A recent flash survey conducted by Black Book Research has highlighted the impact of the current economic climate on decision-making in the U.S. healthcare IT sector. The survey, which collected responses from 107 business development executives at healthcare IT vendors, showcases a marked shift in buyer priorities and procurement processes amid growing cash concerns.
The findings reveal that 71% of respondents have reported pauses in at least one ongoing procurement, while 63% noted significant extensions in sales cycles. The most common delays cited fall within the 30-60 day range, with 12% of participants experiencing extensions of over 90 days.
One of the most striking trends is the delay in new Requests for Proposals (RFPs). A notable 68% of the executives indicated that new RFPs are either being held or postponed. Furthermore, buyers are now prioritizing projects that deliver rapid ROI, with 58% of respondents emphasizing a 12-month ROI window and 28% targeting a 6-month window.
The survey also identified shifts in demand categories. Over half of the executives (52%) reported increased interest in revenue cycle management and denials prevention, while 39% saw a spike in demand for cybersecurity and compliance solutions. In contrast, 41% of respondents noted deferrals for platform upgrades and data initiatives such as data lakes and enterprise analytics.
Financial negotiations are changing as well, with 44% of vendors experiencing requests for extended payment terms – typically 60 to 120 days – and 36% observing a shift from capital expenditures (capex) to operational expenditures (opex), with a greater focus on subscription- and consumption-based approaches.
The economic climate has led many hospital boards and finance committees to impose formal holds on discretionary IT spending until there is more clarity regarding cash flows. According to an informal poll, 60% of Chief Information Officers (CIOs) reported similar pause directives on non-essential upgrades or expansions, while prioritizing revenue-protecting technologies.
Doug Brown from Black Book Research commented on the situation, stating, “The shutdown’s cash uncertainty has moved many decisions into board finance committees. Boards are literally putting hold stamps on non‑essential IT platform upgrades, while green‑lighting revenue cycle and cybersecurity modules that protect cash now.”
In response to these shifts, vendors are adapting their strategies. Approximately 47% are offering proofs of value or pilots with staged commitments, while 33% are adjusting their implementation sequences to focus first on cash-impact modules, such as eligibility verification, prior authorization automation, and denials prevention. Additionally, 27% have paused non-essential product launches or reduced field marketing in favor of concentrating on late-stage deals and existing customer expansions.
This survey underscores how economic uncertainty continues to reshape the healthcare IT landscape, prioritizing immediate financial benefits and risk mitigation in decision-making processes across the industry.
The survey was conducted in the last week of October 2025, providing insights reflective of the current state of healthcare IT procurement and vendor relationships. With a maximum margin of error of ±9.5 percentage points at the 95% confidence level, the results are crucial for understanding the sector’s evolving dynamics.