Portfolio Delivery Leadership
Managing a book of client engagements at scale: SLAs, delivery teams, performance, and the retention and margin that define managed services.
Revenue Cycle Services · Managed Services
Tony Esposito
Managing Director, Revenue Cycle Services — Altera Digital Health
I lead a portfolio of revenue cycle managed-services engagements — aligning delivery, client retention, and margin across health systems running on EPIC, Athena, AthenaIDX, and eClinicalWorks. Three decades in the space where clinical operations meet financial performance.
- 30+ Years in RCM
- Epic Resolute & Multiple EHR Platforms
- Portfolio Delivery Leadership
The discipline of revenue integrity
For thirty years I've worked at the intersection of healthcare operations and financial performance — building and rebuilding revenue cycle functions for hospitals, health systems, and multi-site physician groups.
Today I lead Revenue Cycle Services within Altera Digital Health's Managed Services division: a portfolio of client engagements, each with its own platform mix, delivery team, service levels, and economics. My focus is the discipline that makes managed services work at scale — consistent delivery, measurable performance, client retention, and healthy margin.
My background runs deep in EPIC, Athena, AthenaIDX, and eClinicalWorks (EcW) — across charge capture, billing, denials, AR, and the reporting integrity that ties them together.
Platform Depth: Resolute, Athena, AthenaIDX & EcW
Hands-on expertise across build, optimization, and post-live support — charge capture, billing, and AR workflows.
Denials & AR Performance
Structured, data-driven approaches to denial prevention and AR management that accelerate cash flow.
Reporting Integrity & KPIs
Trustworthy metrics and the reporting discipline that ties clinical and financial performance together.
The RCM Perspective
Most conversations about AI in revenue cycle ask where we can use it. I'm more interested in a harder question borrowed from how other industries already think: where does each additional unit of AI consumption create measurable economic value? These are notes toward treating AI as a capital-allocation problem, not just a technology one.
All posts on LinkedInWe May Be Asking the Wrong AI Question
The first question shouldn't be 'where can we use AI?' It should be 'where does an additional unit of AI consumption create measurable economic value?' That distinction changes everything downstream.
Read on LinkedIn →Training Builds the Engine. Inference Does the Work.
The long-run economics of AI in revenue cycle won't be decided by how sophisticated the models get, but by how often we can put them to economically productive work — one inference at a time.
Read on LinkedIn →AI Has Railroads. Revenue Cycle Needs Freight.
GPUs, data centers, and power are the railroad. The economically productive work moving across it is the freight. Transformative infrastructure can still be overbuilt — and so can an AI deployment.
Read on LinkedIn →Not Every Revenue-Cycle Problem Deserves AI
The existence of an AI solution doesn't establish the existence of an AI business case. The highest-value uses aren't the most visible ones — they're where a small amount of intelligence changes a high-value financial decision.
Read on LinkedIn →The AI Question a CFO Should Ask
The breakthrough won't come when AI gets more sophisticated. It comes when an executive can say where the next unit of intelligence produces the highest return — and AI stops being an innovation initiative and becomes an operating asset.
Read on LinkedIn →Work that moved the needle
01Epic Resolute · Enterprise
Health System Revenue Cycle Transformation
Led a full-cycle Epic Resolute implementation across a multi-hospital health system — charge capture redesign, billing workflow optimization, and post-live AR stabilization. Delivered go-live on schedule with a measurable reduction in days in AR within 90 days.
02Denials · Multi-site
Systematic Denial Reduction at Scale
Rebuilt a denials function for a multi-site physician group, shifting from reactive appeals to proactive upstream prevention with denial trending, root-cause workflows, and cross-functional accountability across coding and clinical documentation.
03Managed Care
Payor Strategy & Contract Renegotiation
Led renegotiation of a major commercial payor contract using utilization data and outcome benchmarks, and stood up a reimbursement-monitoring infrastructure that surfaced underpayments systematically.
04Ambulatory · M&A
Post-Acquisition Revenue Cycle Integration
Directed revenue cycle integration for an acquired ambulatory network — harmonizing billing platforms, credentialing, and payor enrollment while maintaining collections continuity through the transition.
Let's talk revenue cycle
I'm always glad to talk revenue cycle with peers across the industry.