Wednesday, October 15, 2025

Healthcare AI investment focused on profit margins, ROI: report

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Dive Brief:

  • Healthcare organizations are doubling down on adoption of artificial intelligence tools, particularly products most likely to improve profit margins and demonstrate clear return on investment, according to a report published Thursday by Klas Research and Bain & Company. 
  • For example, the four most common AI use cases among providers — ambient notetaking, clinical documentation improvement, coding and prior authorization — include revenue cycle management functions, the survey found. 
  • But so far, many provider executives say it’s too early to assess precise financial returns. Still, fewer than 5% of survey respondents said AI hasn’t met expectations in areas where the technology had been implemented. 

Dive Insight: 

Healthcare organizations are looking at AI tools that could boost profit margins as providers and payers navigate an increasingly challenging financial landscape, according to the Klas and Bain report, which surveyed nearly 230 industry executives.

Many providers still face workforce challenges that worsened during the COVID-19 pandemic, while bracing for a heightened number of uninsured patients due to Medicaid cuts and the expiration of more generous financial assistance for the Affordable Care Act exchanges.

Meanwhile, insurers have been managing a dogged increase in utilization, particularly in Medicare Advantage, and could face a financial hit from policy turbulence in their Medicaid and ACA plans. 

“Executives want quickly scalable solutions that address key business challenges and pay for themselves with tangible results and short time-to-value windows,” Aaron Feinberg, partner in Bain & Company’s healthcare and life sciences and private equity practice, said in a statement. “This is all about the bottom line now.”

Meanwhile, healthcare organizations are moving from exploring AI products to focused implementation. The report found 70% of providers and 80% of payers had an AI strategy in place or in development, up from 60% for both groups in last year’s survey. 

Among providers, nearly half of executives surveyed said revenue cycle management was a top three IT investment priority — an area that could be ripe for AI use, given the repetitive and rules-based work, Klas and Bain wrote. 

AI documentation tools represent the most common use case for the technology, with about 1 in 5 providers fully implementing these products and another 2 in 5 piloting notetaking assistants.

For payers, nearly 60% of leaders cited care coordination and utilization management as one of their top IT priorities. That includes plans to improve care management workflows and data analytics to close care gaps as well as automating prior authorization processes — a major pain point for providers who say the requests take too much time and delay care. 

So far, insurers have largely implemented AI in call center operations and member follow-up and engagement, according to the report. 

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