In the week of August 17, 2026, the landscape of revenue cycle management (RCM) continues to evolve, highlighting a significant focus on the challenges posed by prior authorization processes. With insurers denying between 12% to 18% of requests in 2025, it's clear that capital is increasingly flowing towards solutions that streamline administrative burdens and improve operational efficiency in healthcare. This trend underscores the urgent need for innovative technologies and practices that can enhance the RCM process amidst rising denial rates.
Fierce Healthcare
In 2025, insurers denied between 12% to 18% of prior authorization requests across Medicare Advantage, Medicaid managed care, and ACA Marketplace segments, affecting around 71 million enrollees. This trend raises concerns about access to care and the efficiency of revenue cycle management (RCM) processes. The key implication for the RCM market is the potential for increased demand for solutions that streamline prior authorization and reduce denial rates.
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