U.S. hospitals and health systems are in a revenue crisis. About four in 10 are losing money and many others are working with operating margins under 1%, all while juggling increasingly complex patient cases, staffing shortages and federal funding cuts.
Amid funding cuts and thin financial margins, health systems can rely on AI to reveal millions in uncaptured revenue. AI is emerging as a powerful engine for financial growth in healthcare. By unlocking clinical insights hidden in vast troves of existing data in electronic health record (EHR) and billing systems, AI is enabling hospitals to recover revenue they’re already earning — but not capturing — through more accurate and efficient medical coding for reimbursement.
Clinical AI has been particularly powerful in capturing revenue from less common diagnosis codes. Though CDI teams typically capture the top 40% of frequently missed codes, like sepsis or respiratory failure, AI helps catch the rarer codes that can account for up to 60% of lost revenue.
Clinical AI offers a powerful, proven lever to strengthen financial performance, helping organizations do more with the resources they have. By surfacing revenue that would otherwise go uncaptured, AI can help hospitals move beyond today’s narrow margins and toward a sustainable future.
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