• Bain/KLAS's survey of 303 US healthcare executives finds tech investment is on the rise even amid industry headwinds
• Around 95% of both providers and payers place software and digital technology among their top five strategic priorities
• AI advances are strengthening incumbent moats despite investor concerns that AI could lower barriers to entry
• AI investment returns are now critical: the most common hurdle for both payers and providers with formal return thresholds is a return of 3.0 to 3.9 times their original investment

NEW YORK, Sept. 23, 2026 /PRNewswire/ -- US healthcare providers and payers will continue to invest heavily in healthcare IT amid operating headwinds and investor fears of a software "SaaSpocalypse," a new study from Bain & Company and KLAS Research reveals today.

Bain/KLAS's annual survey of 303 US healthcare executives finds that nearly 95% of providers and payers alike rank software and digital technology among their top five strategic priorities, and most expect to increase spending. For the first time, this year's survey includes independent physician groups (ambulatory providers) as a distinct population alongside health systems (acute providers) and payers, offering a fuller picture of where healthcare IT dollars are flowing.

The bar for investment, particularly on AI, has risen as executives now demand solutions tied to specific use cases with measurable returns and short time to value, rather than broad exploratory bets. Among providers and payers that have formal return thresholds, the most common hurdle is a return of 3.0 to 3.9 times the original investment.

Meanwhile, incumbent moats, particularly around electronic health record (EHR) platforms, are proving resilient despite investor concerns that AI would erode incumbents' advantages. Nearly 80% of acute provider organizations surveyed, for example, believe GenAI advances will increase their switching costs or have no impact.

"The 'core system' playbook is far from dead in healthcare: providers and payers alike tell us they are looking to focus their resources on a small number of strategic platforms," said Aaron Feinberg, partner in Bain & Company's Healthcare & Life Sciences and Private Equity practice. "AI is reinforcing this trend, given its potential to automate manual workflows, and capturing that opportunity will be an important driver of vendor growth over the next few years."

"It is clear that technology is a solution to, not a casualty of, mounting margin pressures," said Adam Gale, CEO of KLAS Research. "But tangible, measurable outcomes are becoming increasingly important as providers and payers' AI strategies mature."

Where providers are investing

Revenue cycle management (RCM) remains a key spending priority for both provider types, ranking as a top-three priority for 43% of acute providers and 64% of ambulatory providers. Providers are investing in RCM to stay apace with payers as they further automate processes, and they are accordingly focusing on denial management and clinical documentation improvement.

Beyond RCM, provider investment priorities diverge. Health systems are focused on clinical workflow optimization, such as ambient documentation, clinical decision support, and patient flow and bed management. Ambulatory groups rank patient access and engagement as their single highest priority, reflecting how important scheduling, registration, and outreach are as revenue drivers.

Providers continue to prioritize EHR systems, with Epic users showing a strong preference for EHR-native solutions over third-party solutions. That preference is most pronounced in categories tightly coupled to clinical work, such as clinical workflow optimization and patient access, and less so in categories further from the clinical core, such as enterprise resource planning and governance, risk, and compliance, where third-party vendors have carved out space.

Where payers are investing

Member care coordination and utilization management remains a top payer investment priority for the third consecutive year, with 67% naming it a top-three priority in 2026, up from 57% in 2025. Member/care navigation (54%) and claims processing (53%) are close behind. The January 2027 deadline for CMS interoperability and prior authorization requirements (CMS-0057-F) is adding regulatory urgency to an already strong ROI case for payers.

Overall, payers are focusing on total cost of ownership when choosing technology solutions and vendors, favoring categories with near-term financial returns. They are targeting cost opportunities in people-heavy workflows that they can further automate via AI, for example in member navigation and claims processing.

Unlike providers, payers show less allegiance to any single software platform. Only about 15% consider themselves "CAPS-first" (built around their core administrative processing system), though this varies by plan size, with regional plans more likely to default to their CAPS vendor's broader suite.

The AI outlook

For both providers and payers, AI adoption continues to move away from experimentation and towards use cases with tangible returns.

Providers list ambient documentation, chart summarization, and clinical documentation improvement as their leading AI use cases today. The share of providers with an established AI strategy has nearly doubled over the past two years, and about 80% of payers now have an AI strategy in place or in development. About 75% of providers describe themselves as optimistic or highly optimistic about AI's potential.

Among payers, AI investment has been concentrated in people-intensive workflows, with call center operations showing the strongest traction. Over 60% of payers report AI pilots or full rollout in call center operations, and about 60% say those investments are meeting or exceeding ROI expectations. Care gap analysis is emerging as another AI use case.

Still, cost and accuracy remain the primary barriers to scaling AI further, though attitudes are changing. After two years in which AI experimentation was encouraged as a board-level imperative, rising AI token spend is forcing a harder look at returns. Meanwhile, signs of a détente in the payer-provider "arms race" are emerging, with clinical data exchange now advancing, especially regarding eligibility verification and prior authorization.

Media contacts:
Mike Simon (New York) —mike.simon@bain.com
Ann Lee (Singapore) — ann.lee@bain.com
Gary Duncan (London) — gary.duncan@bain.com

About Bain & Company

Bain & Company works with leaders worldwide to solve their toughest challenges and deliver enduring results. Since 1973, we've partnered with clients, including private equity and portfolio companies, to build the capabilities they need to stay ahead of change and help them redefine their industries. We measure our success by our clients' success, and we proudly hold the highest levels of client advocacy in our field.
Bain is consistently recognized globally as one of the best places to work. We operate as one global team, uniting strategists, industry and functional experts, technologists, and advisors with a vibrant ecosystem of technology partners.

Notes to Editors

Bain & Company was founded in 1973 and today has 19,000 employees across 67 cities in 40 countries. We have worked with more than two-thirds of the Global 500 and more than 9,000 companies worldwide. Bain has pledged to deliver $2 billion in pro bono consulting to nonprofit, public-sector and charitable organizations by 2035. The firm is consistently recognized as a Leader in major analyst rankings across multiple areas, including digital business, innovation, strategy, experience design, customer experience, and carbon-zero transformation.

About KLAS

KLAS is a research and insights firm on a global mission to improve healthcare delivery by amplifying the provider's voice. Working with thousands of healthcare professionals and clinicians, KLAS gathers data and insights on software, services, and medical equipment to deliver timely reports, trends and statistical overviews. The research directly represents the provider voice and acts as a catalyst for improving vendor performance. Learn more at klasresearch.com.

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