Carlyle, Knack RCM and Equalize RCM logos with light blue geometric background

Carlyle Closes Dual RCM Deal With Knack RCM and EqualizeRCM

The dual acquisition gives Carlyle a combined RCM operation covering hospital groups, physician practices, rural health clinics, federally qualified health centers, and DME providers across the US.

The combined platform will use AI-driven automation to serve hospital groups, rural clinics, and specialty practices across the United States.

The Carlyle Group has acquired Knack RCM and EqualizeRCM, combining two U.S.-based revenue cycle management companies into a single AI-native platform targeting multi-specialty healthcare providers globally. Carlyle’s majority stake in Knack Global, the parent company of Knack RCM, was valued at approximately $500 million. Financial terms of the EqualizeRCM transaction were not disclosed.

Knack RCM, founded in 2007 and headquartered in Florida, provides end-to-end revenue cycle services including medical billing and coding, durable medical equipment billing, credentialing, and accounts receivable management. The company uses AI-driven automation alongside global delivery teams, serving hospital groups, physician practices, and ambulatory care centers.

EqualizeRCM, based in Austin, Texas, focuses on small to mid-sized hospitals, federally qualified health centers, rural health clinics, and specialty practices across dental, DME, and behavioral health.

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The two companies serve complementary segments of the U.S. provider market. Knack RCM’s client base skews toward larger, multi-site hospital and physician group clients. EqualizeRCM has built its base among critical access hospitals and rural providers, a segment facing mounting financial pressure. Under Carlyle’s ownership, the combined operation spans the full U.S. provider market with delivery infrastructure across domestic and offshore locations.

The deal arrives as private equity consolidation in healthcare RCM accelerates sharply. Blackstone acquired AGS Health for $1.1 billion, and Waystar announced a $1.25 billion acquisition of Iodine Software, positioning AI-enabled revenue cycle management as one of the most actively contested segments in healthcare services investment.

Carlyle itself held a majority stake in CorroHealth, another technology-driven RCM company, since 2019, giving the firm deep institutional knowledge of the sector before this latest move.

U.S. healthcare providers lose an estimated $440 billion annually to administrative costs, a figure that has made revenue cycle management an increasingly attractive target for capital looking to deploy AI automation at scale.

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