04 - 05 - 2026

Carlyle bets on AI-driven healthcare billing with two acquisitions

By Our Bureau
Mumbai, May 4, 2026

Global investment firm Carlyle acquired majority stakes in Knack RCM and EqualizeRCM, two leading U.S. healthcare revenue cycle management (RCM) providers, aiming to create an AI-native, global, multi-specialty RCM platform. The financial terms of the transactions were not disclosed.

Carlyle will fund the investment from funds affiliated with Carlyle Asia Partners VI and Carlyle Asia Partners Growth II. The founders of both US-based companies, Rajiv Sharma of Knack RCM and Nagi Rao of EqualizeRCM, will remain invested in the platform through a reinvestment of a portion of their proceeds, it said in a release.

 “One of the core tenets of this investment is to build a scaled, strategically attractive physician and rural hospital RCM platform in a fragmented industry. Carlyle has a track record of executing similar strategies in sectors such as auto components and pharmaceuticals,” Amit Jain, Partner and Head of Carlyle India Advisors, said.

The companies are considered complementary providers serving physician groups, durable medical equipment (DME) providers, rural hospitals, and other specialty segments. Together, they offer expertise across anaesthesia, eyecare, behavioural health, and urgent care.

“The U.S. healthcare revenue cycle market is growing rapidly, driven by margin compression, workforce shortages, and the shift to value-based care,” said Kapil Modi, Partner at Carlyle India Advisors. “Carlyle has significant experience in scaling RCM platforms to achieve market leadership and we believe Knack and Equalize stand out as leaders with their AI-native, specialty‑focused, and outcomes‑driven approach, which aligns well with the growing needs and demand in healthcare RCM.”

The strategy builds on Carlyle’s experience in the healthcare technology sector, where it has previously invested in platforms such as Indegene and CorroHealth.

The transactions would enhance operational scale and broaden the delivery footprint for both entities. Knack RCM operates a global delivery model across the U.S., India, and the Philippines, powered by its orchestration platform, Workmate. EqualizeRCM features established U.S. and India-based delivery alongside AI-driven tools like Bill Smart, which is designed for denial prediction and avoidance.

“Our clients, particularly rural hospitals and behavioural health providers, face immense pressure in sustaining margins and ensuring access to care,” said Nagi Rao, Founder of EqualizeRCM. “Partnering with Knack enables us to integrate our advisory expertise with their advanced analytics and global operations, to deliver more robust and tailored solutions. We are excited to work with Knack and Carlyle to drive wider adoption of our AI-native platform to support healthcare providers.”

New Jersey-headquartered Knack RCM has over 8,000 employees across 10 delivery centres in India, the Philippines and the United States, while EqualizeRCM is a U.S.‑based revenue cycle management company serving physicians, hospitals, ambulatory surgery centres, laboratories and rural providers.