R1 Takes Aim at Healthcare’s Fragmented Revenue Cycle with Six Connected AI Solutions

New Phare Denials module joins Phare OS, giving health systems a pathway from point solutions to a connected revenue operating system spanning pre- and post-bill operations

Phare OS adoption now spans more than $275 billion in net patient revenue in a new model for improving health system financial performance supported by outcome-based pricing

CHICAGO, Nov. 12, 2026 (GLOBE NEWSWIRE) -- R1 (“R1” or the “Company”), the leader in healthcare revenue management, today announced a major expansion of Phare OS, its revenue operating system, bringing together six connected modules designed to bring agentic automation across the revenue cycle. Four are commercially available today: Phare Auth, Phare Audit, Phare UM and a new Phare Denials module. Phare CDI and Phare Recovery are in early access with select customers, with broader availability planned for 2027. Following the recent closing of R1's acquisition of Humata Health, Phare Auth is now powered by Humata.

Together, the six modules give health systems a path to modernizing revenue management. Organizations can start with the revenue cycle challenge that matters most, prove value and add connected capabilities over time, using their own teams or drawing on R1’s operational expertise.

Health systems have invested heavily in revenue cycle technology, yet much of that technology remains fragmented and focused on resolving problems after they occur. Two new sets of research show how costly a fragmented revenue cycle has become. Reopened claims, carrying costs and rework, consume approximately $28 million annually for every $1 billion in Medicare Advantage payments, according to proprietary R1 research. Fragmentation makes the problem harder to solve. 68.7% of healthcare organizations run six or more revenue cycle management vendors or platforms, while just 3.8% report a fully unified and orchestrated environment, according to new IDC research, sponsored by R1.

Phare OS is designed to address that fragmentation by applying shared clinical, financial and payer intelligence across six critical revenue cycle workflows:

• Phare Auth - prior authorization
• Phare UM - utilization management
• Phare CDI - clinical documentation integrity
• Phare Audit - claim accuracy
• Phare Denials - denial management and appeals
• Phare Recovery – post-payment revenue recovery

The newly launched Phare Denials automates work across technical and clinical denials. It manages the denial lifecycle from early identification and evidence gathering through appeal creation and submission, increasing teams’ capacity to address more denials while enabling experts to focus on complex, high-value cases. When paired with the full Phare OS, Phare Denials builds the intelligence behind the original determination into each appeal, making every submission stronger. Insights from payer decisions and denial patterns can then inform pre-bill workflows, helping health systems understand why claims are denied and prevent similar issues before claims are submitted.

In the past six months, health systems representing approximately $95 billion in NPR have adopted individual modules for claim accuracy and utilization management, including UF Health's collaboration on AI-Powered Revenue Cycle Transformation and Guthrie Clinic’s recent adoption of Phare UM, bringing total net patient revenue on Phare OS to more than $275 billion.

“In this margin environment, we have to be deliberate about where we deploy our most skilled people,” said Geoff Gardner, UF Health’s chief financial officer. “Phare Audit aligns with our existing coding on more than 95% of inpatient discharges, so our experts can concentrate on the fewer than 5% of accounts that merit a closer look. That’s a more disciplined path to revenue integrity. Phare OS gives us a platform we can scale across the revenue cycle, so the return extends well beyond a single use case.”

Phare OS modules share the intelligence foundation of Phare OS:

• Data Platform – unify clinical and financial data
• Phare Intelligence – a clinical intelligence engine that reasons across clinical and payer requirements
• Payer Atlas – draws on more than 1.25 billion payer transactions processed in 2026 and monitors more than 115,000 payer policies in real time to inform every workflow in the OS
  

This common foundation enables intelligence gained in one part of the revenue cycle to inform decisions elsewhere, bringing clinical and reimbursement context into every module and connecting post-bill resolution and pre-bill prevention.

“We’ve established Phare OS as the foundation for a different model of revenue management where technology isn’t measured by how many tasks it automates, but by the results it delivers,” said Joe Flanagan, chief executive officer of R1. “After decades of helping providers navigate the complexity of revenue cycle, we know what it takes to improve performance. We’re bringing that expertise together with AI and payer intelligence, and we stand behind the outcomes. This is the level of accountability health systems should expect from their revenue management partners.”

R1 will showcase its expanded Phare OS portfolio at HLTH 2026, November 15–18 in Las Vegas, with live demonstrations at booth #4057. On November 16, R1's Lee Kupferman will discuss the critical role of operational expertise in scaling healthcare AI during “The Missing Ingredient in Healthcare AI” (2:40 p.m., AI Theater A). R1 will also join Ascension Chief Revenue Officer James Logsdon for “From AI Adoption to Transformation: A Health System's Journey” (3:40 p.m., AI Theater C), exploring how Ascension is advancing AI adoption at scale.

About R1
R1 is the leader in healthcare revenue management, helping providers achieve new levels of performance through smart orchestration. A pioneer in the industry, R1 created the first Healthcare Revenue Operating System: a modular, intelligent platform that integrates automation, AI, and human expertise to strengthen the entire revenue cycle. With more than 20 years of experience, R1 partners with 1,000 providers, including 95 of the top 100 U.S. health systems, and handles over 1.25 billion payer transactions annually. This scale provides unmatched operational insight to help healthcare organizations unlock greater long-term value. To learn more, visit: r1rcm.com.

Media Contact
Mike Gilhooly, Director of Public Relations and Communications
media@r1rcm.com