Global Healthcare RCM Provider Reduces Cloud Costs by 27%, Saving $491,000 Annually

About the client

Our client is a global healthcare Revenue Cycle Management (RCM) and medical billing provider, headquartered in the United States with operations across North America, Europe, India, Africa and the Middle East. The company serves physician practices, anesthesiology groups, labs and pathology providers, behavioral health organizations, EMS agencies, hospitals, and surgery centers. Its business applications and virtual desktop estate run across Azure, AWS and Oracle Cloud Infrastructure (OCI), supporting billing and RCM teams around the clock.

Business challenges

As the client expanded across regions and added clouds, its estate grew to 100+ subscriptions and accounts and 2,272 resources spread across US-East, US-West and Central India. Each cloud was managed in isolation, with its own tools, owners, and reporting. Cloud spend kept rising and limited visibility affected budgeting, accountability, forecasting, or optimization speed, but no one could say with confidence which services, teams or applications were driving it.

The client partnered with Aspire Systems to address the following challenges:

• No unified view of multi-cloud spend Cost data sat in separate consoles for Azure, AWS and OCI. Without a single inventory or cost lineage, finance and engineering teams could not trace spend back to services or business owners, and optimization decisions were made on partial information.
• Idle and oversized resources Unused VMs, unattached disks, stale snapshots, orphaned load balancers and underused Kubernetes capacity accumulated across subscriptions. Many workloads, including Azure Virtual Desktop (AVD) session hosts, ran on VM sizes well beyond what their usage required.
• An inefficient virtual desktop estate The AVD host pools used depth-first load balancing, which filled hosts one at a time and kept far more session hosts running than the user load needed. Because these desktops support live billing operations, any change created a real risk of disrupting users.
• Weak cost governance Inconsistent tagging made chargeback impossible; storage sat in hot tiers regardless of access patterns, and there was no roadmap for Reserved Instances or Savings Plans. Cleanup efforts were one-off exercises with no operating model to sustain them.