Carlos Hernandez, Partner, RSM US LLP

Invest: sat down with Carlos Hernandez, partner at RSM US LLP, to discuss what’s next for South Florida’s middle market, from healthcare consolidation and private equity activity to the operational pressure reshaping hospital systems. Hernandez also outlined how RSM is investing in technology and expanding its global reach as clients scale across borders. “The three aspects that our firm will continue to strive for are being digital, being compelling, and being global,” said Hernandez.

What unique opportunities does the South Florida market present for RSM’s middle market clients, particularly in industries like healthcare, real estate, or construction?

The middle market is poised for significant growth in 2026, especially through mergers and acquisitions. We are anticipating the federal government to pick back up and cut rates throughout the year, which will also enhance private equity activity. Private equity firms have been sitting on the sidelines with a lot of what’s called dry powder, and now we’re starting to see them deploy that dry powder and start to make deals.

Healthcare continues to be one of private equity’s strongest long-term interests. Their model is often to acquire individual physician practices, dental practices, or urgent care centers, then integrate them to create scale, efficiencies, and stronger platforms. 

We anticipate even more of this activity in 2026 as economic conditions strengthen, especially in South Florida, where private equity is highly active. This momentum is exciting because we know they’re going to need us across a range of services, from tax consulting to audit, due diligence, valuation, and consulting services that support mergers and acquisitions. It also connects to HR and payroll needs as organizations integrate and scale. We’re excited about what 2026 will bring.

How does RSM leverage its global network to help South Florida businesses expand or strengthen their international footprint?

We are merging with RSM UK and Ireland, which increases our combined firm from $4 billion to $5 billion essentially overnight. We’re thrilled to welcome those partners and collaborate even more closely across borders.

We also maintain strong relationships with network firms in Mexico, Colombia, and throughout South America. This matters deeply to our clients in South Florida, where cross-border business is the norm. Even though we specialize in the middle market, today’s middle market companies are global. Strengthening these global connections allows us to support clients wherever they operate. South Florida businesses move fluidly between countries, and they need advisors who can keep pace with that reality.

As a firm with a strong focus on innovation, how is RSM using technology to address challenges faced by businesses in South Florida?

In 2025, we announced a $1 billion investment in AI as part of our journey to becoming a digital firm. That transformation is being led by Miami-based partner Sergio de la Fay, who is doing an outstanding job driving our digital strategy forward.

Technology is fundamentally reshaping our profession. We need to be digital, and we need to take advantage of our AI platforms. I’m 51, and when I compare myself to colleagues who are 25 or 26, how they use technology today is different. The profession has changed, and it will continue to change.

AI allows us to shift from time‑intensive analysis and calculations to more strategic, client‑focused conversations. This enables us to deliver insights faster, be more proactive, and show up with meaningful perspective when decisions need to be made.

Miami has become a magnet for tech startups and venture capital investment. How is RSM supporting these startups, and what services are most in demand?

One of the best things about our country is the capitalistic society we live in, and one of the best parts about Miami is the entrepreneurial spirit. People here want to build, innovate, and take risks, and that energy aligns perfectly with our own culture at RSM.

As new ventures come up in Miami, it gets us excited because we’re able to help in many ways. For startups, cash flow projections are among the most critical services we deliver. Growing companies need clear visibility to raise capital, manage risk, and plan effectively. We also help implement technology and ERP systems, which are essential as companies scale.

The healthcare sector is a major driver of the South Florida economy. What trends is RSM seeing in this industry, and what are clients asking for?

Hospitals and health systems continue to look for efficiencies in their operating model. Unfortunately, they continue to be challenged with reduced payments from insurance payers or the federal government. As Medicare and Medicaid look to cut reimbursements, hospitals have no choice but to look at their processes and find ways to be more effective and efficient.

Technology, especially AI, is becoming essential not only for patient care but for operations. We’re seeing investments in everything from patient registration and bed management to billing, finance, and payroll. These tools help organizations deliver on their community mission while maintaining sustainable margins. What I’ve seen AI do with patient care is the coolest thing that you’ll ever see.

I see health systems continuing to invest in technology because they need to look for ways to deliver on their mission, serving the community and prioritizing patient care, while also being sustainable through their margin and operations. It’s an important time in healthcare and in the country because of the changes that are occurring.

And when reimbursement tightens, it creates real pressure. If the government cuts Medicaid patients or doesn’t increase Medicare reimbursement in a way that matches inflation, you may have fewer insured people in the community, but that doesn’t mean there are fewer sick people. Hospitals still have to take care of patients, especially through the emergency room, so they have to navigate that challenge carefully.

What do you see as the most significant trends shaping the future of South Florida’s business landscape over the next few years?

South Florida continues to attract new residents—from New York and New Jersey, as well as from across Latin America, including Nicaragua, Cuba, and Colombia. People are drawn here not just for the climate, but for the opportunity. The talent coming into Miami is motivated and skilled, and they bring diverse expertise to the region. The city’s appeal isn’t going away. Its culture, beauty, and vibrancy remain its biggest advantages. As the region grows, our firm is focused on investing in our people and expanding our local presence. We want to ensure we have the technical capabilities and capacity to serve clients as demand increases.

What are your top priorities for RSM going forward? 

The three aspects that our firm will continue to strive for are being digital, being compelling, and being global.

RSM will continue our voyage through being digital. Digital is key. We’re going to continue to implement technology and invest in technology.

Next is being compelling. We must show up with innovative solutions and think creatively alongside our clients.

The last piece is being global. We will continue to be global and invest globally. We will continue to work to be experts in what’s going on outside of Miami because Miami’s going to be the center of doing business globally.