医疗服务人工智能代理：1550亿美元的机会（英）2025

EMERGING TECH RESEARCHHealthcare Services AI Agents: PitchBook Data, Inc. A $155 Billion Opportunity Nizar TarhuniExecutive Vice President ofResearch and Market IntelligencePaul CondraGlobal Head of PrivateMarkets ResearchJames UlanDirector of EmergingTechnology Research Digital workhorses to shoulder the labyrinthine Institutional Research Group PitchBook is a Morningstar company providing the most comprehensive, mostaccurate, and hard-to-find data for professionals doing business in the private markets. Brian WrightLead Research Analyst,Healthcare Ben RiccioAssociate Research Analystben.riccio@pitchbook.com Key takeaways •This is a follow-up to our recentHealthtech AI Scribesreport as we now providea broader landscape of healthcare services AI agents, including ambient scribes pbinstitutionalresearch@pitchbook.com PublishingDesigned byChloe Ladwig •The leading AI ambient scribes will likely become a core platform and organicallyand inorganically develop other provider-centric workflow agent capabilities. Published on December 11, 2025 •Existing RCM leaders are most at risk of disruption. Contents •We establish a TAM estimate for this broader category as we incorporateadditional capabilities beyond ambient scribe functionality and early RCMestimates. We now see a $155 billion annual revenue opportunity for the broader •This sector is ripe for consolidation as various functions are integrated into •We include a list of healthcare services AI agent companies and leading investorsin the category and highlight some of the early leaders in the sector. •We provide a market map of this healthcare services AI agent category as well asa proposed taxonomy for AI in healthcare beyond healthcare services functions. Reducing the administrative burden on healthcare Healthcare services AI agents at the very leastwill lessen administrative burden on doctors,nurses, assistants, and administrative staff.This will reduce physician hours and burnout AI offers the opportunity in healthcare to reverse an endemic that began in 1966:the exponential expansion of the administrative state in healthcare. Healthcare administration employment increased 3,200% from 1970 to 2010, while physicianemployment grew only 150% over the same period.1While we recognize concernsthat AI could lead to ever greater complexity of the healthcare system, we believe Healthcare services AI agents at the very least will lessen administrative burdenon doctors, nurses, assistants, and administrative staff. This will reduce physician According to Menlo Ventures, providers have been quicker than payers to morebroadly adopt AI solutions, with 27% of health systems with paid commercial licenses for AI applications compared with just 14% for payers.2While this could be a functionof external sourcing versus internal development, given revenue trends at hospitals in This dynamic will likely continue to benefit providers. AI allows them to more quicklyand effectively break through the seemingly never-ending administrative hurdlesdevised by payers. This has cost trend implications as higher medical costs are likely to persist for the next several years and is evidenced by 2026 commercial health Assessing the opportunity size Menlo Ventures estimates that the existing medical documentation market is worth$19.6 billion and that back-office revenue cycle management (RCM) representsan $18.8 billion market. However, Menlo notes that the addressable market is well According to a 2021 McKinsey & Company analysis, healthcare administrative spending in the US was $950 billion in 2019.4McKinsey’s analysis further identified upto $265 billion in annual cost savings opportunities in US healthcare administrative If 2019 administrative spending increases at a 5% annual rate, this implies $1.55 trillionin expenditures by 2030. Such an estimate is conservative as the Centers for Medicare& Medicaid Services (CMS) projects that national health expenditures will increase at a 6.9% annual rate from 2019 to 2030.5Assuming the cost of AI automation is10% of healthcare administrative spending, the potential addressable market wouldbe $155 billion in annual revenue for this nascent industry. Furthermore, if AI can reduce overall administrative expenditures by 30%, this would imply 20% in potentialnet savings or over $300 billion annually. For a more granular corroboration of this Fence and function-based taxonomy Our segmentation taxonomy’s first layer is based on end customer (provider-focusedversus payer-focused versus “payvider”/value-based care) or what side of the fenceyou are on. The provider-focused agents are further refined by front office versus back Below we provide a list of functions being automated at providers and payers thatcoincides with our healthcare services AI segmentation taxonomy: Providers •Front office -Triage •Back office -Prior authorization - medical-Prior authorization - prescriptions-Prescription management -Nursing