Mounting regulatory pressures, payer-driven automation, and a widening operation gap were featured topics at the 2025 EDPMA RCM Workshop (December 3 - 4). This year's Emergency Department Practice Management Association event drew its largest attendance yet, an unmistakable sign that revenue cycle leaders are searching for clarity and capability in an increasingly complex payment landscape.
For those of us working in healthcare technology, the message was clear: the next era of revenue cycle management will be defined by how effectively providers adopt and integrate software-driven solutions.
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A recurring theme throughout the workshop was concern over the “One Big Beautiful Bill Act” signed into law on July 4, 2005. While presented as a simplification effort by politicians, attendees widely recognized it as highly disruptive. This is particularly true for Medicare reimbursement. Rural hospitals were spotlighted as especially vulnerable, with many confronting an uncertain future if administrative support and public funding remain misaligned.
Speakers Shanna Howe (Vice President, Strategic Partnerships, Ventra Health), Patrick Velliky (Chief External Affairs Officer, HaloMD), and Paul Hudson (FACHE, Consultant Team, Rev4ward) left room for optimism, noting that extended timelines offer valuable preparation time. Still, they emphasized the need for providers to step up their collective efforts in advocacy and policy engagement.
The clearest consensus of the entire event: providers must invest in automation to counter the automation that payers have already deployed. The session Bot vs. Doc: Surviving AI-Driven Denials in Emergency Medicine highlighted how payers are scaling pre-payment review, down-coding logic, and other forms of algorithmic claims suppression at unprecedented levels. Without an equivalent level of technological leverage, providers simply cannot keep pace.
Survival now depends on scalable, tech-driven throughput; the days of manual appeal drafting or chasing documentation across systems are over. Tools that automate appeals were highlighted as essential, especially those capable of generating structured, evidence-based responses instantly.
Note: Macedon helps teams scale their RCM processes with automation, such as with our No Surprises Act Automation software.
Throughout the event, there was broad speculation that costs for outsourced RCM partners are expected to rise. These costs are due to new expectations placed on revenue cycle vendors to compete more aggressively with payers, provide higher automation levels, and deliver more sophisticated denial-management strategies, and will inevitably be priced into contracts with healthcare providers.
For many organizations like yours, this raises an important question: Is it more sustainable to build in-house tools rather than absorb ever-increasing vendor fees and revenue share? It is a compelling question. Tailored solutions deliver better long-term ROI, greater control, and the ability to adapt quickly to shifting regulatory or payer behaviors.
The 2025 EDPMA RCM Workshop made one thing abundantly clear: the most successful RCM strategies involve pairing deep operational expertise with strong technical infrastructure.
Automation, data-driven negotiation, and in-house innovation will define the next competitive edge. For vendors and technology partners, the opportunity and responsibility is to build solutions that help providers stay resilient in an environment where the rules continue to evolve faster than ever.
Macedon’s work in healthcare operations aligns with what surfaced at the 2025 EDPMA RCM Workshop. We have seen that operational clarity and thoughtful workflow automation strengthen both clinical and financial outcomes. The technology matters, but only after the workflow is well understood and intentionally designed.
This is why we offer a Workflow Performance Assessment for free - to help start the work of evaluating and aligning your process before any technology is even introduced. For the No Surprises Act in particular, we also have an award-winning No Surprises Act Automation software solution which provides end-to-end automation and increased win rates.
Interested in continuing the conversation or learning more about how our services can help you improve your workflows? Let's talk.