WellSky CEO Says Healthcare Will Decide Big Tech's $700B AI Bet

Microsoft, Alphabet, Meta and Amazon are expected to spend more than $700 billion on capital expenditures this year to build out AI infrastructure. Bill Miller, chairman and CEO of healthcare software firm WellSky, argued in Fortune that the test for that spend runs through U.S. healthcare.

"U.S. healthcare spending reached $5.3 trillion in 2024, or 18% of GDP," Miller writes. "By some estimates, close to $1 trillion goes toward administration alone." The administration layer, in his telling, is where AI gets its cleanest shot at compressing cost.

Miller points to two deals already in flight: Microsoft and Mayo Clinic are developing a frontier AI model built for healthcare, and Google Cloud and CVS Health have signed a long-term partnership to power CVS's new Health100 platform with Gemini.

The op-ed also carries a warning to providers. For 2026, Miller writes, CMS has brought productivity logic to physician payment, "applying a '2.5% efficiency adjustment' to the work component of certain non-time-based services." Medicare already incorporates productivity into payment updates for hospitals, skilled nursing facilities, home health and other settings, so efficiency gains don't stay with the provider forever. "Providers may have a limited window to benefit from those efficiencies before reimbursement catches up," he writes.

The piece attaches no dollar figure to what Microsoft/Mayo or Google/CVS have deployed, and it is an op-ed from a vendor that sells into the sector it is describing. It also lands the same week Senator Elizabeth Warren's office pushed a report arguing those same hyperscalers are shifting the grid costs of their AI build-out onto ratepayers. Miller's close is unhedged: "The harder question is whether that technology can produce productivity at a scale that makes the investment worthwhile. Healthcare may be one of the clearest places to find out."