Turning operational strain into sustainable performance
Executive summary
Healthcare organizations are under sustained pressure from workforce shortages, rising costs and tightening margins. World-class shared services are emerging as a practical operating model to stabilize performance while enabling automation and AI at scale. By rethinking where work gets done and how it is governed, providers can improve quality, overcome talent challenges, achieve savings and fund modernization without disruptive, high-risk transformations.
Healthcare leaders are navigating an unforgiving reality. Labor shortages persist across clinical and administrative roles. Supply and operating costs continue to rise faster than reimbursement. Margins remain thin enough that operational failures can quickly become enterprise-level risks.
Against that backdrop, healthcare organizations are asking harder questions about how work gets done behind the scenes. Traditional models that rely on fragmented teams, manual processes and incremental technology upgrades are no longer sufficient. The issue is not whether processes can be optimized, but whether operations can scale with fewer people, more payer complexity and tighter financial constraints.
Shared services solutions for these issues are being considered with renewed urgency, as discussed on a recent Grant Thornton webcast. Once viewed primarily as a cost-reduction tactic, high-performing shared services models are now being used to drive operational discipline, improve access to talent and accelerate automation.
As Scott McGurl, Head of Healthcare Industry at Grant Thornton, said, “Shared services is a true strategic lever for healthcare organizations. It creates the operational discipline needed to improve quality, lower costs and build resilience at a time when the margin for error is extremely thin.”
Shared services as a strategic operating model
World-class shared services are often misunderstood as a driver of centralization. Eric Liebross, Senior Managing Director of Business and Finance Transformation at Grant Thornton | Auxis, said, “World-class shared services aren’t defined by centralization alone. It starts with a deliberately designed operating model that makes accountability, performance and continuous improvement visible and measurable.” A shared services model defines how work flows across the organization and who is responsible for outcomes. That structure creates consistency and efficiency in areas where healthcare organizations often struggle, including revenue cycle, finance and other administrative functions.
Shared services also introduce a service-oriented mindset. Internal teams are treated as customers. Performance is measured. Service levels are monitored. Continuous improvement becomes an expectation rather than an aspiration. According to Liebross, organizations that skip these fundamentals often centralize work without realizing meaningful gains.
Shared services can also help solve one of healthcare’s most pressing constraints: access to skilled talent. By aggregating work and standardizing processes, organizations can deploy specialized skills more effectively and reduce reliance on scarce – and more expensive – local labor markets.
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Rethinking where work gets done
One consequential shift in shared services has been the move away from single-location or purely offshore delivery models. Healthcare organizations are increasingly adopting hybrid approaches that align work complexity with the right delivery location.
Liebross described a clear segmentation emerging across leading organizations. Highly transactional, rules-based activities often perform well in offshore environments focused on efficiency and scale. Work that requires judgment, frequent collaboration or payer and provider interaction benefits from nearshore delivery models that operate in similar time zones and cultural contexts.
Nearshore shared services has proven particularly effective for revenue cycle activities such as denials management, collections and prior authorizations. These functions demand critical thinking and real-time communication. According to Eduardo Diquez, Managing Director of Intelligent Automation at Grant Thornton | Auxis, “Building a world-class shared services operation with nearshore capabilities can really drive significant labor savings ꟷ between 25 and 50%.”
The benefits extend beyond cost: Proximity improves collaboration and language and cultural alignment reduces friction. Talent markets in regions such as Latin America offer deep pools of educated professionals who view back-office healthcare revenue cycle support roles as long-term career opportunities — reducing the high turnover common in U.S.-based jobs characterized by repetitive and often frustrating work.
Automation and AI as force multipliers
As shared services creates a foundation, automation and AI amplify its impact.
Because healthcare has already seen widespread adoption of core digital platforms, Diquez said the next wave of value comes from layering automation onto standardized processes. Eligibility verification, scheduling, prior authorization and claims follow-up are all areas where automation has reduced manual effort and accelerated throughput.
The impact is measurable. In revenue cycle operations, automation and AI have driven dramatic reductions in denial rates and faster claims resolution. “Once a shared services foundation is in place, automation and AI become force multipliers,” Diquez said. “They allow organizations to move faster, reduce denials and scale productivity without replacing their core systems.” Faster action on denials increases the likelihood of recovery. Automation also improves consistency, reducing errors that often trigger payer rejections.
Importantly, most automation initiatives do not require wholesale replacement of existing systems. Modern tools can sit on top of legacy platforms, orchestrating workflows and extracting data without disrupting core applications, lowering risk and shortening time to value.
Shared services can also change the economics of automation. By capturing labor savings through outsourcing, organizations can reinvest a portion of those savings into automation and AI. Transformation becomes self-funding rather than dependent on large capital allocations.
At a time when many organizations struggle to realize real value from digital investments, shared services also offers immediate access to digital talent and advanced capabilities that are difficult to develop in-house. Backed by deep expertise and a proven record of identifying, prioritizing, and executing high-impact AI initiatives, quality partners can help healthcare enterprises achieve measurable ROI and lasting operational advantage.
Governance, compliance and trust
Healthcare leaders may have concerns around data privacy and regulatory compliance in shared services and automation initiatives, but experience demonstrates that strong governance makes these challenges manageable.
Quality shared services providers typically operate directly within healthcare client systems rather than storing data locally. Access controls, audit trails and role-based permissions mirror internal standards. HIPAA compliance is enforced through training, monitoring and third-party certifications.
Liebross emphasized that compliance requirements focus on how data is protected, not where talent is physically located. With proper controls in place, nearshore and offshore teams can safely support sensitive healthcare operations.
Equally important is trust. Shared services performs best when it is treated as an extension of an enterprise rather than an external vendor. Integration into governance structures, shared performance metrics and clear career paths reinforce that connection.
Managing change in a complex environment
Operational change is difficult in any industry. Healthcare adds layers of complexity due to mission sensitivity and workforce fatigue.
Successful shared services transformations begin with executive alignment. Leadership commitment signals that the model is strategic, not experimental. From there, involving internal teams in design and transition builds confidence and reduces resistance.
Liebross highlighted the importance of capturing not only standard workflows but also exceptions and edge cases during transition. Many failures occur when organizations document only the “happy path” and overlook the nuances that define real-world operations.
Diquez added that the most durable change is cultural. When shared services shifts from a back-office mindset to a service-oriented model, productivity improvement and automation adoption become ongoing expectations.
Conclusion
Healthcare organizations are under pressure to do more with less while maintaining quality, compliance and patient trust. World-class shared services offers a pragmatic path forward.
By intentionally designing operating models, aligning work with the right delivery locations and using automation as a force multiplier, providers can stabilize operations and unlock measurable gains. The most effective organizations treat shared services as a true extension of the enterprise, governed by performance, accountability and continuous improvement.
The result is not a one-time efficiency gain, but a resilient operating model capable of adapting as healthcare continues to change.
Healthcare’s next decade will not be defined by who invests in technology, but by who finally extracts value from it. As McGurl says, “The greatest risk facing healthcare providers today is not moving too fast — it’s carrying yesterday’s cost structure into tomorrow’s care model.”
Hospital and health system leaders can no longer afford to treat cloud ERPs, electronic health records, automation, and AI as parallel initiatives or sunk investments. The imperative now is to redesign the future of work across the provider network — intentionally and at scale. That means fully activating the platforms already in place, automating the vast volume of routine work core systems were not designed to handle, and establishing a clear roadmap for AI adoption across clinical and operational domains before workforce constraints make the choice for you.
It means rethinking where work gets done by leveraging shared services, nearshore and offshore delivery models, and trusted third parties to expand access to talent while improving quality, resilience, and cost discipline.
Organizations that act decisively will bend the cost curve and protect their mission. Those that hesitate will find that volatility is no longer a headwind — it is a structural disadvantage. The choice is no longer whether to change, but whether you will lead that change or be overtaken by it.
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This Grant Thornton Advisors LLC content provides information and comments on current issues and developments. It is not a comprehensive analysis of the subject matter covered. It is not, and should not be construed as, accounting, legal, tax, or professional advice provided by Grant Thornton Advisors LLC. All relevant facts and circumstances, including the pertinent authoritative literature, need to be considered to arrive at conclusions that comply with matters addressed in this content.
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