Providers and payers are willing to experiment with technology such as generative artificial intelligence — but they still want to get their money's worth.
According to a survey of 100 providers and 50 insurance companies released Tuesday from consulting firm Bain & Company and market research firm KLAS, healthcare organizations boosted their information technology spending after the peak of the COVID-19 pandemic. Many respondents said they planned to continue ramping up their investments with an eye toward returns.
Related: How 3 health systems decide when to buy or build AI
Payers were included in the survey for the first time, with responding organizations in both groups representing a range of sizes and geographic footprints. Here are five key takeaways.
1. Views on AI are evolving
According to the survey, adoption of AI tools — including generative technology — has accelerated, though barriers to broader implementation persist.
About 15% of providers surveyed said they had an AI strategy this year, compared with 5% in 2023, while roughly a quarter of payers said they do. The majority of both respondent groups said they're optimistic about generative AI implementation in their companies.
An uncertain regulatory and legal landscape presents hurdles to broader use, however, as the industry attempts to establish guidelines without a clear path forward. About 40% of providers and payers cited regulatory and legal considerations among the top barriers keeping them from implementing generative AI tools. Cost and accuracy were also frequently mentioned.
2. Change Healthcare incident was a wake-up call
The February cyberattack on UnitedHealth Group subsidiary Change Healthcare drove many organizations to ramp up spending on cybersecurity.
About 70% of survey respondents said they were directly affected by the incident, which disrupted processes throughout the healthcare industry for months. Many said they are funneling more resources toward cybersecurity, including by strengthening redundancy efforts and auditing internal systems and third-party vendors. More than half of payers and nearly 40% of providers said they've responded to the incident by increasing their investments in cybersecurity software.
Only 11% of providers and 8% of payers reported not taking action.
3. Providers are prioritizing infrastructure
Surveyed providers rated IT infrastructure and services, including cybersecurity, among their top priorities regarding technology and software investment. Other major focuses included clinical workforce optimization, data platforms and interoperability, and revenue cycle management.
Provider organizations are taking a multi-pronged approach as they move forward, said Eric Berger, partner at Bain & Company and a co-author of the report accompanying the survey results.
“We continue to see this fragmentation," he said.
4. Payers want utilization management
When it comes to spending, payer organizations are prioritizing care coordination and utilization management, claims processing and payments, and quality management and risk adjustment.
In Berger's view, the results speak to how members can affect insurance companies' bottom line.
5. Cost, EHR integration rank among top pain points for providers
Nearly half of providers cited cost as one of their top IT pain points, while 42% pointed to integration with the electronic health record.
According to Berger, some organizations favor EHR integration over other capabilities when it comes to selecting technologies.
“That's the tension we see, and we don't see that tension getting any better,” Berger said.
Dated legacy technology was a key problem for about two-thirds of payer respondents.
Correction: An earlier version of this article incorrectly listed Bain & Company as the sole survey author.
