Key takeaways
- R1 has reimagined its revenue performance solutions to help healthcare providers improve reimbursement, reduce administrative burden and recover revenue faster
- The solutions are designed to address key revenue cycle challenges across patient access, claim quality, denials and accounts receivable
- Powered by Phare OS, R1 revenue performance solutions can be deployed individually for specific use cases or together as a connected operating system
- Providers benefit from flexibility while enabling shared intelligence, workflow connectivity and continuous learning across the entire revenue cycle
Point solution speed and flexibility meet system-wide intelligence and connectivity
Imagine a healthcare system where revenue cycle management isn’t a maze of manual tasks and fragmented technologies, but a seamless, intelligent process that adapts to every change and challenge. With the advent of a reimagined suite of agentic revenue performance solutions, R1 is turning that vision into reality.
R1 revenue performance solutions are now being enhanced through the intelligence captured and created by the Phare Operating System—while continuing to deliver best-in-class standalone value for specific use cases. This architecture gives providers the flexibility to adopt targeted solution capabilities suited to their immediate needs while benefitting from system-wide learning gained through R1’s fully scaled approach.
Revenue performance gets a functional makeover
By integrating the foundations of R1 revenue performance solutions under Phare, healthcare providers benefit from advanced technology paired with R1’s AI and revenue cycle expertise. Shared intelligence and continuous learning across Phare OS enables health systems to identify transactional patterns, prioritize reimbursement actions and recover revenue faster and more efficiently.
Healthcare providers also benefit from more flexible deployment options; from a holistic end-to-end platform deployment to targeted solutions that address specific pain points while still benefitting from platform-wide scale and intelligence. Phare OS is healthcare’s first revenue operating system, unifying intelligence, continuous learning and connectivity across the revenue cycle in a single platform.
R1 Prior Authorization powered by Phare, guided by people
Prior authorization, originally cast as a utilization and resource management tool, has become one of healthcare’s most significant administrative burdens, costing the industry an estimated $35 billion annually and causing 92% of care delays. R1 Prior Authorization powered by Phare significantly lightens that load, delivering unmatched speed, accuracy and scale that standalone options can’t deliver.
R1 Prior Authorization manages the full healthcare service authorization lifecycle, delivering faster approvals, lower costs and improved patient and provider satisfaction.
R1 Prior Authorization by the Numbers
68%
of orders cleared in one hour
97%
of orders cleared in one day
< 1%
denial rate
In customer environments, R1 Prior Authorization has helped accelerate scheduling, reduce administrative work and move patients into care faster.
“Partnering with R1 to modernize prior authorization has transformed the speed at which we can move patients into care,” said the executive director of patient access at a health system with over $700M in NPR. “With R1’s automated, rules-based workflows, we’ve significantly reduced our system’s administrative burden, improved scheduling efficiency and reduced unnecessary friction for patients and referring providers. Today, more than 99% of our prior authorizations are cleared within three days.”
Revenue performance, automated and optimized
The industry knows well enough that healthcare providers struggle to keep up with inflated denials rates, but they are also adjusting to varying volumes and shifting case mixes, inflationary pressures on all fronts, an ongoing staffing shortage and disruptive technologies that break and shift traditional paradigms. These pressures increase the need for solutions that improve clinical documentation, claim quality, denial resolution and reimbursement speed.
Revenue Performance in the Back End
10%
increase in recoveries
$1B
in annualized recoveries
15%
more cash collected on average
R1 Denial Management uses AI-assisted workflows to accelerate appeals, increase recoveries and help clients recover revenue in as little as 30 days.
R1 AR Recovery combines advanced technology with AI-assisted experts to reduce accounts receivable, driving approximately $1 billion in annual recoveries for customers and an incremental five-day reduction in AR cycle time.
R1 Insurance Discovery identifies missing insurance coverage, captures additional revenue and returns coverage information to the EHR.
A new blueprint for revenue performance
Together, R1 revenue performance solutions improve patient access, strengthen claim quality, manage denials, recover revenue and accelerate reimbursement. Phare OS connects these workflows through shared intelligence, orchestration and continuous learning. The platform enables targeted solutions for resolving specific pain points, while delivering the intelligence and scale of a complete operating system.
“R1 has been a key partner, helping us build and maintain financial and operational health so we can focus on our mission of caring for patients in greatest need,” said Eric Wexler, CEO of Providence. “Phare OS, combined with R1’s delivery model and commitment to collaboration, plays an important role in supporting care delivery across our seven states and 51 hospitals.”
R1 continues to invest in innovation, expanding its R37 AI Lab operations to New York City to accelerate the development of the next-generation AI capabilities for Phare. With more than 1,000 providers and 95 of the top 100 U.S. health systems as partners, R1 is dedicated to unlocking greater long-term value and making healthcare better for all, and remains committed to transforming healthcare financial performance through technology, domain expertise and innovation.
