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How a Healthcare CIO Cut AI Model Cost 60% Without Losing Accuracy.

A field guide to AI cost optimization for VP Engineering teams running clinical and operational LLMs in production.

In depth

Your AI bill is doubling every six months and finance is asking why.

01

Inference now eats 85 percent of the enterprise AI budget.

02

In healthcare, the problem looks different than it does at a SaaS company.

03

Quality matters more in healthcare than in almost any other domain.

The detail

The 10-week program that gets you there.

Zone · 01

Weeks 1–3 Model routing by request class

Not every request needs the frontier model. A medication reconciliation summary does.

Zone · 02

Weeks 4–7 Model distillation for high-volume tasks

For any task that runs more than 50,000 times a month, distillation pays. A distilled model is 5 to 10 times smaller, runs on cheaper hardware, and typically holds 95 percent of the original's accuracy on the narrow task it was trained for.

Zone · 03

Weeks 8–10 Semantic caching

About 30 to 40 percent of clinical LLM traffic in our audits is duplicate or near-duplicate. The same patient message gets summarized for three different staff.

By the numbers

The figures that make it a board-level conversation.

60%
Unit cost per inference reduction
41%
Total monthly AI spend reduction at 30% higher volume
1%
Avg request quality score within original
Inside the report

What you'll take away.

01

Model routing by request class

Not every request needs the frontier model.

02

Model distillation for high-volume tasks

For any task that runs more than 50,000 times a month, distillation pays.

03

Semantic caching

About 30 to 40 percent of clinical LLM traffic in our audits is duplicate or near-duplicate.

Questions

Frequently asked.

Will this slow down our existing use cases?

No. Routing and caching reduce average latency. Distillation can be slower at the tail in early weeks but stabilizes once the eval loop is in place. Across our deployments, P95 latency dropped 20 to 35 percent.

Do we have to change LLM providers?

No. The four levers work across providers. We have run the same program on Anthropic, OpenAI, and Bedrock-hosted models without switching.

How do we prove accuracy held?

An evaluation set of at least 200 labeled examples per request class, scored weekly. The proof is the score over time, not a one-shot benchmark.

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Next step

Unit cost trends down quarter over quarter while usage grows.

Talk through how this applies to your roadmap with our engineering leads - a working session, not a sales pitch.

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