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Separately, EHR adoption in surgery centers keeps climbing. As of ASCA's July 2025 60-Second Survey, 76% of ASCs were running one, up from 64% in 2023 and 55% in 2021. Dan Tasset, CEO of NueHealth, put the stakes bluntly:
"If they don't have even an EHR inside and they're still using paper medical records, I'm just a real believer that [that] ASC is going to be in real trouble."
That adoption curve is the backdrop for everything else in this issue. Software and services are collapsing into each other, and payers are moving faster than either.
Coming soon: "What Is AI?" A practical look at healthcare applications
A webinar with Dr. Jan Krumsiek, our Head of AI and an Associate Professor at Weill Cornell Medicine. Plain language, no hype: what these systems actually do, where they hold up in clinical and financial workflows, and where they don't. Reply if you want the invite when we lock a date.
This week on exactrx.ai
Deals
Experity acquired Exdion Healthcare (early July). GTCR-backed Experity, which touches roughly half of U.S. urgent care centers, picked up an AI chart-to-cash platform that claims an 86% reduction in denials.
Raintree acquired Spike Technologies (Jul 16), embedding agentic AI voice agents in its rehab/PT EMR for payer calls, eligibility, and claim follow-up. Terms undisclosed.
InsideDesk raised $12.6M (Jul 15), led by Pender Ventures. AI RCM built for dental service organizations.
Cleargate Capital invested in Fellow Health Partners (Jun), an RCM services provider to physician groups and ASCs. PE continues consolidating mid-market billing firms.
Ensemble Health Partners signed a definitive agreement with Thoreau (Jun), the Apollo-backed platform founded by Matt Holt, at roughly a $12B valuation. Ensemble runs revenue cycle for 200+ hospitals and over $55B in net patient revenue.
What I’m watching
The fight over the No Surprises Act. UnitedHealthcare spent real airtime on its Q2 call calling the arbitration process broken and noting that five entities file 60% of all cases. That is a payer laying groundwork for reform. If it lands, out-of-network leverage changes for a lot of you.
More companies moving here. Oracle's HQ relocation is pulling others behind it. We just moved Exactrx to Nashville ourselves, so take my enthusiasm with a grain of salt, but the talent pool is getting deeper fast.
Whether exchange losses hit your AR. HCA booked roughly $400M in Q2 from patients losing exchange coverage. Hospitals have the scale to absorb that. I'd be watching my self-pay aging closely this quarter.
Where we’ll be
4 days built specifically for revenue cycle, finance, and technology leaders, with AI in the revenue cycle running as a throughline across the agenda. Becker's offers complimentary registration for qualified executives. If you're going, hit reply and I'll find you there.
What are you seeing on the ground? Whether it is a denial pattern, a payer behavior, or a cost that keeps showing up in the wrong place, hit reply. We read everything.
This newsletter goes out to a focused group of operators, finance leaders, and revenue cycle professionals working in ambulatory and outpatient settings. If someone forwarded this to you and it felt relevant, it probably was.