R1 RCM 10-Q 2012 Q3 Quarterly report

Exhibit 32.1

Certification of Chief Executive Officer pursuant to 18 U.S.C. Section 1350, as adopted

pursuant to Section 906 of the Sarbanes-Oxley Act of 2002

In connection with this Quarterly Report on Form 10-Q of Accretive Health, Inc. (the “Company”) for the period ended September 30, 2012 (the “Report”), the undersigned, Mary A. Tolan, Director, Founder, President and Chief Executive Officer of the Company, hereby certifies, pursuant to 18 U.S.C. Section 1350, that, to her knowledge:

(1) the Report fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2) the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company.

Date: November 8, 2012

/s/  Mary A. Tolan

Mary A. Tolan

Director, Founder, President and Chief Executive Officer