Eighty-eight percent of health systems are using artificial intelligence internally, but just 18% have a mature governance structure and fully formed AI strategy, according to a new report from the Healthcare Financial Management Association and market research company Eliciting Insights.
Governance is lacking despite the fact that 71% of survey respondents have identified and deployed pilot or full AI solutions in finance, revenue cycle management or clinical functional areas.
Health systems realize the importance of governance — in 2025, nearly 70% of CFO respondents indicated there was some governance structure, whereas in 2024, only 40% of CFOs indicated there was some governance structure.
"Much like following accounting rules and regulations, healthcare executives understand that good governance around AI builds community trust and ensures responsible and ethical use of information," said Todd Nelson, HFMA chief partnership executive.
WHAT'S THE IMPACT
When it comes to expectations for vendors around artificial intelligence, "most health systems are still in early stages of AI adoption," Eliciting Insights CEO Trish Rivard said. "Those that are looking to start using AI are looking to do so with trusted vendor partners."
In fact, nearly 80% of health systems say an existing vendor, or a firm partnered with an existing vendor, would have a significant advantage over a new vendor looking to pilot AI. And 70% of health systems say they would be more comfortable sharing data to power AI models with existing vendor partners.
The majority of health systems report they lack resources to identify opportunities for ROI with artificial intelligence.
While market interest in AI is strong, the report showed more than 80% of health systems lack mature AI programs to manage investments adequately.
The survey is based on the responses of 233 health systems and interviews with CFOs in the second quarter of 2025.
THE LARGER TREND
The use of artificial intelligence in healthcare is gaining popularity among physicians, found a February survey from the American Medical Association, though many remain guarded in their enthusiasm due to lingering concerns.
About 35% of physicians expressed more enthusiasm than concern – up from the 30% who felt the same last year. The portion of physicians whose concerns exceeded their enthusiasm for health AI decreased to 25% in 2024 from 29% in 2023, and about two in five physicians remain equally excited and concerned about health AI, with almost no change between 2023 and 2024.
In particular, physicians are increasingly intrigued by AI's power as a clinical assistant, and in its potential to reduce administrative burdens, enhance diagnostic accuracy and personalize treatments.
Yet some are being cautious. Just last week, the governor of Illinois signed into law a piece of legislation that will ban the use of artificial intelligence in delivering therapy or psychotherapy unless it's overseen by licensed clinicians.
The Wellness and Oversight for Psychological Resources Act prohibits anyone from using AI to aid in mental health and therapeutic decision-making, while still allowing the use of AI for administrative and supplementary support services for licensed behavioral health professionals.
The intent, said Illinois Governor J.B. Pritzker, is to protect patients from unregulated AI products, protect the jobs of qualified behavioral health providers, and protect children from rising concerns about the use of AI chatbots in mental health services.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.