Global investment firm Carlyle today announced it has acquired a majority stake in Knack RCM (Knack) and EqualizeRCM (Equalize), two leading US healthcare revenue cycle management (Reverse Charge Mechanism ORRCM)) providers, to create an AI-native, global, multi-specialty RCM platform. Equity will come from investment funds affiliated with Carlyle Asia Partners VI (CAP VI) and Carlyle Asia Partners Growth II (CAPG II). The terms of the transaction are not disclosed. Rajiv Sharma, Founder of Knack RCM, and Nagi Rao, Founder of EqualizeRCM, will remain associated with the platform through a reinvestment of a portion of their proceeds.
Knack and Equalize are complementary healthcare RCM providers serving physician groups, durable medical equipment (Durable Medical Equipment or DME) providers, rural hospitals, and other specialty provider segments. Together, they bring deep, specialty-specific expertise across DME, anaesthesia, eyecare, behavioural health, rural hospitals, urgent care, and multi-specialty physician groups.
The combined platform is expected to enhance operational scale and diversification, broaden the delivery footprint, strengthen leadership depth, and help accelerate AI capabilities to enhance outcomes for clients. Knack contributes scaled, global delivery across the US, India, and the Philippines, anchored by an intelligent, end-to-end revenue engine powered by its orchestration platform, Workmate. EqualizeRCM complements this with its established delivery scale in the US and India, alongside a proprietary payer enrolment platform and advanced AI-driven tools,such as Bill Smart for denial prediction and avoidance, that are purpose-built for hospitals, urgent care, and targeted specialty segments. Equalize’s AI-native platform, built on large language models and agentic AI, has demonstrated proven commercial traction, including the displacement of established, large-scale vendor contracts at leading DME manufacturers.
Kapil Modi, Partner at Carlyle India Advisors, said: “The US healthcare revenue cycle market is growing rapidly, driven by margin compression, workforce shortages, and the shift to value-based care. 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.”
Rajiv Sharma, Founder, Knack RCM, said: “Carlyle has been a trusted partner to Knack, bringing not only capital but also valuable expertise in healthcare and RCM. The addition of Equalize is a progression of this partnership and strengthens the value we provide to our clients.”
Nagi Rao, Founder, EqualizeRCM, said: “Our clients, particularly rural hospitals and behavioural health providers, face immense pressure in sustaining margins and ensuring access to care. 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.”
Gautam Barai, CEO, Knack RCM, said: “Healthcare providers measure success by their ability to meet payroll, preserve services, and support their communities, not by the amount of automation deployed. Coming together with Equalize allows us to combine our strengths to tackle the most complex parts of the revenue cycle, including rural cost reports, DME intake, and challenging anaesthesia cases. For us, success is not about automating simple workflows but about addressing the most critical financial risks faced by our clients, which ultimately translates into improved financial health and better patient care.”
Amit Jain, Partner and Head of Carlyle India Advisors, concluded: “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. This investment extends our India for the World thesis and builds on our experience investing in technology and tech-enabled services. We have invested in healthcare technology platforms including Indegene, Visionary RCM, and CorroHealth, and we will bring this expertise and execution capability to scale the combined Knack and Equalize platform.”
Carlyle intends to build on this platform strategy by pursuing additional opportunities in the RCM industry and will continue to seek to add synergistic assets with complementary offerings to the RCM platform.
Disclaimer - The above content is non-editorial, and TIL hereby disclaims any and all warranties, expressed or implied, relating to it, and does not guarantee, vouch for or necessarily endorse any of the content.
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The combined platform is expected to enhance operational scale and diversification, broaden the delivery footprint, strengthen leadership depth, and help accelerate AI capabilities to enhance outcomes for clients. Knack contributes scaled, global delivery across the US, India, and the Philippines, anchored by an intelligent, end-to-end revenue engine powered by its orchestration platform, Workmate. EqualizeRCM complements this with its established delivery scale in the US and India, alongside a proprietary payer enrolment platform and advanced AI-driven tools,such as Bill Smart for denial prediction and avoidance, that are purpose-built for hospitals, urgent care, and targeted specialty segments. Equalize’s AI-native platform, built on large language models and agentic AI, has demonstrated proven commercial traction, including the displacement of established, large-scale vendor contracts at leading DME manufacturers.
Kapil Modi, Partner at Carlyle India Advisors, said: “The US healthcare revenue cycle market is growing rapidly, driven by margin compression, workforce shortages, and the shift to value-based care. 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.”
Rajiv Sharma, Founder, Knack RCM, said: “Carlyle has been a trusted partner to Knack, bringing not only capital but also valuable expertise in healthcare and RCM. The addition of Equalize is a progression of this partnership and strengthens the value we provide to our clients.”
Nagi Rao, Founder, EqualizeRCM, said: “Our clients, particularly rural hospitals and behavioural health providers, face immense pressure in sustaining margins and ensuring access to care. 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.”
Gautam Barai, CEO, Knack RCM, said: “Healthcare providers measure success by their ability to meet payroll, preserve services, and support their communities, not by the amount of automation deployed. Coming together with Equalize allows us to combine our strengths to tackle the most complex parts of the revenue cycle, including rural cost reports, DME intake, and challenging anaesthesia cases. For us, success is not about automating simple workflows but about addressing the most critical financial risks faced by our clients, which ultimately translates into improved financial health and better patient care.”
Amit Jain, Partner and Head of Carlyle India Advisors, concluded: “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. This investment extends our India for the World thesis and builds on our experience investing in technology and tech-enabled services. We have invested in healthcare technology platforms including Indegene, Visionary RCM, and CorroHealth, and we will bring this expertise and execution capability to scale the combined Knack and Equalize platform.”
Carlyle intends to build on this platform strategy by pursuing additional opportunities in the RCM industry and will continue to seek to add synergistic assets with complementary offerings to the RCM platform.
Disclaimer - The above content is non-editorial, and TIL hereby disclaims any and all warranties, expressed or implied, relating to it, and does not guarantee, vouch for or necessarily endorse any of the content.
