Revenue cycle and healthcare IT M&A is accelerating again. Greenberg Advisors counted 142 RCM and HCIT transactions in the first half of 2026, up 11% from the first half of 2025 and 43% from the same period in 2024. The bigger signal is what buyers appear to value now: customer relationships, distribution, specialty workflows, advisory depth and data that AI can make more productive.
The first half of 2026 produced the most active start to a year for RCM and HCIT M&A since 2021.
But aggregate deal value actually fell versus the prior year because there were fewer billion-dollar-plus transactions. Deals above $1 billion represented 74% of transaction value in the first half of 2025, compared with only 25% in the first half of 2026.
That distinction matters.
This does not look like an M&A market being driven solely by a handful of massive strategic combinations. It looks broader: more companies are changing hands, more middle-market assets are being acquired, and more investors appear willing to make bets across the RCM and HCIT ecosystem.
AI is not freezing RCM M&A. It is changing the acquisition thesis. Buyers increasingly appear to want assets that give AI distribution, specialty context, proprietary workflow data, implementation capabilities and customer access.
Greenberg recorded 68 private-equity exits in the first half of 2026, the highest level in several years and well above the recent average.
The surprising part is who bought them.
In 59% of those transactions, another private equity firm was making a platform investment.
That tells us something important about investor sentiment.
PE firms are not simply using the current market to exit older RCM investments. Other sponsors are stepping in behind them.
Institutional investors do not appear to believe AI is about to make the RCM sector obsolete. They are still underwriting RCM businesses as durable platforms.
The investment thesis is changing. But it is not disappearing.
One of the most surprising findings in the report is the rise of consulting services.
Companies offering consulting represented 24% of total transaction volume, the highest level Greenberg has seen in the past decade.
That seems counterintuitive in an AI market.
Software is supposed to replace services. Margins are supposed to expand. Humans are supposed to disappear from the delivery model.
Instead, technology companies are increasingly acquiring or building consulting capabilities.
Why? Because enterprise healthcare still has an implementation problem.
AI can make a workflow better. It does not automatically redesign the workflow, integrate the software, change staffing models, manage payer relationships, implement an EHR, fix broken revenue-cycle processes or convince an executive team to change how the organization operates.
The more powerful the technology becomes, the more valuable the company capable of actually getting it adopted may become.
This becomes even clearer in Greenberg's venture-capital data.
VC investment in RCM and HCIT exceeded $1 billion for the third consecutive half-year period, much of it going toward early-stage HCIT businesses using agentic AI.
But Greenberg points out an important trend: some startups are partnering with or acquiring established RCM vendors to accelerate distribution and avoid the painfully slow process of selling directly to healthcare providers.
That is a major strategic signal.
The AI model may be easier to build than the healthcare distribution network.
A startup can hire engineers. It can access increasingly capable foundation models. It can automate a claims workflow.
What it cannot manufacture overnight is hundreds of existing provider relationships, trusted connections into health systems, years of claims and workflow data, payer-specific operating knowledge, established integrations, and a team that already knows how to sell into healthcare.
The buyer may not be acquiring the old operating model. It may be acquiring the distribution system, workflow data and customer access through which the new AI operating model can scale.
Greenberg says one of the most common questions it hears from sellers is whether a company is still attractive if it does not have sophisticated AI capabilities.
Their answer, for now, is largely yes.
Investors remain interested in well-run businesses with attractive customers, differentiated expertise and defensible market positions even if their current AI capabilities are limited.
That will probably change over time.
Greenberg specifically calls out workflows like claim statusing, patient engagement, billing and coding review, and clinical documentation review as functions where investors may increasingly question businesses that have not adopted automation.
That feels like the right distinction.
AI itself is not yet the moat. But failing to adopt AI in a workflow that obviously should be automated may increasingly become a valuation discount.
Coding represented 12% of first-half 2026 deal volume, down from 13% in the first half of 2025 and 18% in the second half of last year.
Greenberg attributes much of the decline to years of prior consolidation.
This could offer a preview of what happens across other RCM categories.
Fragmented service markets attract capital. Platforms acquire smaller operators. Technology improves productivity. The market consolidates. Eventually, fewer attractive independent assets remain.
Coding may simply be further along that curve than denial management, eligibility, patient access, prior authorization or specialty RCM.
EHR and EMR companies represented only 4% of first-half deal activity, down sharply from 12% in the first half of 2025 and 10% in the second half.
Greenberg says the decline is primarily a supply problem, not a lack of demand.
Scaled, specialty-focused EHR companies with Rule of 40 financial profiles remain scarce and can command premium valuations when they come to market.
That fits a broader pattern emerging across healthcare technology.
Horizontal software is getting easier to reproduce. Specialty workflows are not.
A behavioral health platform, wound-care operating system, dental platform or oncology workflow contains years of embedded knowledge about how that specialty actually functions.
AI may make those platforms more valuable rather than less valuable because the underlying workflow and data give the model context.
Another notable signal: companies providing prior authorization solutions represented 8.5% of first-half 2026 deal volume, the highest level Greenberg has recorded.
Greenberg connects that activity partly to the January 1, 2027 implementation timeline surrounding CMS interoperability and prior-authorization requirements.
This makes strategic sense.
Prior authorization now sits at the intersection of regulation, payer-provider friction, interoperability and AI.
That is exactly the type of messy healthcare workflow where software can create significant value — and where workflow ownership may become strategically important.
Put all of these trends together and a clearer picture emerges.
The future RCM company may not look like a traditional outsourcing business. But it may not look like a pure SaaS company either.
The more likely model is a hybrid:
technology + services + proprietary workflow data + distribution.
The services create customer intimacy. The software creates operating leverage. The workflow produces proprietary data. The customer base creates distribution. AI improves all four.
This also explains why consulting businesses are being acquired while agentic AI startups are raising capital at the same time.
Those trends are not contradictory. They may be converging.
There is a popular version of the AI thesis that says software agents will simply eliminate large portions of the RCM industry.
The M&A market is telling a more nuanced story.
Investors are still buying RCM businesses. Private equity is still building platforms. Technology companies are adding consulting capabilities. AI startups are looking for established distribution. Specialty software remains scarce.
And buyers increasingly value the operational assets that allow technology to actually work inside healthcare.
Greenberg's own view is that predictions that AI will eliminate most RCM and HCIT vendors are exaggerated. AI is likely to move from differentiator to competitive necessity, but the transition will not happen overnight.
The more interesting outcome may be consolidation.
The RCM companies with customer relationships, domain expertise and proprietary workflow data will increasingly add AI. The AI companies with strong technology will increasingly seek distribution, services and healthcare expertise.
Eventually, the distinction between the two may become difficult to see.
RCM M&A is booming again because the asset mix is getting richer: distribution, specialty knowledge, proprietary workflow data, services and the infrastructure that lets AI scale.
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Source: Greenberg Advisors — First Half 2026 M&A Update for RCM & HCIT · RevCycleAI analysis · October 1, 2026