Anthropic has launched a suite of AI tools designed for the U.S. healthcare system, entering direct competition with OpenAI and signaling a broader industry push to apply artificial intelligence to one of the economy’s most complex sectors. The move comes amid growing recognition that AI may offer solutions to administrative burdens, but also carries risks and challenges that have stalled previous attempts at industry-wide change.
The Problem: A System Overwhelmed by Paperwork
The U.S. healthcare system is notorious for its complexity, with providers spending an estimated 13 hours per week on prior authorizations alone. This administrative overhead delays patient care and contributes to clinician burnout. AI tools, such as Anthropic’s Claude for Healthcare, aim to alleviate these burdens by automating tasks like drafting insurance requests and streamlining regulatory submissions.
This is no theoretical fix. In 2023, the U.S. spent $4.9 trillion on healthcare — roughly $14,570 per person — meaning even incremental efficiency gains could be massive.
How Anthropic’s AI Works
Anthropic’s system, built on its Claude Opus 4.5 model, connects directly to verified American medical databases. This includes:
- Centers for Medicare & Medicaid Services (CMS) Coverage Database: Determines which procedures insurance will cover.
- ICD-10 Coding Standards: The alphanumeric system used for medical billing.
- PubMed: A library of biomedical research papers.
The key is that unlike generic chatbots, Claude for Healthcare doesn’t hallucinate advice but references real-world medical infrastructure. Anthropic has also added “Agent Skills” — customizable tools for workflows like prior authorization, and integrations with platforms like HealthEx, Apple HealthKit, and Android Health Connect.
Privacy is a key concern, and Anthropic claims its integrations are HIPAA-ready and designed to protect patient data. Users can opt-in to share specific information, with no data stored in Claude’s memory or used for training.
The Competitive Landscape
OpenAI recently introduced its own healthcare product, and AI-focused health startups such as Abridge and Sword Health are already valued in the billions. This indicates growing confidence in the market, but also a recognition of its challenges.
Past attempts at AI-driven healthcare solutions have often failed to deliver on promises, either by amplifying biases in medical data or by failing to integrate into existing clinical workflows. The real value for patients will depend on whether AI can reliably improve outcomes without introducing new risks.
What’s Next?
Anthropic is also expanding its AI’s capabilities to life sciences, connecting to platforms like Medidata and ClinicalTrials.gov. The near-term focus is on streamlining administrative tasks, but the long-term goal is to aid in clinical trial protocol drafting and performance monitoring.
Whether this AI push will succeed remains to be seen. The healthcare AI market is still nascent, and sustainable adoption will require tools that prove accurate, reliable, and compatible with real-world medical workflows. This is a high bar that has previously proven difficult to clear.
