AI vendors bet on guaranteed ROI as competition with Epic intensifies

Editor's Note

Startups selling artificial intelligence (AI) tools to hospitals are putting money on the line, offering guaranteed returns in a bid to win business from Epic and other entrenched vendors, Modern Healthcare September 16 reports. Several AI companies are reportedly restructuring their pricing strategies to reassure buyers and prove value in a market where health systems struggle to quantify return on investment (ROI).

Epic recently expanded its AI offerings for patients, providers, and revenue cycle operations, signaling it intends to dominate the space. In response, startups like Vital Software are rolling out bold guarantees. Vital, which designs AI tools that communicate with patients during hospital visits, promises buyers a return of at least $1 million depending on system size, or else the product is free. CEO Aaron Patzer, who previously founded Mint.com, said the tool helps reduce readmissions and patients leaving without treatment by guiding them through test results, encounters, and discharge instructions. The guarantee excludes rural hospitals or systems outside competitive markets, and while discussions with potential buyers are underway, deals are not yet finalized.

The push comes amid widespread uncertainty around measuring AI’s financial impact. Only 23% of health systems that report achieving ROI from AI can quantify it, the outlet noted. That gap leaves startups under pressure to prove savings. Penguin ai, led by former Kaiser Permanente chief data officer Fawad Butt, is offering its platform for free if it fails to deliver measurable ROI within 120 days. The company’s tools support both payers and providers with tasks such as prior authorization, risk adjustment, coding, and claims scrubbing. Butt said financial assurances help build trust with large health systems wary of smaller vendors.

Other companies are applying the same strategy to different niches. Carta Healthcare uses AI to automate clinical data abstraction, a labor-heavy process typically handled by clinicians. The company charges only after a hospital realizes savings, with no upfront fees. Vice President Greg Miller said the pay-on-results model avoids lengthy budget approvals and appeals to health systems stretched by staffing challenges.

According to the article, these approaches reflect how vendors are attempting to compete not only on technology but also on risk-sharing. With Epic’s scale and reputation, startups see financial guarantees as a way to open doors and demonstrate confidence in their products.