Cloudmed

What Cloudmed does

Cloudmed is a US-based healthcare revenue cycle management company that delivers a "Revenue Intelligence" platform to hospitals, health systems, and provider networks. Its core technology is the CloudmedAI Platform, which combines data-driven analytics with decades of human revenue cycle expertise to surface actionable insights across the full revenue cycle. The offering is organized into four integrated suites: an Acceleration Suite (denials recovery, complex claim referrals, AR recovery, Entri Pay, physician advisory), an Optimization Suite (DRG validation, charge capture, underpayment recovery, transfer DRG), a Government Navigation Suite (Medicare Bad Debt, Disproportionate Share Hospital, Worksheet S-10, SSI redetermination, 340B recovery), and an Automation Suite that simplifies labor-intensive workflows.

Name

Cloudmed

Legal name

Cloudmed

Website

https://cloudmed.com

Company type

Private

Founded year

1996

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Cloudmed provides AI-enabled revenue intelligence and recovery solutions to US hospitals and health systems, combining the CloudmedAI Platform with specialized automation and expert services across the full revenue cycle.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Services

NAICS

Software Publishers (5132), Computer Systems Design and Related Services (54151)

SIC

Services-Computer Programming, Data Processing, Etc. (7370), Services-Management Services (8741)

akta.pro primary industry

Cloud Managed Services (Operations, Monitoring, Patching) (BPAEACAF)

Keywords

• Healthcare revenue cycle management
• Revenue integrity services
• Denials management
• Underpayment recovery
• 340B drug pricing

Headquarters

HQ city

Oak Brook

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales

Revenue model

1. Revenue Cycle Management Services: Cloudmed provides revenue cycle management services to healthcare providers, operating as part of the R1 RCM ecosystem. The company helps healthcare organizations identify and capture revenue opportunities through their Revenue Intelligence platform and suite of specialized solutions.

Go-to-market motion1 record

Distribution channels1 record

Marketing channels3 records

Core offering

Cloudmed provides Revenue Intelligence solutions for healthcare providers, combining data-driven technology (the CloudmedAI Platform) with deep revenue cycle management expertise. It sells four integrated service suites — Acceleration, Optimization, Government Navigation, and Automation — that identify, capture, and recover missed or underpaid revenue across the entire revenue cycle, from denials and AR recovery to 340B and Medicare programs.

Product overview

Cloudmed is a revenue intelligence platform for healthcare providers, offering a unified platform-plus-modules architecture. The core CloudmedAI Platform powers four integrated solution suites: Acceleration Suite (Denials Recovery, Complex Claim Referrals, AR Recovery, Entri Pay, Physician Advisory Solutions), Optimization Suite (DRG Validation, Charge Capture, Underpayment Recovery, Transfer DRG), Government Navigation Suite (Medicare Bad Debt, Disproportionate Share Hospital, Worksheet S-10, SSI Redetermination, 340B Recovery), and Automation Suite. The platform delivers Revenue Intelligence combining industry expertise with data-driven technology to help healthcare providers identify and capture revenue opportunities across the entire revenue cycle.

Differentiator

Problem solved

Functional benefit

Brands

• CloudmedAI Platform: AI-powered platform that delivers Revenue Intelligence by combining industry expertise with data-driven technology.
• Acceleration Suite
• Optimization Suite
• Government Navigation Suite
• Automation Suite
• RevintConnect

Products and services

• Acceleration Suite Solutions that fast-track cash by recovering denied, aged, complex, and clinically challenged claims for healthcare providers. Includes denials recovery, complex claim referrals, AR recovery, Entri Pay, and physician advisory services.
• Optimization Suite Comprehensive payment review services to capture missed or underpaid revenue across the entire revenue cycle, including DRG validation, charge capture, underpayment recovery, and transfer DRG.
• Government Navigation Suite Specialist services that optimize government reimbursement accuracy, maximize pharmacy savings, and ensure compliance across Medicare Bad Debt, Disproportionate Share Hospital, Worksheet S-10, SSI Redetermination, and 340B Recovery.
• Automation Suite Award-winning automation services that simplify complex, labor-intensive revenue cycle workflows, configured, managed, and optimized by revenue cycle and technology experts. Recognized as 2023 Best in KLAS for Robotic Process Automation.
• Revenue Intelligence The core Cloudmed offering that delivers actionable insights at the convergence of industry-leading revenue cycle expertise and data-driven technology, enabling healthcare providers to identify and capture revenue opportunities while preventing further losses.
• CloudmedAI Platform The proprietary data-driven technology platform that powers all Cloudmed Revenue Intelligence solutions, combining industry expertise with AI-driven analytics to surface actionable revenue cycle insights.
• par8o Healthcare technology solution specializing in 340B drug pricing discovery and patient referral management, powered by machine learning technology acquired by Cloudmed.
• MCRC Group Managed Care Revenue Consulting Group offering revenue cycle solutions for hospital networks, acquired by Cloudmed to enhance its Revenue Intelligence platform.

Quantifiable outcome

• Cloudmed has generated large amounts of money for clients in recoveries they didn't know were coming
• +1 more outcomes

Named customers5 records

Segments1 record

Ideal customer profiles1 record

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability2 records

Feature3 records

Partnerships

One partnership is on record.

• R1 RCMcoreStrategic or Co-development Partner · 1 January 2024R1 RCM acquired CloudMed for $4.1 billion, integrating Cloudmed into the R1 RCM ecosystem. Cloudmed now operates as an R1 company, with the same advanced technology and deep RCM expertise under the R1 umbrella. The acquisition represents a major consolidation in the healthcare RCM sector, with Clayton Dubilier & Rice and TowerBrook Capital Partners' $8.9 billion take-private of R1 RCM providing the backing.

Scale indicators2 records

Recent moves7 records

Expansion highlights4 records

Broad incumbents

• R1 RCM: R1 RCM is the parent company of Cloudmed and a leading end-to-end healthcare revenue cycle management platform serving large hospital systems. Direct overlap in denials management, underpayment recovery, and enterprise RCM technology; R1 provides the broader platform into which Cloudmed is integrated.
• Optum (UnitedHealth Group): Optum is the largest US healthcare services and technology platform, offering revenue cycle management, analytics, and AI-driven automation to providers and payers. Comparable as a full-stack RCM and healthcare data analytics incumbent competing for the same large hospital networks.
• Experian Health: Experian Health offers revenue cycle management, identity management, and patient engagement solutions to US hospitals and health systems. Comparable as an enterprise RCM technology vendor with overlapping denials and AR recovery capabilities.

Direct peers

• Waystar: Waystar provides cloud-based healthcare revenue cycle management software including claims management, denials, and patient payment solutions. Direct competitor to Cloudmed's Acceleration and Optimization Suites for mid-to-large healthcare providers.
• FinThrive: FinThrive is a healthcare RCM technology platform covering patient access, mid-cycle, and business office workflows, including denials and underpayment management. Closely comparable product portfolio and target market to Cloudmed's multi-suite RCM offering.
• Craneware: Craneware provides healthcare revenue cycle software focused on charge capture, 340B, and value-based care analytics. Overlaps with Cloudmed's Optimization Suite (Charge Capture, Transfer DRG) and Government Navigation Suite (340B Recovery).
• Availity: Availity operates a healthcare information network for revenue cycle and clinical data exchange, including eligibility, claims, and denials management. Comparable as a technology-enabled RCM platform serving large provider networks.
• nThrive: nThrive (formerly known as MedAssets/Precyse) provides end-to-end RCM services and technology including denials management, underpayment recovery, and analytics. Direct overlap with Cloudmed's full-suite RCM managed services model.

Emerging players

• Huron Consulting Group: Huron provides healthcare RCM consulting and managed services including revenue cycle optimization and technology-enabled performance improvement. Comparable advisory-plus-technology model competing for the same large health system engagements.
• AKASA: AKASA applies AI/ML to healthcare revenue cycle workflows including claims, denials, and appeals automation. Comparable as an AI-first RCM automation player emerging as an alternative to Cloudmed's Automation and Acceleration Suites.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/RevintSolutions

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles5 records

Funding overview

Funding rounds1 record

Investors2 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A9 records

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Cloudmed