US healthcare providers and payers expect to keep investing in healthcare IT despite operating headwinds and investor fears of a software "SaaSpocalypse," according to a survey of 303 US healthcare executives by Bain & Company and KLAS Research. Nearly 95% of providers and payers place software and digital technology among their top five strategic priorities, and most expect to increase spending, the two firms said.
For the first time the annual survey counts independent physician groups, or ambulatory providers, as a separate population alongside health systems, or acute providers, and payers, which the firms said gives a broader view of where healthcare IT money goes. The bar for investment has risen, particularly on AI: executives now want solutions tied to specific use cases with measurable returns and short time to value rather than broad exploratory bets. Among providers and payers that set formal return thresholds, the most common hurdle is a return of 3.0 to 3.9 times the original investment.
Incumbent positions, particularly around electronic health record platforms, have proved resilient despite investor concerns that AI would erode incumbents' advantages. Nearly 80% of the acute provider organisations surveyed said advances in generative AI would raise their switching costs or have no effect. Aaron Feinberg, a partner in Bain & Company's healthcare and private equity practice, said providers and payers are looking to concentrate resources on a small number of strategic platforms, and that AI is reinforcing that trend through its potential to automate manual workflows.
Revenue cycle management ranks as a top-three priority for 43% of acute providers and 64% of ambulatory providers. Beyond it, priorities diverge: health systems are focused on clinical workflow optimisation such as ambient documentation, clinical decision support and patient flow, while ambulatory groups put patient access and engagement first. For payers, member care coordination and utilisation management is the leading priority for a third consecutive year, named by 67% as a top-three priority for 2026, up from 57% in 2025, followed by member and care navigation at 54% and claims processing at 53%. The January 2027 deadline for CMS interoperability and prior authorisation requirements adds regulatory urgency. About 15% of payers describe themselves as built around their core administrative processing system, though regional plans are more likely to default to their CAPS vendor's wider suite.
Providers name ambient documentation, chart summarisation and clinical documentation improvement as their leading AI uses today, and the share with an established AI strategy has nearly doubled over two years. About 80% of payers have a strategy in place or in development, and roughly 75% of providers describe themselves as optimistic or highly optimistic about AI. More than 60% of payers report AI pilots or full rollouts in call centre operations, with about 60% saying those investments meet or exceed ROI expectations. Cost and accuracy remain the main barriers to scaling AI further. Adam Gale, chief executive of KLAS Research, said technology was a solution to margin pressures rather than a casualty of them, and that tangible, measurable outcomes were becoming more important as AI strategies mature.
