Saudi Arabia’s healthcare sector is entering a new era of digital finance transformation under Vision 2030, where data, technology, and collaboration are reshaping how healthcare is funded and delivered.

The new Santechture white paper, “Evolution of Revenue Cycle Management (RCM) in the Kingdom of Saudi Arabia,” reveals how regulators, providers, and technology innovators are jointly building a connected, intelligent, and value-driven healthcare finance ecosystem.

Historically dependent on government block funding, Saudi healthcare has transitioned into a hybrid public–private model anchored by the Council of Health Insurance (CHI) and the Insurance Authority (IA). The National Platform for Health Information Exchange Services (NPHIES) now processes nearly 90% of all healthcare claims, connecting over 3,000 providers and payers and enabling real-time adjudication, financial transparency, and standardized compliance across the sector.

According to the white paper, Saudi Arabia’s healthcare market is valued at SAR 260 billion in 2025, while private health insurance premiums have risen by 9% year-on-year, reaching SAR 42.2 billion in 2024. The RCM market alone is projected to exceed SAR 14.1 billion by 2033, growing at an 11.77% CAGR—underscoring its strategic importance to the Kingdom’s healthcare future.

BPO Partnerships: Catalysts for Financial Efficiency

Accredited Business Process Outsourcing (BPO) firms are playing a pivotal role in this transformation. Supported under Public–Private Partnership (PPP) frameworks, BPO partners are modernizing hospital revenue operations with AI-driven tools, compliance frameworks, and real-time analytics that enhance accuracy and accelerate reimbursements.

The Kingdom currently processes between 50–65 million claims annually, and hospitals collaborating with certified RCM partners report first-pass acceptance rates above 85%, 15–20% fewer denials, and 30% faster payment cycles.

RCM: Powering Saudi Arabia’s Shift to Value-Based Healthcare

The Revenue Cycle Management (RCM) landscape is undergoing strategic and financial transformation as the Kingdom accelerates toward value-based care and outcome-linked reimbursement. The full activation of the Centre for National Health Insurance (CNHI) and the rollout of Diagnosis Related Groups (DRG) will redefine how hospitals are funded—linking payments to quality, efficiency, and outcomes rather than volume.

Under this evolving framework, universal health insurance coverage will progressively include all citizens and residents within a unified national payer system. This shift is expected to increase annual healthcare claims from SAR 25 billion to more than SAR 80 billion by 2026, driving exponential demand for AI-powered automation, predictive analytics, and advanced denial management systems.

The white paper highlights that hospitals implementing AI-assisted coding, predictive analytics, and agentic automation have achieved up to 30% faster reimbursements, 20% fewer denials, and 25% lower administrative overheads. Through such innovations, RCM is emerging as the financial backbone of Vision 2030’s healthcare transformation.

“Saudi Arabia’s healthcare system is experiencing a transformative moment,” said Anas Batikhi, Founder and CEO of Santechture.

“Through data, technology, and collaboration, the Kingdom is redefining how healthcare is financed, measured, and sustained. I encourage healthcare providers to take the Santechture-RCM Maturity Index™ assessment — this framework enables hospitals to evaluate their RCM maturity across five key dimensions: Technology, Process, Workforce, Financial Performance, and continuous improvement through Data Insights. It helps providers understand their current RCM state, identify performance gaps, and define the desired level of maturity they aim to reach. By doing so, they can align operational excellence with the national vision for sustainable, data-driven healthcare under Vision 2030.”

Kingdom is Building a Solid Foundation for the Region

The Santechture White Paper underscores Saudi Arabia’s rapid progress toward a sustainable, transparent, and innovation-led financial ecosystem that empowers both providers and patients. With more than 80% of private sector claims already digitized and AI adoption accelerating across hospitals, the Kingdom is now setting the regional benchmark for advanced RCM and value-based healthcare by 2028.

Download the full white paper: Evolution of KSA RCM – Oct 2025.