The bottom line: Erin Burke

When Erin Burke talks about revenue cycle management (RCM), the language of billing quickly disappears. In its place are treatment centers, clinicians, families and – most importantly – patients.

This distinction goes back to the heart of why she founded Hansei Solutions, a leading RCM partner for behavioral health providers, almost a decade ago. Where others saw an administrative function buried in the back office of behavioral healthcare, Burke saw infrastructure that could determine whether care was available at all.

"Behavioral health has always been treated like the stepchild of healthcare – chronically underfunded, poorly understood by payers and built on infrastructure that was never designed for how this care actually works," she tells The CEO Magazine.

"But I came to it from a place most people in RCM don’t. I know what it is to have insurance stand between someone and the treatment they need and to be on the other side of that phone call. So when I looked at the system, I wasn’t looking at a spreadsheet. I was looking at people I recognized."

Finding the failure points

Combined with Burke’s training in systems engineering, this perspective led the CEO to question not how organizations could become better at navigating a flawed system, but rather, why those flaws existed in the first place.

"What I kept seeing was treatment centers turning away patients – not because they couldn’t help them, but because they couldn’t afford to," she points out.

"Clinicians spending hours on hold with payers instead of in session with patients. Good programs were closing their doors because the revenue never caught up in the care they were providing."

The conclusion became unavoidable.

"That’s when it clicked for me: RCM isn’t back-office, it's the thing standing between a patient and the treatment they need," Burke explains.

"Every denied claim, every parity violation, every slow reimbursement cycle has a real person on the other end of it: someone in crisis, or a family, waiting to find out if help is actually within reach."

But Burke’s desire went beyond processing claims faster.

"I wanted to build a company that could go toe-to-toe with the systemic barriers and win, so that treatment centers could stay open and patients could stay in care," she says.

"Ten years later, we're not in the billing business. We're in the business of making sure care doesn’t stop because the money didn’t show up."

Scaling with purpose

Since its founding in 2016, Hansei Solutions has expanded into a national organization employing more than 400 people across 42 states.

In 2021, its partnership with Gulf Capital marked a turning point for the company. But Burke insists sustainable growth has had much less to do with any single milestone than with the work that happens between them.

"Growth doesn’t happen overnight," she acknowledges. "It’s not a single check; it’s a daily discipline."

As the company has expanded, her bigger concern was preserving the reason it exists in the first place.

"Scaling never worried me as much as losing our ‘why’. And the way we’ve protected that is by being deliberate about the people, not just the processes," Burke explains.

In practice, this looks like hiring for alignment and building a leadership team capable of carrying it.

"If I hold onto it, it stops at me," she says. "Scale means handing it to my leaders and letting them own it, and letting them own the people they lead."

Continuous improvement

The name ‘Hansei’ comes from the Japanese philosophy of self-reflection and continuous improvement. For Burke, applying that philosophy to the business has sometimes meant taking a critical look at her own role in it.

"Hansei as a philosophy means you don’t wait for something to break before you examine it," she points out. "You build the habit of looking inward constantly, even when things are working well."

This practice has helped the company navigate turbulent periods, like when several major payers introduced new requirements and tighter criteria, resulting in denials at unprecedented scale. Burke says Hansei Solutions then faced a choice between protecting itself from the fallout or stepping further into the fight.

"The instinct in a moment like that is to protect yourself: tighten your own margins, quietly let go of the hardest accounts, ride it out," she says.

"We did the opposite. We decided that if the system was going to move against our clients, we were going to be the thing that moved back. We rebuilt our appeals infrastructure, invested in the data to prove the patterns and, in some cases, took the fight all the way to parity enforcement."

This moment revealed a powerful lesson.

"Leadership isn’t tested when things are working. It’s tested when they’re not," Burke explains.

"Anyone can hold the mission when it’s cheap. The job is holding it when it costs you something."

Turning data into advocacy

As it relates to technology, Burke sees significant potential for automation to remove administrative work from clinicians and providers, but believes the greatest opportunity lies largely under the radar.

"The promise of AI in healthcare isn’t replacing people, it’s unburying them," she says. "Let the technology handle the administrative load and put our smart people back on the work that requires judgment. Critical thinking doesn’t scale by adding head count. It scales by protecting the time of the people who can do it.

"When you’re processing claims across hundreds of facilities, you start to see the denial patterns no single provider can see on their own. Technology lets us turn those anecdotes into evidence, and evidence is what changes policy."

However, Burke is equally conscious of the risks.

"We’re heading into a decade where an AI on one side is arguing with an AI on the other, and the danger is that the patient disappears in that exchange," she cautions.

"Technology in this space is only as good as the mission pointing it. Used right, it’s the most powerful advocacy tool we’ve ever had. Used carelessly, it just makes a broken system break faster."

Beyond the business

Advocacy is not something Burke keeps inside the company. She and her husband, Will, work in their communities to make sure people know what help exists and where to find it.

"You can’t lead a company in this space from a distance," she says. "You have to stay close to the people it’s actually for.

"My advocacy work outside Hansei isn’t separate from the work inside it – it’s the same mission. It’s easy to treat your business as a closed system – revenue, growth, operations. But sitting in rooms focused purely on advocacy and access sharpens your judgment as a CEO.

"It keeps you honest about whether your decisions are actually serving the mission you claim to care about, or just the bottom line."

As Hansei Solutions approaches its 10-year milestone – and as Burke’s leadership is recognized with her selection as a finalist in The CEO Magazine’s 2026 Executive of the Year Awards in the United States – her attention is firmly on what comes next.

"Ten years in, we’ve built the people, the data, the expertise, the reputation and the relationships to revolutionize this space, not just keep pace with it," she says.

"Everything we’ve built rests on people who chose to spend their careers fighting for a patient they’ll never meet – someone whose access to care came down to whether a benefit got verified right or a denial got appealed hard enough. That’s what this company actually is."

And as the first female CEO in her investor’s portfolio, Burke is conscious that the impact she hopes to leave extends beyond behavioral healthcare.

"I don’t take lightly what it means for the next person watching – the next woman or the next person who’s been through something hard and wants to build from it rather than hide it," she reflects.

"If Hansei’s next 10 years do what I believe they can, I want the legacy to be simple. The door is open wider for the people coming behind us than it was for us."