Global investment firm Carlyle has acquired a majority stake in U.S.-based healthcare revenue cycle management (RCM) firms Knack RCM and EqualizeRCM, aiming to create a scalable, AI-first, multi-specialty global platform in the fast-growing healthcare services space.
The deal, backed by Carlyle Asia Partners VI and Carlyle Asia Partners Growth II, combines two complementary RCM providers, though financial details were not disclosed. Founders Rajiv Sharma and Nagi Rao will continue to play active roles and retain ownership through reinvestment.
The merged platform will offer comprehensive, end-to-end revenue cycle solutions to a diverse client base, including physician groups, rural hospitals, and durable medical equipment providers. It will also target specialized segments such as anesthesia, behavioral health, eyecare, and urgent care.
Knack RCM contributes a global delivery footprint across the United States, India, and the Philippines, along with its proprietary workflow platform, Workmate. EqualizeRCM strengthens the combined entity with its presence in the U.S. and India and its advanced AI capabilities, including tools that help predict and reduce insurance claim denials. Its platform, built on large language models and agentic AI, has already gained traction, even displacing larger legacy vendors in certain contracts.
“The U.S. healthcare RCM market is expanding rapidly, and Knack and Equalize differentiate themselves with an AI-native, outcomes-focused approach aligned with evolving industry needs,” said Kapil Modi, Partner at Carlyle India Advisors.
Leadership from the combined company stressed that performance will be measured by tangible financial outcomes for healthcare providers, rather than automation metrics alone. “Providers ultimately judge success by their ability to meet payroll and sustain operations. This partnership enables us to tackle complex financial risks across the revenue cycle,” said Gautam Barai, CEO of Knack RCM.
Nagi Rao highlighted the importance of supporting underserved sectors such as rural hospitals and behavioral health providers, which often face significant financial pressure. He noted that the deal aligns with Carlyle’s broader strategy of building scaled platforms in fragmented industries. Carlyle has previously invested in healthcare-focused companies such as Indegene and CorroHealth.
“This investment reinforces our ‘India for the world’ strategy,” said Amit Jain, Partner and Head of Carlyle India Advisors, underscoring India’s role as a global hub for delivery and innovation.
Carlyle plans to pursue additional acquisitions to further scale the platform’s capabilities and expand its market presence. The move reflects a broader consolidation trend in the RCM sector, as investors look to build technology-enabled service providers that can navigate the increasing complexity of healthcare administration.
Overall, the acquisition marks a strategic push to integrate scale, specialization, and AI in healthcare revenue management positioning the new platform to meet rising demand for efficient, tech-driven financial operations in the U.S. healthcare system.
