Revenue Cycle Centralization Is Making a Comeback. Is Your Workforce Model Ready?

Imagine a patient showing up for a scheduled procedure, only to find that their authorization is still pending. Meanwhile, a claim is just sitting there, untouched, because the denial team is buried under a growing pile of work. One hospital in the system has its own registration process, while another follows a completely different workflow. Leadership might see the big picture at the enterprise level, but accountability is all over the place, scattered across various departments, service lines, and locations.

For years, many health systems have accepted this fragmentation as just part of growing pains. Individual hospitals, physician groups, and departments enjoyed more freedom over how they handled patient access, billing, authorizations, and collections. While this local control allowed for some flexibility, it also led to a mishmash of work queues, productivity standards, payer strategies, technologies, and what success looks like.

Now, it seems that model is up for re-evaluation.

Some of the largest health systems in the U.S. are starting to bring their revenue cycle operations back under a unified governance structure. The goal isn’t just to shuffle employees into one department; it’s about creating common workflows, shared performance metrics, consistent accountability, and a seamless financial experience for patients.

However, this push for centralization brings up a crucial question: Does the organization have the right workforce model to make it all work?

A centralized structure can shine a light on administrative bottlenecks in healthcare, but it doesn’t automatically fix them. Without the proper workforce infrastructure, a health system might centralize responsibilities while still leaving the same overwhelmed teams, backlogs, and manual processes in place.

Why Revenue Cycle Centralization Is Returning

Health systems are navigating a tough landscape where they're facing rising pressures from reimbursement, complicated administrative tasks, soaring labor costs, and ever-evolving patient expectations all at once. On top of that, staffing shortages in healthcare and hospitals are making it even harder to grow their internal teams.

According to the American Hospital Association, workforce expenses accounted for about 60% of total hospital costs in 2025, with those costs climbing by 5.6% compared to the previous year. The same report highlighted that hospitals shelled out around $43 billion in 2025 just to collect payments from insurers for care that had already been provided. Factors like prior authorization requirements, claims denials, repeated requests for documentation, and shifting coverage rules all played a role in driving up those expenses.

In that environment, it’s becoming harder to defend fragmented revenue cycle operations. When similar tasks are handled differently across various facilities, health systems can face several challenges, including:

• Inconsistent patient registration and financial clearance
• Duplicate leadership and administrative structures
• Fluctuating staff productivity
• Varied payer escalation processes
• Limited insight into organization-wide backlogs
• Inconsistent denial prevention and appeal practices
• Uneven standards for patient communication
• Challenges in implementing automation throughout the organization

Centralization presents a way to enhance operational efficiency in healthcare. It enables leaders to view the revenue cycle as a unified patient and financial journey, rather than a series of disconnected departments.

However, this doesn’t mean that every decision has to come from a central point or that local expertise is no longer valuable. Effective centralization usually sets enterprise-wide standards while allowing for well-defined exceptions based on specialty, market, payer, or patient needs. The aim is to achieve consistency without becoming inflexible.

Reports From the Leading Health Systems

A recent article from Becker’s Hospital Review shines a light on how five major health systems are embracing enterprise revenue cycle models.

Texas Health Resources is leading the charge with its “One Revenue Cycle” initiative, which focuses on a unified strategy, governance, standardization, automation, and shared accountability. Meanwhile, Mount Sinai Health System recognized that its previous decentralized approach led to inconsistencies in workflows, productivity, payer strategies, performance, and accountability. After centralizing their operations, they reported improved financial performance, enhanced operational resilience, and a more seamless financial experience for patients.

Novant Health took a fresh approach by redesigning its revenue cycle to align with the patient’s financial journey. They consolidated various functions into centers of excellence and established a unified business office for both hospital and professional billing. As a result, they saw nearly a 6% drop in accounts receivable days and a 16% decrease in aging.

VCU Health also made strides by bringing together previously separate front-end functions under a unified revenue cycle leadership. According to Becker’s, this system has surpassed cash targets for over three years, reduced accounts receivable days to a five-year low, and cut down on revenue cycle costs while keeping workforce stability intact during periods of growth.

These results highlight a crucial takeaway: centralization isn’t just about changing reporting lines. Its true value lies in harmonizing people, processes, technology, governance, and performance expectations around a shared operating model.

This idea is further backed by existing research on revenue cycle management. A study indexed in PubMed on optimizing revenue cycles stressed the importance of realigning people, processes, and technology, rather than viewing technology as a standalone fix.

Centralization + Optimization = ROI

Shifting work into a unified operating structure doesn’t actually lessen the amount of tasks waiting to be tackled.

Take a health system, for instance. It might streamline processes like scheduling, eligibility checks, prior authorizations, denial management, or following up on accounts receivable. However, if the centralized team is short-staffed, all that happens is a more noticeable backlog.

This is precisely why redesigning the revenue cycle and optimizing the healthcare workforce need to go hand in hand. A centralized revenue cycle demands a workforce that can:

• Handle volume across different facilities and service lines
• Consistently adhere to enterprise protocols
• Scale up during peak seasons, acquisitions, or efforts to reduce backlogs
• Provide extended coverage hours when necessary
• Monitor productivity and quality with standardized metrics
• Adjust as payer requirements and technologies evolve
• Shield internal employees from chronic overload

According to the American Hospital Association’s 2026 workforce analysis, the industry is grappling with high labor costs, staffing shortages, administrative burdens, and increasing demand. The report highlights that hospitals are responding by rebuilding their teams, modernizing workflows, expanding roles, and leveraging technology to boost capacity without a corresponding increase in staffing. The AHA also points out that technology delivers more value when it’s combined with revamped workflows.

From Centralized Revenue Cycle to Enterprise Upgrade

Revenue cycle centralization is really a smart strategy for managing healthcare capacity.

It offers leaders a chance to cut down on inconsistencies, boost accountability, enhance the financial experience for patients, and lay down a solid groundwork for future growth. However, reaping these benefits hinges on the organization’s ability to ensure there’s enough trained capacity throughout the entire workflow.

GMVA steps in to support hospitals and health systems by providing a scalable administrative workforce that can handle financial clearance, authorization management, patient access, care coordination, and revenue cycle performance. GMVA specialists seamlessly integrate with an organization’s existing systems and processes, enabling internal teams to expand their capacity without having to create another disconnected operating environment, an ROI that can change the game of your hospital’s operations.

GMVA's model is all about supporting centralized operations by offering leaders a flexible approach to tackle backlogs, manage high-volume workflows, broaden coverage, and shield core employees from the constant strain of administrative tasks. It’s crafted to enhance internal teams rather than take away from the leadership, expertise, or organizational knowledge they bring to the table.

While centralization might be making a resurgence, the real potential goes beyond just redesigning the organization.

It’s a chance to establish a unified operating model, a consistent set of expectations, and a scalable workforce infrastructure that can keep up with the demands of the work.

To explore how scalable workforce infrastructure could support your patient access, authorization, or revenue cycle strategy, book a call with GMVA or learn more by visiting www.GMVA.com.