Closing Healthcare’s Cash Flow Gap

Healthcare organizations can generate revenue, maintain strong patient volumes and still struggle with available cash.

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The reason is timing. Providers incur labor, supply, pharmaceutical and operating expenses as care is delivered, but the revenue associated with that care may remain tied up in the reimbursement process for months. As financial pressure grows, the distance between earned revenue and available cash becomes increasingly difficult to overlook.

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Margins leave little room to absorb that delay. According to Strata Decision Technology, the median health system operating margin stood at just 0.5% in July 2026 as continued expense growth put pressure on financial performance.

Rising Costs Are Increasing the Need for Liquidity

Healthcare providers continue to operate in an environment where expenses are rising faster than many sources of reimbursement.

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According to the American Hospital Association, total hospital expenses grew 7.5% in 2025, more than twice the growth rate of hospital prices. The pressure extended across every major expense category, including workforce, supplies and pharmaceuticals.

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Research from The Health Management Academy reflects similar concerns among senior health system finance leaders. In its Q3 2026 market research, 88% of surveyed finance leaders expected labor and drug costs to negatively affect financial performance, while 78% anticipated pressure from supplies.

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At the same time, reimbursement rates, payer mix changes and shifts in where care is delivered continue to put pressure on revenue. Even organizations with relatively stable operating performance must fund payroll, purchase supplies and invest in care delivery while waiting for claims to be adjudicated and paid.

Earned Revenue Is Not the Same as Available Cash

Submitting a claim does not make the associated revenue immediately available.

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Before payment reaches the provider, the claim may move through payer review, adjudication, requests for additional information, denials, appeals and other administrative steps. Each stage can extend the time between delivering care and having usable cash in the organization’s account.

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The administrative cost is also significant. The American Hospital Association estimates that hospitals spent $43 billion in 2025 trying to collect payments insurers owed for care already delivered. Prior authorization, claims denials, documentation requests and changing payer requirements all contribute to that burden.

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This creates a practical financial challenge: revenue may appear in accounts receivable while the cash needed to fund current operations remains unavailable.

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For finance leaders, the consequences can include:

• Greater variability in cash flow
• More capital tied up in insurance accounts receivable
• Pressure on days cash on hand
• Less flexibility to manage operating needs or pursue strategic investments
• Increased reliance on traditional financing to bridge timing gaps

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Improving the speed and predictability of cash flow can therefore be just as important as improving revenue itself.

Faster Payment Rails Are Changing Expectations

The broader payments environment is also becoming faster.

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The Federal Reserve’s FedNow Service allows participating financial institutions to support instant payments, while The Clearing House’s RTP network moves funds around the clock, every day of the year.

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These payment rails can make funds available within seconds after a payer initiates payment. However, they do not require the payer to review the claim or initiate payment any sooner.

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For example, UnitedHealthcare states that its real-time payment process can eliminate the standard settlement delay for eligible commercial claims, but it does not alter contracted or state-mandated payment timelines. A payer can still initiate payment near the end of the existing reimbursement period.

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Real-time payments may also introduce new reconciliation considerations when the payment and electronic remittance information travel through separate channels. Providers may need to coordinate with their banks, clearinghouses and technology partners to match the funds with the correct claims.

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RTP accelerates the final movement of money, but it does not eliminate the time spent waiting for claim adjudication or solve the entire cash flow timing gap.

Claims Monetization Can Address the Timing Gap

Claims monetization gives qualified healthcare providers another way to manage the period between claim submission and payer reimbursement.

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Rather than waiting for an eligible commercial claim to complete its traditional payment cycle, the provider can receive an accelerated payment based on the claim’s allowable value. The claim continues through payer adjudication, and the related payment and remittance information are reconciled as they arrive.

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This can help healthcare organizations:

• Gain faster access to cash associated with care already delivered
• Reduce days insurance outstanding
• Improve the predictability of cash flow
• Strengthen days cash on hand
• Reduce manual work tied to payment and remittance reconciliation

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For some providers, the primary need to monetize commercial claims may be addressing immediate cash flow pressure. For others, the value may come from creating more consistent access to cash, supporting growth or reducing the amount of working capital tied up in accounts receivable.

Creating a More Predictable Path From Claims to Cash

RMS and Finalytics bring together claims monetization and automated remittance management.

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The process is designed to work within the provider’s existing revenue cycle:

1. Eligible claims are securely sent to Finalytics for evaluation.
2. Finalytics determines the allowable value and delivers accelerated payment within three days.
3. The claims continue through the payer’s normal adjudication process.
4. RMS receives and reconciles the payer transactions and remittance information as they arrive, helping identify and manage any remaining balances.

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Providers gain faster access to cash without replacing the underlying claims or reimbursement process. RMS and Finalytics manage the payment and reconciliation workflows behind the scenes, reducing the operational burden on the provider’s team.

Learn more about healthcare claims paid in three days.