Key insights reveal that trust and transparency are crucial to solving complex provider problems while navigating regulatory hurdles and financial squeeze

The annual Experian Health High-Performance Summit (HPS) recently held in Nashville brought the top patient access and revenue cycle leaders together to discuss the latest in technology, practical application of AI, patient engagement and data management. The client-exclusive event hosted attendees from 42 states representing 123 health systems with many leaders sharing that navigating these challenging times of payer-provider friction, changing reimbursement rules, regulatory burdens and mounting financial pressures cannot be done in isolation.

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Jason Considine, president of Experian Health, energizes a packed room of healthcare revenue cycle leaders with his keynote at the High-Performance Summit, sharing bold insights and strategies shaping the future of healthcare finance.

A major theme at the conference is that the future model for solving complex revenue cycle management (RCM) problems relies on “fearless collaboration” between providers, payers and technology vendors. This mindset demonstrates the true value of AI, not a replacement for staff, but as a powerful tool that serves as the intelligence layer to the revenue cycle, heightening people, processes and technology.

“The future vision is clear: Technology must be used to amplify human expertise, not replace it,” said Jason Considine, President of Experian Health during his HPS keynote. “The revenue cycle has never been more complex. We have regulatory pressures mounting, the financial squeeze of declining reimbursements, and the constant pressure to do more with less. HPS is an opportunity to come together to collaborate and share how we can solve the top provider challenges and simplify healthcare for all.”

The next wave of AI adoption and new technology

AI is no longer a buzzword, but a practical tool already delivering measurable results. Organizations using AI in their revenue cycle are seeing fewer claim denials, faster reimbursements, and significant cost savings. According to a recent Experian Health AI survey, nearly half of providers (45%) are partially using AI in RCM processes. The top barriers for AI adoption were: data privacy or security concerns, lack of trust in accuracy, cost of implementationⁱ. As the industry faces challenges, the focus must shift from reactive problem-solving to proactive optimization. Providers can solve many of the problems within their RCM engine by infusing AI capabilities into their technology stack.

Some of the most popular sessions featured Experian Health’s Patient Access Curator (PAC), which leverages AI and machine learning to streamline patient data collection in real-time. Clients described PAC as a “game changer,” and shared success stories of how the solution verifies and updates patient data, uncovers additional insurance coverage, and completes eligibility checks all within seconds. On average, clients using PAC see a more than 45% decrease in registration denials and a one-third reduction in COB-related and insurance denials (27, 29, 109)ⁱⁱ.

HPS’ Innovation Hub demonstrated the value of close partnerships between providers and technology vendors, fostering joint innovation and enabling real-time collaboration to solve both small and large challenges. Attendees participated in dynamic ideation workshops, live demos, and focus groups. The Hub also showcased how Experian Health’s AI is the intelligence layer for modern revenue cycle management and spotlighted some of Experian Health’s next-generation prototypes along with forward-looking innovations.

What are the regulatory challenges?

New regulatory changes, like the One Big Beautiful Bill Act (OBBBA), were top of mind at HPS. While many leaders admitted they don’t fully know the impact of OBBBA, they anticipate significant shifts in the coming year in areas like patient coverage, financial operations, and administrative processes. Experian Health’s new OBBBA surveyⁱⁱⁱ found similar results:

• Only 13 percent of providers are fully prepared for the changes in OBBBA, more than a third (38.5%) are somewhat unprepared or not prepared, and four percent are unsure if they’re prepared
• Thirty-one percent of providers need to make major updates to their systems and workflows to prepare for OBBBA
• Nearly half of providers (42%) require eligibility and billing process upgrades to handle the additional requirements
• Thirteen percent of providers expect major revenue disruption

“Regulatory pressures will only intensify for providers in the new year,” said Mindy Fortson, Chief Operating Officer at Experian Health. “Compliance is no longer a checkbox; it’s mission-critical to survival and success. To overcome these challenges, providers must pivot from reactive problem-solving to proactive optimization and embrace advanced technology. This next phase will focus on giving staff the technology, support, and insights they need to provide a better patient experience.”

Experian Health offers a variety of solutions to simplify healthcare and address the evolving needs of patients and providers, including patient engagement solutions and AI Advantage that reduces claim denials.

For more information on Experian Health, visit www.experian.com/healthcare.

About Experian Health

At Experian Health, we serve more than 60 percent of U.S. hospitals and more than 7,500 medical practices, labs, pharmacies and other healthcare providers with data-driven platforms and insights that help our clients make smarter business decisions, deliver a better bottom line and establish strong patient relationships.

Experian invests in talented people and new advanced technologies to unlock the power of data and innovate. As a FTSE 100 Index company listed on the London Stock Exchange (EXPN), we have a team of 25,200 people across 32 countries. Our corporate headquarters are in Dublin, Ireland. Learn more at experianplc.com.

For more information about Experian Health, visit http://www.experianhealth.com. Learn more about Experian at www.experianplc.com or visit our global content hub at our global news blog for the latest news and insights from the Group.

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