Carlyle announced it acquired majority stakes in Knack RCM and EqualizeRCM to create what the company described as an AI-native, global, multi-specialty healthcare revenue cycle management platform. Financial terms of the transactions were not disclosed.
The investment is being funded through investment funds affiliated with Carlyle Asia Partners VI and Carlyle Asia Partners Growth II. Knack RCM founder Rajiv Sharma and EqualizeRCM founder Nagi Rao will remain invested in the combined platform through reinvestment of a portion of their proceeds.
Knack and EqualizeRCM both provide healthcare revenue cycle management services across physician groups, durable medical equipment providers, rural hospitals, and specialty healthcare segments. Together, the companies provide expertise across areas including anesthesia, eyecare, behavioral health, urgent care, and multi-specialty physician groups.
Carlyle said the combined platform is expected to enhance operational scale, expand delivery capabilities, strengthen leadership depth, and accelerate AI capabilities designed to improve outcomes for healthcare clients. Knack contributes global delivery operations across the U.S., India, and the Philippines through its Workmate orchestration platform, while EqualizeRCM brings proprietary payer enrollment software and AI-driven tools such as Bill Smart for denial prediction and avoidance.
EqualizeRCM’s AI-native platform is built on large language models and agentic AI technologies and has demonstrated commercial traction in hospital and durable medical equipment markets, according to the announcement.
Carlyle said it plans to continue expanding the platform strategy through additional acquisition opportunities within the healthcare revenue cycle management industry.
Knack RCM is headquartered in Woodbridge, New Jersey, and employs more than 8,000 people across delivery centers in India, the Philippines, and the United States. EqualizeRCM provides revenue cycle management services for physicians, hospitals, ambulatory surgery centers, laboratories, and rural healthcare providers.
KEY QUOTES:
“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.”
Kapil Modi, Partner, Carlyle India Advisors
“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.”
Rajiv Sharma, Founder, Knack RCM
“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.”
Nagi Rao, Founder, EqualizeRCM
“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.”
Gautam Barai, CEO, Knack RCM
“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.”
Amit Jain, Partner And Head Of Carlyle India Advisors
