insurers to resolve their own problems.
Dekinsky also reminds listeners that the country spends about $950 billion a year on health care management, largely due to the large part of the staggering efficiency of outdated administrative technology infrastructure.
“The transactional chassis that we use to adjust healthcare in this country was chartered and created by the Balanced Budget Act of 1997, where we came live with a series of ANSI standard transactions for claims, eligibility, prior authorization and payment. And it is now 2025, and we're running on the same transactions. They got upgraded once to accommodate ICD-10 codes. It's absurd,” he explained.
Most importantly, rising labor costs and the shift from traditional health insurance to health insurance advantages (less fees, harder to charge) are eroding provider profit margins, Dekinsky added.
He said the rejection rate has nearly doubled as payers increasingly use AI to review claims, and providers are often required to submit additional medical records to determine medical needs. He noted that the payer also “has a range of deployed AI tools to revoke claims that have been paid.”
Despite widespread adoption of EHRs over the past few decades, the lack of infrastructure to support seamless data exchanges, delays and claims remain too common, Dekinsky said.
“When you add all of this, I can't think of a better use case for using AI than a US healthcare transaction voucher,” he declared.
He believes that the United States needs not only another healthcare revenue cycle management company—it needs more cost-effective companies. Dekinsky says most revenue cycle management vendors charge their providers for 5-9% of the collection, but the smarter technology target is 1-1.5%.
He said the company was able to offer this affordable model because its AI agents spanned payer portals and billing systems and its low-cost, scalable offshore BPOs.
Dekinsky added that agents of smarter technologies are trained to make mistakes.
“[BPOs] Say, we will conduct a 5% quality audit and we will guarantee you a 95% quality score. This means that an extraordinary error is passing, and these errors are [surprise] The bill or authorization has not been completed,” he explained.
He said agents of smart technology would not make the same mistakes because they follow strict procedures, reasons when necessary and escalate marginal cases to humans’ teams so that they can be properly resolved.
Many companies have promised to fix broken revenue cycles in healthcare before – but Dekinsky believes Smarter Technologies will stand out for its ability to deliver in terms of accuracy and affordability.
The company currently serves over 200 customers, including more than 60 health systems.
Photo: Nick Fanion, breaking the media
