Becker’s Healthcare Podcast: Interview with Nick Warfield, Director at Ziegler

Date: August 27, 2025
Host: Scott Becker
Guest: Nick Warfield, Director at Ziegler

Overview

This episode features Nick Warfield, a leader in healthcare investment banking and revenue cycle management (RCM), discussing current trends in the RCM space, including market consolidation, the growing role of AI, and deal activity. Nick also shares career advice for those entering the sector, drawing on his decade-long experience at Ziegler. The conversation provides valuable insight into the intersection of healthcare finance, technology, and M&A trends.

Key Discussion Points and Insights

1. Nick Warfield’s Background and Ziegler’s Focus

[00:38 – 01:41]

• Nick Warfield’s Role: Director at Ziegler, a 115-year-old investment bank focused solely on healthcare.
• Ziegler’s Services: Provides M&A and capital-raising advisory for middle-market healthcare clients, especially in healthcare IT and RCM.
• Track Record: Ziegler has advised both innovative tech and tech-enabled services companies, helping develop end-to-end RCM solutions.
• Notable Clients: Recently advised SEI Solutions (patient scheduling), R1 (end-to-end RCM), and HBCS (insurance reimbursement/self-pay) on deals to expand their platforms.

“We’ve really built out a strong track record in the RCM space advising tech and tech-enabled services companies at the forefront of innovation…”
— Nick Warfield [00:47]

2. Consolidation in the RCM Market

[02:21 – 05:10]

• End-to-End Solutions Preferred: Providers are fatigued by managing multiple point solutions and are gravitating towards single, integrated RCM vendors.
• Vendor Response: This shift is driving significant M&A activity, with larger firms acquiring or merging with complementary solution providers to offer comprehensive platforms.
• Case Example: HBCS (insurance reimbursement/self-pay) sold to MedMetrics to help the latter expand into the self-pay world, highlighting how companies are rounding out offerings to attract providers.

“What they really want to do now is streamline that whole process and operate with one RCM vendor that can address all of their pain points.”
— Nick Warfield [04:21]

3. Workforce, Denials & the Push for Automation

[05:22 – 07:17]

• Provider Challenges: Increased denial rates and workforce shortages are pressuring providers to push vendors for more ROI and improved efficiency.
• Automation & AI Investment: Surge in investment in AI-driven solutions aimed at automating repetitive, high-volume RCM tasks, reducing labor costs, and raising efficiency.
• Market Examples:
  • Axis Healthcare has merged with AI solution providers under new investment.
  • R1 raising capital for AI-driven initiatives.

“I truly believe AI has one of the more practical use cases within RCM as a large opportunity to automate some of the high-volume repetitive tasks that historically have been done fairly manually.”
— Nick Warfield [06:42]

4. RCM Deal Activity: Forecast and Drivers

[07:49 – 10:04]

• Robust Deal Volume Anticipated: High levels of interest from private equity, especially after slower M&A cycles, are fueling investment in RCM, specifically in tech and AI.
• Premium Valuations Emerging: Intense competition and innovation drive up valuations.
• Ambulatory RCM Opportunities: New tech enables serving smaller, ambulatory providers—historically an underserved segment—due to rollups and the need for automation.
• Broader Market Expansion: Technology is allowing RCM solutions to be viable for a wider range of provider sizes.

“Technology, for instance, I think opens up a couple of different markets as well within RCM… now we’re starting to see technology being able to kind of help them out to automate some of their RCM functions and ultimately help them on the financial end.”
— Nick Warfield [09:36]

5. Career Reflections and Advice for Emerging Professionals

[10:26 – 11:27]

• Industry Evolution: RCM has evolved from in-house, on-premise work to outsourcing, offshoring, and now technology/A.I.-driven models.
• Key Skill—Adaptability: Emphasizes the importance of staying agile and continually learning as the landscape shifts.
• Advice for Newcomers:
  • Learn the space deeply and be open to change.
  • Anticipate where the “puck is moving” to stay ahead.

“It’s truly one of the more innovative fields in healthcare… being able to understand and adapt to that innovation, I think is key.”
— Nick Warfield [10:53]

Notable Quotes & Memorable Moments

• On Consolidation:
  “A ton of consolidation just to kind of build out the end-to-end platforms is one thing that we’re seeing.”
  — Nick Warfield [02:55]

• On AI in RCM:
  “You ended up with a lot of movement in AI and large language models and so forth in revenue cycle.”
  — Scott Becker [07:24]

• On Adaptability:
  “Try to be open to adapting as the industry is constantly changing.”
  — Nick Warfield [11:18]

Important Timestamps

• 00:38: Nick introduces himself and Ziegler’s healthcare banking focus.
• 02:21: Discusses shift toward end-to-end RCM solutions and resulting vendor consolidation.
• 05:22: Explains the pressures driving automation and AI adoption in RCM.
• 07:49: Forecasts ongoing robust deal activity and market expansion.
• 10:26: Nick’s career reflections and advice for industry newcomers.

Conclusion

This episode provides a succinct yet comprehensive overview of major trends shaping the RCM and healthcare deal space, as seen through the lens of an experienced investment banker. From the value of consolidation and end-to-end platforms to the growing impact of AI and shifting private equity attention, listeners receive practical insights into what’s fueling RCM evolution today, and what skills are needed to thrive in this dynamic industry.