EnableComp Acquires H/ROI in Bid to Master Complex Hospital Revenue

FRANKLIN, TN – January 12, 2026 – In a significant move to address the escalating financial crisis facing U.S. hospitals, EnableComp, a leader in Complex Revenue Cycle Management (RCM), has announced its acquisition of Health Resources Optimization, Inc. (H/ROI). The deal combines EnableComp’s AI-powered technology with H/ROI’s three decades of specialized clinical denial expertise, creating what the companies are positioning as the industry’s most comprehensive platform for recovering revenue from the most challenging claims.

This strategic acquisition unites two specialists at a time when healthcare providers are navigating unprecedented margin erosion. With hospitals losing billions annually to improperly denied and underpaid claims, the merger aims to provide a fortified defense against aggressive payer tactics and complex billing issues, particularly in the areas of DRG (Diagnosis-Related Group) downgrades and medical-necessity denials.

A Strategic Play in a High-Stakes Market

The acquisition is more than a simple business expansion; it represents a calculated move to consolidate leadership in the niche but increasingly critical sector of complex RCM. While many RCM vendors focus on high-volume, low-complexity administrative denials, EnableComp has carved out its reputation by tackling the intricate clinical cases that others often write off as unrecoverable. The company's standing is underscored by its recognition as Black Book's #1 Specialty RCM provider for complex claims and revenue integrity for two consecutive years.

By integrating H/ROI, a firm with a strong foothold among top health systems in the Northeast, EnableComp not only expands its geographical reach but also deepens its intellectual capital. H/ROI has long been respected for its results-driven approach, which relies on seasoned clinical professionals to dissect and appeal complex denials. This acquisition effectively absorbs that specialized talent pool and pairs it with EnableComp's national scale and technological infrastructure.

“This acquisition enhances our ability to drive revenue improvement across the most complex parts of the revenue cycle — areas where missing a single opportunity can lead to substantial revenue loss for hospitals,” said Frank Forte, CEO of EnableComp, in the official announcement. “Hospitals are facing intense margin erosion and need a partner built to handle this complexity.”

A Lifeline Amidst Mounting Financial Pressure

The timing of the deal is critical. Hospitals across the nation are grappling with a perfect storm of rising operational costs, post-pandemic financial strain, and increasingly sophisticated claim denial strategies from insurance payers. Recent industry data paints a grim picture: some reports indicate that initial claim denial rates from commercial payers can be as high as 15-20%, creating a massive administrative and financial burden.

Appealing these denials is a costly and resource-intensive battle. Industry-wide, providers spend nearly $20 billion annually just to review and fight denied claims. The average cost to rework a single claim can exceed $50, putting further strain on already thin margins. The most challenging of these are clinical denials, which question the medical necessity or appropriateness of care provided. Unlike simple administrative errors, overturning these requires deep clinical knowledge, meticulous documentation review, and a persistent, evidence-based appeals strategy.

This is precisely the battleground where EnableComp and H/ROI have focused their efforts. The acquisition strengthens their ability to combat DRG downgrades, where payers retroactively reduce the payment for a hospital stay by challenging its assigned complexity, and medical-necessity denials, which directly dispute a physician's clinical judgment. For hospitals, these denials represent significant, high-value revenue losses that can directly impact their ability to invest in patient care, technology, and staff.

Blending Clinical Expertise with AI-Driven Technology

A key theme of the acquisition is the powerful synergy between human expertise and artificial intelligence. While payers increasingly leverage AI algorithms to flag inconsistencies and automatically deny claims, a purely automated response from providers is often insufficient for complex clinical disputes. The newly combined entity champions a hybrid approach.

EnableComp's proprietary e360 RCM® platform utilizes AI and a vast dataset to predict revenue risks, identify underpayments early, and streamline the resolution of complex cases. This technology, branded as Complex Revenue Intelligence™ (CRI), provides the scale and efficiency needed to manage claims across more than 1,000 hospitals.

However, technology alone cannot win every fight. H/ROI brings the indispensable element of human judgment. As Ann Russo, Co-Founder of H/ROI, noted, their success was built on a team that mastered the nuances of clinical denials through “clinical judgment, deep payer knowledge, and persistence — not just automation.”

“By combining our expertise with EnableComp’s AI-driven platform and national scale, we can help our clients achieve faster resolution, higher recovery rates, and the confidence that comes from having the industry’s leading specialists in their corner,” Russo stated. This blend of intelligent technology to identify opportunities and expert clinicians to execute complex appeals is what the company believes will give its clients a decisive edge.

Redefining the Future of Complex Revenue Recovery

With the integration of H/ROI reportedly progressing quickly, the combined organization now serves a vast network of over 1,000 hospitals and is responsible for recovering an estimated $3 billion in revenue annually. This scale provides a formidable data advantage, allowing the company’s AI models to become even more predictive and its expert teams to identify denial trends more rapidly.

Looking ahead, EnableComp has signaled its intention to increase investment in both its clinical teams and its specialized technology. The goal is to transform the complex revenue cycle from a constant source of financial leakage and administrative frustration into a managed and predictable component of a hospital's financial strategy. By safeguarding margins, the company helps ensure that healthcare providers have the financial stability and resilience necessary to focus on their primary mission: delivering high-quality patient care.