Artificial intelligence is being deployed among most surveyed health systems, though less than a fifth reported having fleshed out internal governance and a strategy around the technology, according to a recent report from the Healthcare Financial Management Association (HFMA).
The 18% of health systems that reported having mature AI programs tended to be large, and three-quarters reported annual net patient revenue of more than $1 billion. Still, only half said they had sufficient resources in place for implementing AI tools at their organizations.
On the other hand, the survey—conducted with healthcare strategy and market research firm Eliciting Insights among HFMA members during the second quarter of 2025—reflected a growing acknowledgement of the need of governance. Seventy percent of surveyed health system chief financial respondents said they had any type of AI governance process in place, as opposed to 41% who indicated the same in 2024.
“Internal governance and thoughtful AI strategy are critical for health systems to safely and effectively leverage AI,” the report reads.
“Health systems must consider strategic questions such as whether (or not) and how to share patient data, if the approach to AI will be enterprise-wide or custom to each functional area, how to identify opportunities for AI and how to source and vet vendors. Health systems must also ensure that resources are in place to execute on any internal strategies related to AI, such as the skills to identify opportunities for AI, source vendors, implement solutions and evaluate long-term returns on investment (ROI).”
Governance groups that are in place were often characterized as responsible for determining AI data policy at the health system, vetting vendors with AI capabilities and identifying AI vendors for internal initiatives, according to the survey. At the same time, more than a third of health systems with current investments in AI report having no formal data policy for AI use in place.
Eighty percent of the 233 health system respondents said they had automation tools in at least a pilot stage, and 71% indicated the same for AI tools. Just under half said they had an automation tool fully deployed, as did 36% in regard to AI. Eighty-eight percent said they used AI “in some form,” with internal tools such as Chat GPT, AI transcriptions or chatbots often cited.
Cost reduction was the most frequently cited rationale for AI investments, though only 39% of polled chief financial officers saying they believed the investments would result in an overall cost reduction.
Costs and lack of resources were also the top barriers to AI adoption cited by respondents, and more than 80% said they didn’t have the resources to identify, select and implement AI solutions at their organization.
CFOs and chief information officers were often described as leading decision-makers when weighing a vendor’s AI offerings, according to the survey. Three-quarters of the respondents said their system would prefer to work with vendors integrated with their current electronic health record system, with another 11% responding that they have no plans to invest in AI until a solution becomes available through their EHR.
Almost 80% said that one of their existing vendors, or an AI company partnered with an existing vendor, would have a leg up in winning an AI pilot, and nearly as many indicated greater comfort sharing data with an existing vendor.
Digital health investors have bet big on AI-enabled startups and providers’ growing adoption of AI tools. AI-enabled startups have captured 62% of all venture capital digital health dollars, or nearly $4 billion, during the first six months of 2025 alone. Additionally, development and adoption of the AI within healthcare and beyond are among the chief goals of the White House, which released an AI Action Plan just a few weeks back outlining steps to promote the technology.