Carlyle buys majority stake in Knack, EqualizeRCM to build AI-led healthcare billing platform

Betting on a growing market

“The US healthcare revenue cycle market is growing rapidly, driven by margin compression, workforce shortages, and the shift to value-based care,” said Kapil Modi, Partner at Carlyle India Advisors. “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.”

The combined entity is expected to expand scale and delivery footprint across the US, India and the Philippines, while deepening capabilities in automation and analytics, the company said.

“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,” said Amit Jain, partner and head, Carlyle India Advisors.

The investment will be made through funds affiliated with Carlyle Asia Partners VI and Carlyle Asia Partners Growth II. Both companies have operations in India, and the investment is being made through Carlyle’s Asia-focused funds. The firm has previously backed healthcare technology platforms including Indegene, Visionary RCM, and CorroHealth.

Headquartered in Woodbridge, New Jersey, Knack RCM has over 8,000 employees across 10 delivery centres in India, the Philippines and the US. EqualizeRCM complements this with its delivery presence in the US and India, serving physicians, hospitals, ambulatory surgery centres, laboratories and rural providers.

“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,” Knack’s CEO Gautam Barai said in the statement.

“Our clients, particularly rural hospitals and behavioural health providers, face immense pressure in sustaining margins and ensuring access to care,” Rao said. “Partnering with Knack enables us to integrate our advisory expertise with their advanced analytics and global operations to deliver more robust and tailored solutions.”

Priyamvada C

Priyamvada is a Mumbai-based business journalist at Mint. She writes about the public and private markets with a key focus on venture capital, private equity, M&As and private credit. Her coverage also spans startups and emerging businesses.Over the last two years, she has uncovered some of the largest deals and interviewed important decision-makers from India’s investment ecosystem. She likes to dabble across different formats like long forms and explainers. Her work has been consistently displayed on the publication's deals page, and she has also written multiple front-page stories.Prior to joining Mint in 2024, she worked out of Reuters’ Bengaluru bureau where she extensively covered the travel, transportation, and logistics industries. Across both her stints, Priyamvada has displayed rigour for breaking news and analyzing interesting data-driven trends. She holds a postgraduate diploma from the Asian College of Journalism's Bloomberg programme. In her free time, she enjoys reading books and trying out different cuisines. She is keen to delve deeper into the various sectors she covers and is always up for a chat. You can reach out to her at priyamvada.c@livemint.com.