Background: A Strategic Revenue Cycle Partnership
Bon Secours Mercy Health (BSMH), a large not-for-profit health system based in Cincinnati, Ohio, has maintained a long-running strategic partnership with Ensemble Health Partners, a national revenue cycle management (RCM) firm founded in 2014, to manage end-to-end revenue cycle operations across the health system’s hospitals and physician groups.
How the Partnership Originated
The relationship traces back to a significant 2019 transaction in which BSMH sold a majority equity stake in Ensemble to Golden Gate Capital, while remaining a commercial partner, minority shareholder (holding roughly 41.4% ownership), and continued board participant. This structure allowed BSMH to benefit from Ensemble’s specialized RCM expertise and technology while maintaining an ongoing financial and strategic interest in the company’s success.
Measured Results and Recognition
The partnership has produced measurable, externally recognized results. BSMH received the 2020 HFMA MAP Award for High Performance in Revenue Cycle, the Top Revenue Cycle Performance Award from Crowe in 2022, and was again named a recipient of the 2026 MAP Award for High Performance in Revenue Cycle. Separately, BSMH’s physician group was recognized in Clarivate’s 2023 Revenue Cycle Awards, generating approximately $333 million in annual net revenue with top-decile year-over-year improvement in cash collections.
What Drove the Performance Improvement
According to BSMH leadership, the partnership’s success stems from combining key technologies, established best practices, and experienced operators focused on both financial performance and the patient billing experience. BSMH’s Chief Revenue Cycle Officer has emphasized that high-performing revenue cycle management reduces time spent on administrative functions, freeing up more resources for direct patient care.
Leadership Perspective
BSMH CEO John Starcher has described experiencing ‘dramatically improved performance in every capacity and in every facility’ since deepening the Ensemble partnership, while Ensemble’s leadership has framed the collaboration around a shared commitment to identifying root causes of revenue cycle issues rather than applying generic fixes across different hospital systems.
Broader Industry Significance
The BSMH-Ensemble relationship is often cited within the healthcare RCM industry as an example of how a strategic equity partnership rather than a purely transactional outsourcing contract — can align incentives between a health system and its revenue cycle partner over the long term, contributing to Ensemble’s broader growth to over 326 hospital partnerships nationally.
Final Thoughts
The Bon Secours Mercy Health and Ensemble Health Partners case demonstrates how a deep, equity-linked revenue cycle partnership can deliver sustained, award-winning financial performance improvements for a large health system, offering a model that other hospital systems evaluating RCM outsourcing structures continue to study closely.