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Feb 09 2026
Cloud

A Guide to Cloud Cost Optimization in Healthcare

Rising cloud complexity is forcing hospitals to adopt stronger FinOps practices and governance to align IT spending with clinical and financial priorities.

As hospitals and health systems layer artificial intelligence–driven analytics, clinical decision support and automation onto already complex IT environments, cloud costs are becoming harder to predict — and even harder to control.

The challenge is no longer simply choosing between on-premises and public cloud but learning how to operate both intelligently at the same time.

To keep costs under control, organizations must combine robust FinOps practices with a clear approach to cloud cost governance that aligns technology decisions with clinical, operational and financial priorities.

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Cloud Flexibility Helps Cost Optimization

Allyson Fryhoff, managing director of global healthcare and life sciences at Amazon Web Services (AWS), says the biggest cost drivers today are laying the groundwork for significant cost optimization in the future.

“Much of this comes from migrating legacy systems to the cloud,” she says.

Migrating to the cloud reduces both the costs associated with owning on-premises infrastructure, as well as the costs that add up when existing infrastructure blocks the deployment of new features such as generative and agentic AI tools.

From her perspective, flexibility is the key to optimizing costs while maintaining the high performance and reliability required by healthcare systems.

“The flexible nature of the cloud plays an integral role in ensuring healthcare organizations can continue to meet these requirements, even when things change,” Fryhoff says.

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Bharat Mistry, field CTO at TrendAI, a business unit of Trend Micro, says healthcare leaders should stop thinking one environment can do it all and instead put each system where it works best.

“Important patient data and systems that need fast, reliable performance usually belong on-premises or at the edge because those environments give teams more control,” he explains.

Workloads that need a lot of power, such as analytics or AI training, make more sense in the cloud because it can scale easily without huge upfront costs.

He adds that leaders must take a risk-based approach that balances the business goal of staying innovative and agile with the responsibility of following strict healthcare regulations.

Establish Effective FinOps Practices

From Mistry’s perspective, FinOps must be a simple, disciplined way of keeping cloud costs under control, especially because workloads change constantly and regulations slow down decision-making.

“The most effective approach is to have one central team that brings finance, IT and compliance together, so everyone sees the same numbers and follows the same rules,” he says.

This is why automation matters and the need for tools that automatically flag waste, clean up unused resources and predict cost spikes are essential and far more reliable than manual checks.

EXPLORE: Here are five must-haves for getting started with cloud cost allocation in FinOps.

Fryhoff adds that the most important starting point for successful FinOps practices within a healthcare organization is developing a culture of cost-consciousness.

“Healthcare teams must embrace this mindset and have access to tools to continuously monitor performance and associated costs,” she explains.

That means teams must be properly educated on how to optimize IT spending and quickly take corrective action when needed.

Accurate Visibility Into Usage, Spending

Whether organizations are just beginning their cloud journey or already operate mature monitoring and governance programs, modern cloud and infrastructure platforms provide tools to help track usage, performance and spending across both cloud and on-premises environments.

Mistry explains that the easiest way to understand what is running and how much it costs is to put all the billing and usage data from cloud providers into one central view or cost management platform.

“This gives everyone the same source of truth instead of scattered numbers,” he says.

It is also important to automatically detect new workloads because AI applications, tools and containers can appear quickly without IT knowing, which makes manual tracking almost impossible.

Finally, teams need consistent rules and oversight across cloud, on-premises and edge systems, as highlighted in internal planning work; otherwise, the data will always be incomplete.

Bharat Mistry
The most effective approach is to have one central team that brings finance, IT and compliance together, so everyone sees the same numbers and follows the same rules.”

Bharat Mistry Field CTO, TrendAI

Early Warning Signs, Corrective Actions

For IT leaders and those who manage cloud operations, early warning signs that an environment is drifting toward cost and governance trouble often show up in day-to-day infrastructure behavior rather than in financial reports.

Mistry explains that sudden spikes in compute or storage consumption, an increasing number of untagged or “mystery” resources, and workloads that continue running long after projects have ended are among the most common indicators that cloud environments are starting to slip out of control.

He also points to growing gaps between budget forecasts and actual spending as a signal that teams are deploying services without sufficient oversight or accountability.

When those conditions appear, organizations should move quickly to restore operational discipline. That includes tightening governance processes, enforcing automated alerts for spend anomalies, cleaning up idle or orphaned resources and placing stricter controls on high-cost workloads.

“The warning signs are obvious if you are willing to look for them,” Bharat said.

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