The Challenge

As part of Saudi Arabia’s healthcare transformation, the client was tasked with building infrastructure across Clusters to support a shift from government-funded care to risk-based capitation and insurance billing.

They needed urgent support to establish a Payer and Revenue Services department and scalable Revenue Cycle Management (RCM) capabilities for hundreds of hospitals and thousands of primary healthcare centers to help deliver this ambition.

While some groundwork had been done, the client required a partner that offered both strategic direction and rapid execution to meet national reform goals.

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Our Approach

• Established, recruited and onboarded the core team, integrating national and cluster-level functions.
• Conducted a comprehensive, ground-level assessment of RCM capabilities across the entire healthcare network
• Identified systemic capability gaps across people, processes, technology, and governance.
• Created a detailed capability development roadmap, aligned to transformation objectives.
• Developed standardized management reporting frameworks and practical implementation tools.
• Prioritized and began executing high-impact strategic initiatives within 2.5 months.
• Ensured deep alignment through continuous stakeholder engagement and cultural understanding.

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Outcomes

• Identified ready-to-deploy cutting-edge technologies & DRG billing improvements across approx. 300 hospitals and 2,500 primary care centres in first 2.5 months
• Successfully established the new Payor & Revenue Services Department initiating capability development
• Defined RCM requirements, developed strategic initiatives and produced a practical implementation roadmap with buy-in from all stakeholders through inclusive and culturally sensitive engagement.