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For the full research report in conjunction with Bessemer Venture Partners, see “The 2026 Healthcare AI ROI Scorecard” on bvp.com. The AI payoff in healthcare has arrived: Executives are seeing 3.5 times ROI, on average, in half the time they expected. The gains aren’t spread evenly across use cases, however. Administrative work is making the most progress, particularly with providers and payers. Pharma’s earliest wins are preclinical, and clinical applications still need to advance in adoption and trust. Bain & Company and Bessemer Venture Partners surveyed 226 executives across payers, providers, and pharma on 65 AI use cases to expand our Healthcare AI Adoption Index to include ROI. The results illustrate an industry that has moved past proofs of concept into pilots and scaled deployment, revealing which use cases are returning value fastest, where buyers are placing their bets, and where the largest opportunities still sit unclaimed. Written in collaboration withWritten in collaboration with
Healthcare is moving to scaled deploymentOver the past year, proof-of-concept and ideation work have moved into active pilots at a real clip, especially for providers and pharma (see Figure 1). Payers still have more use cases in the ideation stage, with fewer scaled proofs of concept.
Figure 1
Although healthcare companies are picking winners and scaling pilots, full implementation and production remain a challenge. Executives expect more than half of next year’s incremental AI investment to go toward deployment rather than discovery, allocating 35% of spending to scaling proven use cases and 20% to integrating them into existing workflows. The ROI is already hereBuyers projected 24 months to ROI. On average, they got there in 12. Furthermore, for around 40% of use cases, ROI exceeded expectations in 2026. To track the evolution of AI adoption, we built the ROI Scorecard, plotting each use case on adoption against realized ROI for payers, providers, and pharma (see Figure 2).
Figure 2
Notes: Adoption score is weighted average of companies’ development stage where 0% is not yet started and 80% is implementation or full roll-out Source: Bain and Bessemer Generative AI Survey 2026 (n=226)For payers and providers, value is concentrated in administrative work. Providers lead in adoption and ROI, with revenue cycle management as the top area. They report realizing four times the projected ROI, with 67% of solutions already running as semi- or fully autonomous agents. Pharma lags payers and providers, mostly because multi-year drug development timelines make it difficult to attribute ROI this early. The greatest gains have been in preclinical discovery, achieving an average 3.4 times projected ROI. Clinical AI remains a major open question. Only 4% of provider clinical solutions run as semi- or fully autonomous agents, and clinical returns are among the lowest of our findings. That’s not to say clinical development AI is low on value—in fact, it could help reduce the $3 trillion delivery of care cost, which is growing at roughly 5% year-over-year against a shrinking clinical workforce. But trust in clinical judgment, unresolved liability questions, regulatory uncertainty, and the fee-for-service payment model mean that it will take far longer to prove out than administrative use cases. Buyers are consolidating toward best-of-platformHealthcare buyers are pivoting away from internally built AI tools, particularly within providers. Organizations report that half or fewer are still in active use. An internal team can produce a working MVP easily and quickly, but few can reliably operate, monitor, or update it at scale. The share of internal generative AI solutions has fallen drastically, from 42% to 26% (see Figure 3). Healthcare-specific AI vendors and large healthcare information technology (HCIT) vendors have been the biggest winners in this shift.
Figure 3
Notes: Bar totals may not equal 100% due to rounding; internal includes fully internal and proprietary LLMs as well as foundational models with internal builds and systems integrator or consulting support; healthcare-specific AI vendor includes third-party startups and scaled vendors; large HCIT includes vendors that organizations already have in place and systems of record; AI labs or platform include foundation model providers Source: Bain and Bessemer Generative AI Survey 2026 (n=226)Today’s buyers also want fewer, deeper relationships. Across sectors, 42% say they are consolidating vendors to simplify their stacks and cut costs, and 60% have named a primary foundation-model provider. As they make their bets, buyers are looking for trusted partners that can solve their biggest, most niche problems. There’s still money on the tableEven as AI ROI exceeds expectations, the biggest opportunities are still ahead. In the near term, leading companies will focus on squeezing more value from the areas where they’ve already gained: administrative work and preclinical workflows. The back-office returns are real, but no one has touched the largest prize yet. Roughly $1 trillion is spent on healthcare administration each year, with an estimated $260 billion of that considered waste. That’s the cost of payers and providers each staffing and litigating the exact same disputes on both sides of the table. AI has moved the fastest here, but it hasn’t resolved the underlying issue. Prior authorization and utilization management still run as mirrored workflows on either side of the same dispute, just faster and slightly cheaper. The real opportunity lies in aligned incentives and real-time payments. Pharma can also squeeze more value from the AI use cases that are already working. The US spends $500 billion a year on drugs and therapeutics, and pharma spends $150 billion a year on R&D. AI’s biggest returns so far have been at the front of that pipeline, in preclinical workflows, which capture 25% of R&D spending. The larger prize of raising clinical trial success rates and widening patient access will take longer, given the multi-year regulatory and clinical timeline. The healthcare executive agenda for 2027In the next year, winning healthcare executives will invest in key infrastructure, including evaluations, performance monitoring, guardrails, and agent orchestration. That builds trust within the organization, with customers, and with regulators. Organizations that build this will scale beyond pilots faster, in both administrative and clinical use cases.
About Bessemer Venture PartnersBessemer Venture Partners helps entrepreneurs lay strong foundations to build and forge long-standing companies. With more than 145 IPOs and 300 portfolio companies in the enterprise, consumer and healthcare spaces, Bessemer supports founders and CEOs from their early days through every stage of growth. Bessemer’s global portfolio has included Pinterest, Shopify, Twilio, Yelp, LinkedIn, PagerDuty, DocuSign, Wix, Fiverr, and Toast and has more than $18 billion of assets under management. Bessemer has teams of investors and partners located in Tel Aviv, Silicon Valley, San Francisco, New York, London, Hong Kong, Boston, and Bangalore. Born from innovations in steel more than a century ago, Bessemer’s storied history has afforded its partners the opportunity to celebrate and scrutinize its best investment decisions and also learn from its mistakes. |
