| Reinventing the SaaS model
"Business models are shifting from SaaS pricing to transaction pricing. There's lots of companies that charge per successfully completed action — especially on the agentic side. I think that's what's getting customers to sign up — not feeling like they're paying a lot of money without the ROI being tied to it," stated Vig Chandramouli, partner at Oak HC/FT. This type of pricing structure is becoming particularly common among companies building AI tools for administrative workflows like patient intake, scheduling and revenue cycle management. Chandramouli said that many voice AI and intake automation companies now charge customers per successfully completed task — such as scheduling an appointment, completing an intake workflow or verifying a patient's insurance benefits. The buyer side of the equation
Rachel Feinman — senior vice president of innovation, ventures and digital solutions at Tampa General Hospital and managing director of TGH Ventures — said health systems prefer more fixed, predictable pricing structures. She noted that her team has received plenty of pitches from startups with ROI-based pricing models, particularly in areas like revenue cycle management and coding automation, where vendors often propose taking a percentage of the additional revenue or savings their tools generate. "We haven't been receptive to that as of yet. I don't know if the market will force us in that direction or not. But as of right now, we really try to find a baseline multiple on whatever cost savings or revenue generation there will be, and then set pricing based off of that," Feinman explained. She encouraged investors to talk directly with their potential customers to determine whether these business models are actually feasible in the market. Outcomes-based contracts
Joey Dean, senior director of enterprise solutions at consulting firm Healthcare IT Leaders, said the real challenge isn't whether a startup charges per transaction or uses a flat subscription model — it's proving that the AI technology actually creates value. In his view, outcome-based contracts — where vendors and health systems agree on shared goals — can better align incentives than simple transaction-based pricing. Instead of paying per completed task, both parties set specific objectives upfront, like reducing no-show rates or speeding up patient intake, and tie payment to achieving those outcomes. — By Katie Adams | 
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