👋 Hey, Egemen here.
Bessemer and Bain asked 226 healthcare executives what their AI projects returned. 61% say half or fewer of the AI tools they built in-house still run. 42% have cut or are cutting AI vendors. I looked at the vendors they keep and at one startup that doubled revenue five years in a row.
Here’s a snapshot of what’s on the menu today:
💡 Spotlight: Attio, the agentic CRM for teams that keep moving
🧠 Deep-Dive: The AI vendors buyers keep
🗺️ Method: Quant thinkers are building on WorldQuant BRAIN
⚾️ Catch: Leave Granola, get up to 12 months of Wispr Flow free
☝️ Scaled This Past Week: EliseAI
💡 Spotlight
Some teams never seem to stop moving. They're on Attio, the agentic CRM.
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Teams like Parallel, Turbopuffer, and Wordsmith build on Attio. Are you one of them?
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🧠 Deep-Dive: The AI vendors buyers keep
I expected large buyers to keep building their own AI tools this year. Then I read the 2026 Healthcare AI ROI Scorecard. Bessemer and Bain published it at the end of September, with answers from 226 healthcare executives across 65 use cases.
Many in-house builds did not last. 61% of the organizations say half or fewer of their internally built AI tools are still in use. 32% say fewer than a quarter made it.
Bessemer traces the failure to the step after the pilot. An internal team can ship a working pilot. Fewer teams can keep it running in production and defend it in an audit. Buyers decided they do not want to own that work.
61%
Share of healthcare organizations that say half or fewer of their in-house AI tools are still in use.
Internal teams lost 16 points of share in AI solutions in use within a year.
(Source: Bessemer Venture Partners and Bain & Company, “The 2026 Healthcare AI ROI Scorecard”, September 2026)
Survey of 226 healthcare executives across 65 AI use cases. The chart shows percentage-point changes in the share of AI solutions in use, 2025 to 2026. It leaves out other builder types.
Buyers moved that work to outside vendors. Healthcare-specific AI vendors gained 12 points of share. Large health IT vendors gained 7.
Buyers also started cutting. 42% have consolidated or are consolidating their AI vendors, and 57% say AI companies flood them with point-solution pitches. Bessemer writes that buyers “have moved from evaluating capabilities to buying implementations.” Most of the market still sells capabilities, Bessemer adds.
Respondents plan their budgets the same way. They will put 55% of next year’s new AI spend into deployment. They plan 35% to scale proven use cases and 20% to fit them into existing workflows. Infrastructure gets 13%, and model licenses get 11%.
Bessemer points to three winners, all from its own portfolio. Abridge and SmarterDx grew one product into a platform. Qventus builds and deploys its product with its customers.
My read applies outside healthcare too. If your customer’s team has to keep your product running, you are on their cut list. The vendors these buyers keep run the work in production and fix it when it breaks.
👉 Write down who keeps your product running after go-live. If it is your customer’s team, move deployment and upkeep into your contract and your price. Next, pick one tool your buyer runs next to yours and pitch to absorb it at renewal. Model payback at 12 months. 54% of these buyers saw material returns within the first year.
🗺️ Method
Quantitative Thinkers Are Building Ideas Worldwide on WorldQuant BRAIN
WorldQuant BRAIN is a global simulation and research platform for students, aspiring researchers and quantitative thinkers from around the world.
On BRAIN, that spirit of exploration continues through challenges, collaboration and opportunities to develop new quantitative research ideas.
⚾️ Catch
Leave Granola and get up to 12 months free of Wispr Flow Notetaker + Dictation
If you have paid time left on an individual Granola plan, we'll match it with a Wispr Flow subscription that includes Notetaker and dictation, and add bonus time, up to 12 months total. Sign in or create a Wispr account and submit proof of your plan to check eligibility.
☝️ Scaled This Past Week: EliseAI
New York, NY / AI for housing and healthcare operations / announced 29 September 2026
EliseAI has raised $350M at a $4B valuation. Andreessen Horowitz and Bessemer Venture Partners led the round, and Ontario Teachers’ Pension Plan, Sapphire Ventures and Navitas Capital joined. EliseAI will use the money to automate more customer operations and open a second engineering hub in San Francisco.
CEO Minna Song and Tony Stoyanov founded EliseAI in 2017. Its first product answered after-hours leasing questions for property managers in New York. Today its AI agents handle leasing, maintenance, renewals and collections, and the platform powers 1 in 6 US apartments.
By June, EliseAI had passed $200M in ARR, and it has doubled revenue year over year for five straight years. In September it launched Apollo, an AI teammate that can do any task in the platform.
A dedicated healthcare business runs the same playbook for specialty physician groups. It automates the patient path from the first call through referrals, scheduling, insurance checks, chart prep and follow-up.
What to copy
EliseAI built each product with its customers, Bessemer writes. The company says those customers then asked it to take on more of their operations. Pick one workflow you can run end to end, and use that seat to absorb the work next door. The buyers in this week’s Deep-Dive keep vendors that grow this way.