Exhibit 99.1

R1 RCM Reports First Quarter 2019 Results

CHICAGO - May 9, 2019 - R1 RCM Inc. (NASDAQ: RCM), a leading provider of technology-enabled revenue cycle management services to healthcare providers, today announced results for the three months ended March 31, 2019.

First Quarter 2019 Results:

• Revenue of $275.9 million, up $128.6 million and 87.3% compared to the same period last year

• GAAP net income of $0.2 million, compared to net loss of $23.3 million in the same period last year

• Adjusted EBITDA of $33.4 million, up $33.1 million compared to the same period last year

“Our first quarter results reflect continued excellent execution by our team,” said Joe Flanagan, President and Chief Executive Officer of R1. “We remain focused on delivering high-quality results for our customers and continue to be encouraged by market demand for all three of our go-to-market models.”

“I’m pleased with the results our team delivered in the first quarter. Given this strong start to the year, we have increased confidence in delivering on our 2019 goals,” added Chris Ricaurte, Chief Financial Officer and Treasurer of R1.

2019 Outlook

For 2019, R1 expects to generate:

• Revenue of between $1,150 million and $1,250 million

• GAAP operating income of $50 million to $80 million

• Adjusted EBITDA of $145 to $165 million

Conference Call and Webcast Details

R1’s management team will host a conference call today at 8:00 a.m. Eastern Time to discuss its financial results and business outlook. To participate, please dial 866-393-4306 (734-385-2616 outside the U.S. and Canada) using conference code number 3048987. A live webcast and replay of the call will be available at the Investor Relations section of the Company’s web site at ir.r1rcm.com.

Non-GAAP Financial Measures

In order to provide a more comprehensive understanding of the information used by R1’s management team in financial and operational decision making, the Company supplements its GAAP consolidated financial statements with certain non-GAAP financial performance measures, including adjusted EBITDA and net debt. Adjusted EBITDA is defined as GAAP net income before net interest income/expense, income tax provision, depreciation and amortization expense, share-based compensation expense, acquisition-related costs, transitioned employee restructuring expense, digital transformation office expenses, and certain other items. Net debt is defined as debt less cash and cash equivalents, inclusive of restricted cash.

Our board of directors and management team use adjusted EBITDA as (i) one of the primary methods for planning and forecasting overall expectations and for evaluating actual results against such expectations and (ii) a performance evaluation metric in determining achievement of certain executive incentive compensation programs, as well as for incentive compensation programs for employees.

Table 4 presents a reconciliation of GAAP net income to non-GAAP adjusted EBITDA. Table 8 presents a reconciliation of GAAP operating income guidance to non-GAAP adjusted EBITDA guidance. Adjusted EBITDA should be considered in addition to, but not as a substitute for, the information prepared in accordance with GAAP.

Forward Looking Statements

This press release includes information that may constitute “forward-looking statements,” made pursuant to the safe harbor provisions of the Private Securities Litigation Reform Act of 1995. Forward-looking statements relate to future, not past, events and often address our expected future growth, plans and performance or forecasts. These forward-looking statements are often identified by the use of words such as “anticipate,” “believe,” “designed,” “estimate,” “expect,” “forecast,” “intend,” “may,” “plan,” “predict,” “project,” “target,” “will,” or “would,” and similar expressions or variations, although not all forward-looking statements contain these identifying words. Such forward-looking statements are based on management’s current expectations about future events as of the date hereof and involve many risks and uncertainties that could cause our actual results to differ materially from those expressed or implied in our forward-looking statements. Subsequent events and developments, including actual results or changes in our assumptions, may cause our views to change. We do not undertake to update our forward-looking statements except to the extent required by

applicable law. Readers are cautioned not to place undue reliance on such forward-looking statements. All forward-looking statements included herein are expressly qualified in their entirety by these cautionary statements. Our actual results and outcomes could differ materially from those included in these forward-looking statements as a result of various factors, including, but not limited to, the expected timing of onboarding new business deployment, our ability to integrate the Intermedix business as planned and to realize the expected benefits from the acquisition, our ability to successfully deliver on our commitments to Intermountain and Ascension, fluctuations in our results of operations and cash flows, and the factors discussed under the heading “Risk Factors” in our annual report on Form 10-K for the year ended December 31, 2018 and any other periodic reports that the Company files with the Securities and Exchange Commission.

About R1 RCM

R1 is a leading provider of technology-enabled revenue cycle management services which transform a health system’s revenue cycle performance across settings of care. R1’s proven and scalable operating model, the R1 Performance Stack℠, seamlessly complements a healthcare organization’s infrastructure, quickly driving sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. To learn more, visit: r1rcm.com

Contact:

R1 RCM Inc.

Investor Relations:

Atif Rahim

312-324-5476

investorrelations@r1rcm.com

Media Relations:

Brenda Stewart

312-255-7786

media@r1rcm.com

Table 1
R1 RCM Inc.
Consolidated Balance Sheets
(In millions)
	(Unaudited)
	March 31,			December 31,
	2019			2018
Assets
Current assets:
Cash and cash equivalents	$	116.9		$	62.8
Current portion of restricted cash equivalents	0.4			1.8
Accounts receivable, net	40.8			42.2
Accounts receivable, net - related party	23.1			55.2
Prepaid expenses and other current assets	36.2			34.8
Total current assets	217.4			196.8
Property, equipment and software, net	103.8			95.2
Operating lease right-of-use assets	69.9			—
Intangible assets, net	175.2			180.5
Goodwill	253.2			254.8
Non-current deferred tax assets	63.2			57.5
Non-current portion of restricted cash equivalents	0.5			0.5
Other assets	24.6			22.2
Total assets	$	907.8		$	807.5
Liabilities
Current liabilities:
Accounts payable	$	13.5		$	9.9
Current portion of customer liabilities	11.2			14.7
Current portion of customer liabilities - related party	55.4			51.1
Accrued compensation and benefits	86.2			77.0
Current portion of operating lease liabilities	11.4			—
Current portion of long-term debt	2.7			2.7
Other accrued expenses	52.6			40.8
Total current liabilities	233.0			196.2
Non-current portion of customer liabilities	—			—
Non-current portion of customer liabilities - related party	18.7			17.7
Non-current portion of operating lease liabilities	74.8			—
Long-term debt	250.9			251.0
Long-term debt - related party	105.0			105.0
Other non-current liabilities	8.2			22.9
Total liabilities	690.6			592.8
Preferred Stock	213.4			208.4
Stockholders’ equity:
Common stock	1.2			1.2
Additional paid-in capital	360.9			361.0
Accumulated deficit	(289.6		)	(289.8		)
Accumulated other comprehensive loss	(2.8		)	(3.5		)
Treasury stock	(65.9		)	(62.6		)
Total stockholders’ equity	3.8			6.3
Total liabilities and stockholders’ equity	$	907.8		$	807.5

Table 2
R1 RCM Inc.
Consolidated Statements of Operations (Unaudited)
(In millions, except share and per share data)
	Three Months Ended March 31,
	2019			2018
Net operating fees	$	241.3		$	127.6
Incentive fees	12.2			8.0
Other	22.4			11.7
Net services revenue	275.9			147.3
Operating expenses:
Cost of services	237.2			138.7
Selling, general and administrative	22.5			17.0
Other expenses	8.8			2.4
Total operating expenses	268.5			158.1
Income (loss) from operations	7.4			(10.8		)
Net interest (expense) income	(10.2		)	0.2
Income (loss) before income tax provision (benefit)	(2.8		)	(10.6		)
Income tax provision (benefit)	(3.0		)	12.7
Net income (loss)	$	0.2		$	(23.3	)
Net income (loss) per common share:
Basic	$	(0.04	)	$	(0.26	)
Diluted	$	(0.04	)	$	(0.26	)
Weighted average shares used in calculating net income (loss) per common share:
Basic	109,802,632			105,831,571
Diluted	109,802,632			105,831,571

Table 3
R1 RCM Inc.
Consolidated Statements of Cash Flows (Unaudited)
(In millions)
	Three Months Ended March 31,
	2019			2018
Operating activities
Net income (loss)	$	0.2		$	(23.3	)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operations:
Depreciation and amortization	12.9			4.9
Amortization of debt issuance costs	0.6			—
Share-based compensation	4.4			3.9
Provision for doubtful receivables	1.0			—
Deferred income taxes	(4.1		)	12.3
Non-cash lease expense	2.7			—
Changes in operating assets and liabilities:
Accounts receivable and related party accounts receivable	33.0			(15.3		)
Prepaid expenses and other assets	(3.3		)	(1.3		)
Accounts payable	3.0			(1.4		)
Accrued compensation and benefits	9.1			(0.2		)
Lease liabilities	(2.7		)	—
Other liabilities	12.4			3.4
Customer liabilities and customer liabilities - related party	1.9			7.1
Net cash provided by (used in) operating activities	71.1			(9.9		)
Investing activities
Purchases of property, equipment, and software	(14.8		)	(3.4		)
Net cash used in investing activities	(14.8		)	(3.4		)
Financing activities
Repayment of senior secured debt	(0.7		)	—
Issuance of common stock and stock warrants, net of issuance costs	—			19.3
Exercise of vested stock options	0.4			0.2
Shares withheld for taxes	(3.3		)	(1.9		)
Finance lease payments	(0.2		)	—
Net cash provided by (used in) financing activities	(3.8		)	17.6
Effect of exchange rate changes in cash, cash equivalents and restricted cash	0.2			(0.2		)
Net increase in cash, cash equivalents and restricted cash	52.7			4.1
Cash, cash equivalents and restricted cash, at beginning of period	65.1			166.4
Cash, cash equivalents and restricted cash, at end of period	$	117.8		$	170.5

Table 4
R1 RCM Inc.
Reconciliation of GAAP net income to Non-GAAP adjusted EBITDA (Unaudited)
(In millions)
	Three Months Ended March 31,						2019 vs. 2018 Change
	2019			2018			Amount			%
Net income (loss)	$	0.2		$	(23.3	)	$	23.5		(101	)%
Net interest expense (income)	10.2			(0.2		)	10.4			n.m.
Income tax provision (benefit)	(3.0		)	12.7			(15.7		)	(124	)%
Depreciation and amortization expense	12.9			4.9			8.0			163	%
Share-based compensation expense	4.3			3.9			0.4			10	%
Other expenses	8.8			2.4			6.4			267	%
Adjusted EBITDA (non-GAAP)	$	33.4		$	0.3		$	33.1		n.m.

n.m. - not meaningful

Due to rounding, numbers presented in this table may not add up precisely to the totals provided.

Table 5
R1 RCM Inc.
Reconciliation of GAAP Cost of Services to Non-GAAP Cost of Services (Unaudited)
(In millions)
	Three Months Ended March 31,
	2019		2018
Cost of services	$	237.2	$	138.7
Less:
Share-based compensation expense	1.3		1.3
Depreciation and amortization expense	12.4		4.6
Non-GAAP cost of services	$	223.5	$	132.8

Table 6
R1 RCM Inc.
Reconciliation of GAAP Selling, General and Administrative to Non-GAAP Selling, General and Administrative (Unaudited)
(In millions)
	Three Months Ended March 31,
	2019		2018
Selling, general and administrative	$	22.5	$	17.0
Less:
Share-based compensation expense	3.0		2.6
Depreciation and amortization expense	0.5		0.3
Non-GAAP selling, general and administrative	$	19.0	$	14.1

Table 7
R1 RCM Inc.
Consolidated Non-GAAP Financial Information (Unaudited)
(In millions)
	Three Months Ended March 31,
	2019		2018
RCM services: net operating fees	$	241.3	$	127.6
RCM services: incentive fees	12.2		8.0
RCM services: other	22.4		11.7
Net services revenue	275.9		147.3
Operating expenses:
Cost of services (non-GAAP)	223.5		132.8
Selling, general and administrative (non-GAAP)	19.0		14.1
Sub-total	242.5		146.9
Adjusted EBITDA	$	33.4	$	0.3

Due to rounding, numbers presented in this table may not add up precisely to the totals provided.

Table 8
R1 RCM Inc.
Reconciliation of GAAP Operating Income Guidance to non-GAAP Adjusted EBITDA Guidance
(In millions)
	2019	2020
GAAP Operating Income Guidance	$50-80	$140-170
Plus:
Depreciation and amortization expense	$40-50	$40-50
Share-based compensation expense	$15-20	$15-20
Amortization of intangibles	$10-15	$10-15
Transaction expenses, severance and other costs	$15-20	$5-10
Adjusted EBITDA Guidance	$145-165	$235-260

Table 9
R1 RCM Inc.
Reconciliation of Net Debt (Unaudited)
(In millions)
	March 31,		December 31,
	2019		2018
Senior Term Loan	$	268.0	$	268.7
Notes (primarily with related parties)	110.0		110.0
	378.0		378.7
Less:
Cash and cash equivalents	116.9		62.8
Current portion of restricted cash	0.4		1.8
Non-current portion of restricted cash equivalents	0.5		0.5
Net Debt	$	260.2	$	313.6