Ardent Health’s revenue cycle playbook: 5 notes 

Brentwood, Tenn.-based Ardent Health expects a single payer contract renewal to add between $5 million and $10 million to its 2026 adjusted EBITDA, as the for-profit system takes a more data- and market-driven approach to revenue cycle and payer contracting. 

Here are five things to know about Ardent’s revenue cycle efforts, based on comments from President and CEO Dave Caspers and CFO Alfred Lumsdaine on the system’s Aug. 5 earnings call: 

1. Ardent has integrated functions that used to operate separately.
   “Our revenue integrity function was somewhat siloed, and the revenue cycle management component was not fully integrated with the contracting component,” Mr. Lumsdaine said. “Now we have integrated those. We’ve brought in new leadership. We’ve taken a much more data- and market-driven approach.”
2. The system is using price transparency data to renegotiate payer rates.
   Mr. Caspers said Ardent is taking “a more disciplined, data-driven approach to payer contracting, using price transparency data to identify where our rates lag the market.” He said Ardent’s rates rank below the 50th percentile in many contracts and that the system believes it can push them higher given its market positions.
3. A single payer renewal is expected to add $5 million to $10 million to 2026 adjusted EBITDA.
   Ardent executives pointed to a June 1 contract renewal with a key payer in one market where outpatient payments had been materially below market benchmarks. The new agreement improved both rate and terms. Mr. Lumsdaine said it was a large contract in a single market and that “not all contracts carry the same level of opportunity.”
4. Ardent is willing to let contract disputes become public if it means getting paid fairly.
   Mr. Lumsdaine said the system has sent letters to members about potential disruption in multiple markets this year as part of contract negotiations.
   “That’s not where we want to go,” he said, “but if it takes that to yield being paid fairly, we’re willing to have those conversations.”
5. Denial management remains a joint focus with revenue cycle partner Ensemble. Ardent said payer denial trends were stable and consistent with the prior two quarters, but executives see more room to improve yield. The system said it is strengthening joint operating committees and payer governance with Ensemble and using AI to identify denial patterns and prioritize high-value recovery opportunities.

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