R1 RCM

R1 RCM Inc.

Company type	Private
Industry	Revenue cycle management, Healthcare financial services
Predecessor	Accretive Health
Founded	2003 (2003)
Founder	Mary Tolan, Michael Cline
Headquarters	Utah , United States
Area served	United States
Key people	Emad Rizk (CEO, as of 2014)
Products	Revenue cycle management services
Number of employees	27,200+ (2024)
Parent	TowerBrook Capital Partners and Clayton, Dubilier & Rice (since November 2024)

R1 RCM Inc. is an American firm specializing in revenue cycle management, catering to hospitals, healthcare systems, and physician organizations across the country. In November 2024, private equity investors TowerBrook Capital Partners and Clayton, Dubilier & Rice completed an $8.9 billion acquisition of R1.

Overview

Revenue cycle management encompasses the comprehensive administration of financial processes within healthcare entities, spanning from patient intake to the collection of payments. R1 employs a workforce exceeding 27,200 individuals and achieves annual revenues near $2.1 billion, serving over 1,000 clients throughout the United States.

History

Established in 2003 under the name Accretive Health by founders Mary Tolan and Michael Cline, the organization initially concentrated on revenue cycle services for healthcare providers. Mary Tolan led as CEO until 2013, after which Stephen Schuckenbrock took over, followed by Emad Rizk in 2014.

In 2012, Accretive Health encountered regulatory issues related to security breaches involving unencrypted laptops and patient information theft. This resulted in a two-decade settlement agreement with the Federal Trade Commission in 2013. That same year, the company agreed to a $2.5 million settlement with the Minnesota Attorney General concerning debt collection practices and was prohibited from conducting business in Minnesota for a period.

The company faced financial difficulties including delayed restatements that led to removal from the New York Stock Exchange in 2014; nonetheless, it continued trading on an over-the-counter basis. By mid-2015, Accretive Health had restated its financial reports and resumed filings with the SEC.

In 2015, Ascension Health designated Accretive Health as its exclusive partner for hospital revenue cycle management, supported by a $200 million capital infusion from Ascension and TowerBrook Capital Partners aimed at fueling expansion efforts.

Following its rebranding to R1 RCM in 2017, the firm broadened its collaboration with Ascension to encompass an additional $1.5 billion in net patient revenue, extending services to physician groups as well.

After acquiring Cerner Corporation’s RevWorks division in August 2020, R1 experienced a ransomware incident that disrupted its operations.

A report issued by Jehoshaphat Research in October 2023 accused R1 of inflating revenues and profits based on unrealistic future collection projections. The analysis also highlighted recent resignations among top executives including the CEO and CFO.

In December 2023, R1 resolved a shareholder lawsuit for $45.4 million concerning alleged breaches of fiduciary responsibility.

In March 2024, R1 disclosed a cybersecurity breach compromising sensitive consumer data such as personal identifiers and medical records. The company subsequently informed those affected following its internal investigation.