MUMBAI: Global investment firm Carlyle has acquired a majority stake each in Knack RCM and EqualizeRCM, two US-based healthcare revenue cycle management (RCM) providers, the companies said in a statement on Monday, as it looks to build an artificial intelligence (AI)-led platform in the US healthcare RCM market.
The transaction combines two complementary RCM operators to create what the companies described as an AI-native, multi-specialty platform serving physician groups, rural hospitals and durable medical equipment (DME) providers.
Financial terms of the transaction were not disclosed.
Betting on a growing market
“The US healthcare revenue cycle market is growing rapidly, driven by margin compression, workforce shortages, and the shift to value-based care,” said Kapil Modi, Partner at Carlyle India Advisors. “We believe Knack and Equalize stand out as leaders with their AI-native, specialty‑focused, and outcomes‑driven approach, which aligns well with the growing needs and demand in healthcare RCM.”
The combined entity is expected to expand scale and delivery footprint across the US, India and the Philippines, while deepening capabilities in automation and analytics, the company said.
Carlyle said it intends to pursue additional acquisitions to build out the platform, underscoring a consolidation strategy in a sector that remains highly fragmented.
“One of the core tenets of this investment is to build a scaled, strategically attractive physician and rural hospital RCM platform in a fragmented industry. Carlyle has a track record of executing similar strategies in sectors such as auto components and pharmaceuticals,” said Amit Jain, partner and head, Carlyle India Advisors.
The investment will be made through funds affiliated with Carlyle Asia Partners VI and Carlyle Asia Partners Growth II. Both companies have operations in India, and the investment is being made through Carlyle’s Asia-focused funds. The firm has previously backed healthcare technology platforms including Indegene, Visionary RCM, and CorroHealth.
Headquartered in Woodbridge, New Jersey, Knack RCM has over 8,000 employees across 10 delivery centres in India, the Philippines and the US. EqualizeRCM complements this with its delivery presence in the US and India, serving physicians, hospitals, ambulatory surgery centres, laboratories and rural providers.
Knack and Equalize serve a range of specialty segments including DME, anaesthesia, eyecare, behavioural health, urgent care and multi-specialty physician groups. Knack brings a global delivery model anchored by its orchestration platform, Workmate, while Equalize adds payer enrolment capabilities and AI-driven tools such as Bill Smart for denial prediction.
“Coming together with Equalize allows us to combine our strengths to tackle the most complex parts of the revenue cycle, including rural cost reports, DME intake, and challenging anaesthesia cases,” Knack’s CEO Gautam Barai said in the statement.
Equalize’s platform, built on large language models and agentic AI, has seen commercial traction, including the displacement of large vendor contracts at DME manufacturers, the company said.
The latest investment will be made through funds affiliated with Carlyle Asia Partners VI and Carlyle Asia Partners Growth II, the firm said, without disclosing the exact terms of the transaction.
Rajiv Sharma, founder of Knack RCM, and Nagi Rao, founder, EqualizeRCM, will remain invested in the platform through a reinvestment of a portion of their proceeds, the statement said.
“Our clients, particularly rural hospitals and behavioural health providers, face immense pressure in sustaining margins and ensuring access to care,” Rao said. “Partnering with Knack enables us to integrate our advisory expertise with their advanced analytics and global operations to deliver more robust and tailored solutions.”