For the past several years, health systems have largely been buyers in the AI market by licensing tools, onboarding platforms and integrating point solutions at a pace that would have seemed implausible a decade ago. But a new dynamic is emerging. As agentic AI moves from novelty to infrastructure, the economics of that buyer relationship are shifting and health system leaders are starting to plan accordingly.
At a panel discussion on care model transformation during the Becker’s 16th Annual Meeting, executives from Houston Methodist, CommonSpirit Health and Qventus outlined the forces reshaping how health systems acquire, build and retain AI capabilities.
Michelle Stansbury, associate chief innovation officer and vice president of applications at Houston Methodist, said vendors who priced aggressively to drive adoption are beginning to recognize the value they’ve created and are adjusting their models accordingly.
“A lot of vendors right now are bringing their AI solutions to you, which is a good thing. The current cost model, especially when you’re starting to use agents, will change,” Ms. Stansbury said. “They’re starting to see the value and they’re going to want to start charging more for those agents.”
Houston Methodist is already responding, doubling down on internal build capabilities to reduce exposure. Ms. Stansbury expects a similar directional shift she expects across the industry.
“There are some people that love what they do, but they don’t really want to engage with it that much, and those are not the people I”m looking for,” she said. “I’m looking for the ones who are really excited, who want to drive the overall transformation we’re trying to get at our organization, and we believe it’s there. We’re figuring out how much to buy and build, and I think it’s going to shift. It’s probably 90/10 right now, but as time goes on it’s going to shift more where you’re buying less and building more.”
That pivot toward internal development is not happening in a vacuum. Health systems are navigating some of the most constrained margin environments in recent memory, and every AI investment is being scrutinized for hard ROI. Jason Cohen, MD, CMO at Qventus, said that pressure is actually clarifying vendor selection, pushing health systems to demand proof over promise.
“We’re going to be building more stuff as we go forward. We are all facing margin pressures and we need solutions that deliver ROI. You’re going to be looking for vendor partners who have proven solutions in spaces where you know you have existing problems,whether that’s inpatient capacity, whether it’s your PAT process, surgical growth,” he said. “You’ll want folks you can talk to and actually validate those results, not just something someone says in a sales conversation.”
He also flagged a structural flaw in how many organizations are currently buying products. They are selecting solutions to address symptoms of the problem without resolving the underlying workflow dysfunction.
“You don’t want to go out and buy a solution that’s just a bunch of little point fixes that actually doesn’t solve the problem,” Dr. Cohen said. “It just pushes the problem downstream to some other part of the process. It’s really important as you’re looking at vendors, regardless of what part of the market you’re looking in, that you’re looking to someone that solves the problem end-to-end, because otherwise it just becomes more work for everyone else that’s left behind.”
Technology decisions cannot be separated from the organizational readiness to use them. Liz Popwell, assistant vice president for system corporate strategy and international strategy at Chicago-based CommonSpirit Health, put workforce development at the center of the organization’s current planning, even as CommonSpirit manages more than 250 active AI use cases.
“AI is not necessarily going to replace all the jobs, but it’s going to enhance,” Ms. Popwell said. “How do we upskill or change the skill set of our leadership for that change management?”
CommonSpirit is also trying to find the balance between build, buy and partnerships that can leverage technology and achieve adoption. Ms. Popwell shared a strong partnership example: the health system has an international joint venture program around education and created a nurse residency program that drastically dropped turnover rates and kept nurses longer within the health system using agentic AI.
“It’s been teeing up content the way the learner wants the content to be,” she said. “If I’m a visual learner but you’re a kinesthetic learner and another person is an audio learner, it has the ability to adapt to the individuals. It’s really important that we think about the boots on the ground, the staff that are seeing and interacting with patients on a routine basis and how we can put the right processes in place to help inform the people and give them what they need when they need it, because we want to give the consumer what they want when they need it. But we now need to start thinking harder about our workforce, because our workforce is so diverse and our workforce wants different ways to interact, different ways to learn and different ways to work together.”
Houston Methodist is approaching the same challenge through talent redeployment rather than net-new hiring, converting an existing robotic process automation team — already fluent in workflow logic and automation thinking — into the nucleus of its internal AI build function. Ms. Stansbury framed the technology question as secondary to the people question.
“It’s not the technology, it’s not what you can do with it,” she said. “It’s the change management of it and adoption. Because if they’re not using it, you’re not getting the benefit from it. All you did was just add cost to your organization.”
One concept that came under scrutiny during the discussion was the vendor claim of being a “platform” — a term Dr. Cohen noted has become nearly meaningless through overuse. The more useful question is not whether a vendor uses the word, but whether its architecture can adapt to an evolving set of institutional needs and whether the working relationship actually supports that kind of iteration.
“That style and that culture becomes hugely important in terms of figuring out which vendors you want to keep when you’re doing a rationalization process,” Dr. Cohen said.
Houston Methodist’s experience with Epic is instructive. After years of bringing in third-party vendors to fill capability gaps, the system has increasingly pushed Epic itself to absorb that functionality and found the vendor responsive.
“To build an intelligent healthcare system, it’s not about buying a bunch of new technology. It’s not,” said Ms. Stansbury. “None of us can afford to do that. But how can you leverage overall the relationships that you have with key vendors?”
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