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RWJBarnabas Health’s Adamson Says AI Governance Needs Value Gates Before Consumption Pricing Hits

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RWJBarnabas Health’s Adamson Says AI Governance Needs Value Gates Before Consumption Pricing Hits

RWJBarnabas Health CIO Rob Adamson explains his approach to controlling AI costs through 90-day value tests, model routing and running suitable workloads locally. Watch below or on YouTube.

RWJBarnabas Health’s CIO expects AI to take about a quarter of the system’s IT budget by 2029. He says only a governance process willing to switch tools off can absorb that growth. AI accounts for 7% of the budget this year. Rob Adamson, EVP and chief information officer at the 14-hospital New Jersey system, laid out his approach on a recent episode of the healthsystemCIO Show. He recorded it ahead of a Nov. 12 CHIME Fall Forum panel on whether health systems still control the technology they depend on. Flat monthly fees for AI tools in an Epic program have given the organization little view of what any single tool would cost under consumption pricing.

RWJBarnabas Health uses AI tools offered through an Epic program Adamson identified as Jumpstart. It charges a flat monthly fee regardless of how heavily the tools are used. As a result, Adamson said, the organization has developed a false impression of what its AI actually costs. He expects that arrangement to move to full consumption pricing in 2028 and has been modeling costs for 2028 through 2030 since early 2025.

To that end, he built a model that asks operational leaders to estimate the volume each tool will run. When a colleague asked about discharge summarization, for example, the model put its annual cost at about $312,000 under consumption pricing.


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