Bain & Company and KLAS Research Report Finds Healthcare AI Focus Shifting to ROI and Workflow Efficiency

A new study by Bain & Company and KLAS Research finds that U.S. healthcare providers and payers are accelerating AI investments aimed at improving profitability and operational efficiency. The 2025 Healthcare IT Spending study surveyed 228 executives, revealing that 70% of providers and 80% of payers now have an AI strategy in place or in development, up from 60% last year.

Among providers, revenue cycle management (RCM) has regained priority, driven by its potential for measurable ROI through improved documentation, coding, and claim accuracy. Common RCM AI applications include ambient and clinical documentation improvement, coding automation, and prior authorization. About one in five providers have fully rolled out ambient documentation tools, while another two in five are in pilot stages.

Payers are concentrating on AI for care coordination, utilization management, and network optimization. These efforts target cost control through automation of prior authorization, enhanced care management workflows, and analytics for provider performance and plan design. Spending on value-based care applications, especially those supporting risk and quality management, is expected to grow faster than other IT categories over the next three years.

Both providers and payers report positive early outcomes from AI deployments, with fewer than 5% of providers indicating unmet expectations. Payers are also seeing promising results, particularly in contact centers and member engagement, where generative AI is enabling greater personalization and operational scale.