Carlyle Group Inc. announced that it has acquired majority stakes in Knack RCM and EqualizeRCM, two U.S. revenue‑cycle management (RCM) providers. The deal will combine Knack’s global delivery network and AI‑powered Workmate orchestration platform with EqualizeRCM’s specialty‑focused payer enrollment and Bill Smart denial‑prediction tools to create an AI‑native, multi‑specialty RCM platform.
The transaction is financed through equity funds affiliated with Carlyle Asia Partners VI and Carlyle Asia Partners Growth II, with the terms of the deal undisclosed. Knack’s founders, Rajiv Sharma and Nagi Rao, will remain invested in the combined platform through a reinvestment of a portion of their proceeds.
Carlyle’s acquisition aligns with its broader strategy to expand its solutions portfolio in high‑growth, technology‑enabled markets. By integrating Knack’s Workmate orchestration platform and EqualizeRCM’s Bill Smart denial‑prediction tool, the firm aims to enhance operational scale, broaden its delivery footprint, and accelerate AI capabilities to improve client outcomes. The move positions Carlyle to capture a larger share of the rapidly expanding U.S. healthcare RCM market, which is driven by margin compression, workforce shortages, and a shift toward value‑based care.
The U.S. healthcare RCM market was valued at $13 billion in 2023 and is projected to grow significantly. AI adoption is increasing to automate tasks, improve accuracy, predict denials, and enhance efficiency, making the combined platform attractive to physician groups, durable medical equipment providers, rural hospitals, and other specialty segments across the United States, India, and the Philippines.
In Q4 2025, Carlyle reported income before provision for income taxes of $462 million, a 24.3% margin. Full‑year 2025 income before provision for income taxes was $1.2 billion, also 24.3% margin. AUM reached $477 billion, with Global Credit $211.3 billion, Carlyle AlpInvest $102 billion, and Global Private Equity $163.5 billion. CEO Harvey M. Schwartz highlighted disciplined execution and investor confidence in a February 2026 earnings call.
Kapil Modi, Partner at Carlyle India Advisors, said the U.S. 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 of 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 of 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.”
The combined entity will serve physician groups, durable medical equipment providers, rural hospitals, and other specialty segments across the United States, India, and the Philippines. The acquisition positions Carlyle to capture a larger share of the rapidly expanding RCM market and supports future bolt‑on acquisitions in the space.
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