Emmett Bernsohn
How specialty providers can shape the technology they adopt, and why the benefits keep building long after go-live.
Most specialty provider organizations buy technology the same way. Build a requirements list. Sit through demos. Choose the vendor that says yes to the most items. Sign. Then spend the next year adapting the organization to the product.
It’s a reasonable process. It’s also why so many tools end up half-used, and why so many “yes” answers turn into “that’s on next year’s roadmap.”
I’ve watched a different approach work. The provider organizations that get the most from new technology don’t arrive with a feature list. They arrive with a problem, the numbers behind it, and a willingness to help build the answer. The payoff reaches well past the tool itself: staff who own the change, patients who get clearer answers, and a product that keeps improving for everyone who uses it.
Two of our provider organizations show what that looks like. The first wanted a better way for patients to pay their balance by phone. The second wanted that phone line to answer patients’ questions, not just take payments. I’ll come back to both along the way.
Why the old way is breaking down
AI has made software faster and cheaper to build. That shifts the risk for provider organizations. When a vendor can build almost anything, it’s easy to promise almost anything. The hard question is no longer whether something can be built. It’s whether it should be, and whether it will actually change the work.
Many revenue cycle leaders are already living with the gap. In HFMA’s 2026 Revenue Cycle of the Future survey, 37% of finance and revenue cycle leaders described their vendor relationships as “functional but increasingly complex,” and nearly one in five called them “fragmented and difficult to manage.”1 Adoption doesn’t guarantee results, either. In a 2025 MGMA poll, 44% of practices using AI in patient visits said it had not reduced staff workload.2
What provider organizations need is a better fit. And they have more influence over fit than most realize.
Five ways to engage a vendor as a partner
1. Bring the problem, with numbers attached.
“Our phones are overwhelmed” is a symptom. “Here’s our monthly call volume, here’s what patients are calling about, and here’s how much staff time it takes” is a business case.
Our first provider organization did exactly that. Patients were calling about their balances, and those calls were eating into staff time. Before asking us for a solution, the team sized the problem and shared the data.
The downstream benefit: the vendor builds against your reality instead of a generic use case, and you start with a baseline. When it’s time to measure results, you already know what better looks like.
2. Ask for a thoughtful plan, not a yes.
When you bring a list of requests, ask the vendor to sort every item into four groups: available now, in development, needs more scoping, and not planned.
Our second provider organization got exactly that kind of breakdown from us. Instead of waiting on promises, the team could see right away which gaps to fill with other tools, and when the rest would be ready.
The downstream benefit: you can plan. A clear “not planned” today is worth more than a vague yes that turns into an 18-month wait. Over time, the prioritized list becomes a shared roadmap, with the vendor’s plans mapped against your priorities.
3. Push for focus over customization.
It’s tempting to ask a vendor to build exactly what your organization wants. Sometimes that’s the right call. Often it isn’t. When a vendor says yes to everything for everyone, you end up with what the leader at our second provider organization called a “smorgasbord of solutions.” Every one-off feature has to be maintained, secured, and supported, and in software that handles patient financial information, that burden is real.
A better question to ask: do other providers need this too? Features that solve a shared problem get used, tested, and improved. One-off builds tend to stall. The same thinking applies to scope. Ask where the tool stops and your EHR, or another system, picks up. A partner that knows its boundaries fits into your workflow instead of competing with it.
The downstream benefit: a product that stays stable and keeps getting better, because it’s built around problems many providers share.
4. Name a champion and protect time to test.
Every successful co-development effort I’ve seen, including both of these, had someone inside the provider organization who owned the outcome and drove alignment across the organization. Each also had a team willing to test new workflows in real conditions and give honest feedback.
The downstream benefit: faster decisions, faster iteration, and a tool shaped by how your organization actually works.
5. Bring your frontline team in early.
This is the step provider organizations most often skip, and the one that matters most.
When our second provider organization introduced the conversational version to its phone team, its leader had to answer the obvious question first: is this replacing my job? Her answer was clear. The AI agent answers routine billing questions, like what a patient owes and why, and hands anything else, such as refunds, disputes, or non-billing questions, straight to her team. That frees her staff for the complex calls, without feeling rushed by call metrics, so patients still feel heard.
Then her team went further. The staff who answer those calls joined quality assurance testing for the product. They tested it, gave feedback, and helped refine it. By launch, it wasn’t something that felt outside of their control. It was something they helped build, which would make their lives easier.
The anxiety her team felt is common. A 2025 WellSky study found that 49% of healthcare professionals worry AI could replace some healthcare jobs.3 Yet in June 2026 MGMA polling, 68% of practice leaders said they had not redesigned a role or adjusted staffing because of AI in the past year.4 For most provider organizations, AI is changing the work, while the people doing it stay.
The downstream benefit: adoption. Teams that help shape a tool use it. Teams that have it handed to them often work around it.
The benefit compounds
The most important result of this approach often shows up later, and somewhere else.
Our first provider organization’s phone line started as a touch-tone system. It did what it was designed to do. Then our second provider organization showed where it fell short: touch-tone could tell a patient what they owed, but not why. Patients don’t think in menu options. They ask in their own words, like “Was my insurance billed?” That organization’s input led to the conversational version described above.
Both organizations shaped the product, and every provider using it now benefits from what they contributed. That’s the part of co-development that rarely gets discussed. When provider organizations engage as partners, they improve more than their own tool. They raise the bar for every provider that comes after them.
For the provider organizations themselves, the results stack up: a tool that fits their workflow, staff who own the change, patients who get clearer answers about what they owe, and a vendor relationship built on clear expectations. That’s how a better patient experience and stronger financial outcomes end up moving together.
Where to start
The next time you evaluate a vendor, ask one question before you ask about features: What do you consider your core capability and what is outside your workflow?
The answer tells you a lot. A partner that can answer clearly knows what it does well, knows where its product stops, and respects your time enough to be honest. That’s the difference between a service you buy and a partner you build with.
Rachel Mertensmeyer is CEO of Rivia Health, a patient payments platform that helps specialty providers capture patient revenue and makes it easier for patients to understand and pay their bills.
References
- HFMA, The Revenue Cycle of the Future (2026 survey of finance and revenue cycle leaders).
- MGMA Stat, Most practices use some form of AI, but is it actually reducing staff workloads? (2025).
- WellSky, Technology Strongly Influences Where Healthcare Professionals Choose to Work, According to National Study (2025).
- MGMA Stat, AI is slowly redesigning work in medical practices rather than replacing workers (2026).
