Healthrise Delivers Semi-Captive Offshore Model as Health Systems Seek Greater Control Over Revenue Cycle Operations

The end-to-end delivery structure gives hospitals direct oversight of offshore workflow, governance and automation while preserving offshore cost, efficiency and scale

Key Facts (At-a-Glance):

• The Healthrise Perspective: In semi-captive offshore revenue cycle operations, Healthrise owns recruitment, hiring, onboarding, HR and workforce management while the health system retains control of workflow, performance metrics, operating priorities and continuous improvement. The offshore team operates within the health system’s operating model—not the vendor’s operating model—creating stronger alignment between strategy, execution and long-term operational goals.
• Market Drivers: Hospitals spent an estimated $43 billion in 2025 trying to collect payments insurers owed for care already delivered. Administrative costs now account for more than 40% of total hospital expenditures.
• Strategic Advantage: Semi-captive structures give health systems direct operational control, stronger workforce retention and lower attrition at roughly one-third to one-fourth of comparable domestic labor costs, with productivity benchmarked against existing onshore teams.
  

FARMINGTON HILLS, Mich., July 08, 2026 (GLOBE NEWSWIRE) -- Hospitals spent an estimated $43 billion in 2025 trying to collect payments insurers owed for care already delivered, including costs tied to prior authorization, claims denials, repeated documentation requests and changing billing and coverage rules. Administrative costs now account for more than 40% of total hospital expenditures. With operating margins running between 1% and 3% across much of the industry, the financial math has become unforgiving.

For years, the standard response was to push work offshore. The arrangement offered labor cost savings and scale. What it did not include was control. Health systems ended up managing a collection of vendor relationships, each with its own service level agreements, attrition rates and technology priorities, and found themselves absorbing performance variability they had no direct mechanism to fix.

A semi-captive model separates workforce ownership from operational ownership. Healthrise handles recruitment, hiring, onboarding, HR and the day-to-day management of the offshore team. The health system owns the workflow design, performance standards, training cadence and operating priorities. Through retained onshore leaders, health systems directly manage offshore operations by setting strategy, defining priorities, guiding workflow changes, establishing training expectations and maintaining accountability for performance outcomes.

The offshore team runs as a functional extension of the health system, with the transparency and accountability of an internal department and the cost structure of an offshore operation, typically one-third to one-fourth of comparable domestic labor costs with productivity benchmarked against existing onshore teams. Rather than operating as a traditional outsourced vendor relationship, the offshore team functions as an extension of the health system’s own revenue cycle organization, following the health system’s workflows, priorities and operating standards while Healthrise manages workforce operations.

“Health systems are learning that offshore scale alone is not enough,” said Marcos Bonafede, Chief Operating Officer of Healthrise. “A semi-captive model gives health systems greater control over how work is managed, measured and improved while still preserving the scale and efficiency they need.”

According to Healthrise, semi-captive models can help health systems:

• Increase visibility into offshore operations and performance metrics
• Restore direct governance and accountability over offshore execution
• Improve alignment between automation initiatives and operational execution
• Enhance workforce stability and institutional knowledge retention
• Enforce workflow consistency across fragmented revenue cycle functions
• Participate more directly in long-term value creation

Unlike traditional outsourced models where institutional knowledge can leave with vendor transitions or workforce changes, semi-captive models allow health systems to build and retain deeper operational expertise over time. Knowledge of workflows, payer challenges, organizational priorities and process improvements remains connected to the health system and continues to compound.

Because Healthrise owns recruitment, hiring and HR, clients can retain high performers, move people into expanded roles and scale teams up or down as workloads shift, without renegotiating a vendor contract. The cost profile lands at roughly one-third to one-fourth of comparable domestic labor, with productivity benchmarked against existing onshore teams.

“The Healthrise offshore team has delivered enormous value to our organization. We faced a significant backlog due to an underperforming vendor, and they successfully cleared the transactional backlog,” said David Worthy, Vice President of Ambulatory Services for Franciscan Missionaries of Our Lady Health System (FMOLHS). “Their flexible model, combining offshore resources with onshore management, offered continuous support and expertise."

The model’s relevance is sharpening as AI moves deeper into revenue cycle operations. Industry estimates suggest that up to 30% of revenue cycle inefficiencies originate in upstream processes such as documentation gaps, eligibility errors and charge capture breakdowns, areas where governance and workflow consistency are prerequisites for automation to work. Fragmented vendor environments make that coordination structurally difficult.

Because the health system maintains operational ownership, AI protocols, automation initiatives and workflow redesign efforts can be developed with direct input from the organization’s operational leaders. This ensures technology investments are grounded in real operational needs, informed by frontline insights and continuously refined as the organization evolves.

“AI exposes gaps that vendor contracts can paper over for years,” said David Farbman, Chief Executive Officer of Healthrise. “When you start connecting workflow, data and automation across an offshore operation, you find out quickly whether the model actually has governance or just the appearance of it.”

The semi-captive model shifts offshore operations from a labor cost strategy to a long-term operational capability. By combining health system governance and ownership with Healthrise workforce expertise, organizations gain greater control, continuity and the ability to continuously improve revenue cycle performance.

To learn more about Healthrise’s revenue cycle advisory services and semi-capture offshore operating model, visit www.healthrise.com.

About Healthrise

Healthrise is a healthcare consulting and technology firm that provides revenue cycle management, electronic health record optimization and strategic advisory services to hospitals and health systems across the United States. Founded in 2012, the company partners with organizations to improve financial and operational performance through customized, data-driven solutions. Healthrise has supported more than 25 health systems and managed over $35 billion in net patient revenue, helping clients strengthen long-term sustainability and care delivery. For more information, please visit www.healthrise.com.

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Trysten Loos
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tloos@identitypr.com

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