Private Equity Conversations with Fexingo · 2026-06-20 · 8 min
Lucas and Luna explore private equity's growing appetite for revenue cycle management (RCM) firms - the companies that handle medical billing and claims for hospitals and clinics. With healthcare margins squeezed, RCM has become a $100 billion market, and PE firms see it as a sticky, tech-enabled service ripe for consolidation. This episode drills into one specific deal: the 2023 acquisition of R1 RCM by TowerBrook Capital Partners and New Mountain Capital, valuing the firm at over $8 billion. Lucas explains why RCM offers predictable recurring revenue, low capex, and regulatory moats. Luna questions whether consolidation could lead to higher billing pressure on patients. They also touch on the broader trend of PE in healthcare services, from urgent care to dental, now zeroing in on the administrative backbone of medicine. A concrete look at the business of getting doctors paid.
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