At HealthLeaders’ 2025 RevTech Exchange, leaders say the biggest hurdles to tech adoption are not technical, but internal struggles with governance and strategy.
Revenue cycle leaders convened at HealthLeaders’ 2025 RevTech Exchange for candid discussions on the significant internal challenges that come with rapid technological change. While automation and AI attract the most attention, leaders are focused on building the right internal structures to manage technology and set a clear path forward.
One key question that emerged during early roundtable discussions: How do leaders establish effective governance and develop meaningful long-term strategy when the pace of change moves at lightning speed?.
Striking the Governance Balance
Leaders are grappling with how to balance oversight with flexibility. Too little governance leads to chaos, but too much hampers progress, and the wrong approach can render a committee meaningless. One leader noted that a previous “punitive” denial committee was so ineffective that “nobody wanted to go”.
Effective governance requires clear objectives, according to Exchange members. Many are in favor of focused work groups over broad committees to ensure that every meeting has a purpose. Still, there is no single model for success. Some large health systems employ highly structured processes, including an 80-person committee that votes on every proposed Epic enhancement. As leaders face pressure to vet and implement a growing number of AI and automation tools, establishing clear and efficient governance frameworks has become a top priority.
The Challenge of Vague Strategy
Leadership directives for setting goals for revenue cycle departments are often unclear or unfocused. An instruction to be innovative, for instance, leaves too much room for interpretation for revenue cycle leaders to meaningfully act on. This contributes to fragmentation as different executives create their own definitions and forces revenue cycle teams to defend against pursuits of “shiny object” projects that threaten to derail core priorities.
This challenge is often compounded by a communication gap. Revenue cycle leaders are frequently not in the executive meetings where long-term plans are developed, leaving them dependent on information trickling down from the CFO. Even when a strategic plan is in place, the rapid pace of technological change makes it difficult to commit to multi-year vendor contracts or roadmaps, further complicating long-range planning.
The discussions here in at RevTech make it clear that the biggest challenges in technology implementation are often not technical, but structural.
Keep an eye out in the following weeks for more in-depth coverage and analysis from the 2025 RevTech Exchange.
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