# Selling to hospitals: how hospitals buy, and who signs, by purchase type

Capital equipment, IT software, supplies and staffing each take a different path through a hospital. Here is who evaluates, who approves and who can block each one.

By Supreet Gupta, Co-founder and Chief Product Officer, Dmand AI · Published 2026-10-19

Read on the web: https://dmand.ai/blog/selling-to-hospitals

**Short answer**

Selling to hospitals means matching your product to the buying path it will take. Capital equipment waits for the annual capital budget, IT software goes through IT governance and a security review, supplies go through a value analysis committee and GPO contracts, and staffing runs through the hospital's contract labor program. Each path has its own evaluators, signers and blockers.

Most advice on selling to hospitals treats the hospital as one buyer. It is not. A $40,000 software subscription, a $2 million imaging system and a new surgical stapler each move through a different part of the hospital, on a different calendar, with different people who can say no.

This guide splits the hospital buying process by purchase type, shows who sits on the committee for each one, and ends with how to find those people at the hospitals you sell to.

## Selling to hospitals starts with knowing which buying path your product takes

Before you write a first email, answer one question: what kind of purchase is this for the hospital? The answer decides who reads the email.

A hospital sorts spending into a few buckets. Labor, including purchased services and professional fees, was 56% of hospital expenses in 2024, supplies were 13% and drugs 9%, according to the American Hospital Association.[3] Each bucket has its own owner and its own approval path.

| Purchase type | Buying path | Who evaluates, then approves | Who can block |
| --- | --- | --- | --- |
| Capital equipment (imaging, surgical systems, beds) | Annual capital budget; out-of-cycle requests need a business case | Department head, clinical users and biomedical engineering; then the capital committee and CFO, and the CEO or board above set limits | Finance, when the request misses the budget cycle |
| IT software and services | IT governance intake, security risk review, a BAA if patient data is involved | CIO or IT director, informatics (CMIO, CNIO) and end users; then the CIO with the CFO, or an IT steering committee | The security review, and legal on the BAA |
| Medical supplies and devices | A clinician's new product request, value analysis review, GPO contract check | The value analysis committee; then the VP of supply chain or value analysis lead | The committee, or an existing GPO contract |
| Contract staffing (travel nurses, locum tenens) | The hospital's MSP or VMS program, or a direct agreement | CNO, nurse managers, HR and department chairs; then the CNO and CFO | The MSP, when your agency is not on the program |
| Purchased services (consulting, revenue cycle, outsourcing) | Procurement, often a bid or RFP | The department leader and finance; then the CFO, or a contract committee above set limits | Procurement and legal |

*How a typical US hospital buys, by purchase type. Paths vary by hospital; check the target's own purchasing policy.*

Source: AHA, HFMA, HHS and published hospital purchasing policies

## How many hospitals are in the US, and how many belong to a health system

There are about 6,100 hospitals in the United States, according to the AHA's 2026 Fast Facts, built on its 2024 annual survey.[1] Of those, 5,121 are community hospitals: 2,984 nonprofit, 1,224 investor-owned and 913 run by state and local governments. Another 210 are federal hospitals, run by agencies such as the VA.

Most of those hospitals do not buy alone. The AHA counts 397 health systems, and 68% of US hospitals and 77% of hospital beds sit inside one.[2] Among community hospitals, 3,567 belong to a system.[1]

That changes who you sell to. When a hospital is part of a [health system](https://dmand.ai/glossary/health-system) or an [IDN](https://dmand.ai/glossary/integrated-delivery-network-idn), the system often sets product standards, runs capital and IT decisions centrally and signs contracts that cover every hospital it owns.

**Integrated Delivery Network:** An integrated delivery network (IDN) is a health system that owns or manages care across the continuum, such as hospitals, physician groups, outpatient sites, post-acute care and sometimes a health plan, under one parent organization. IDNs often buy centrally for all their sites, so sellers map the hierarchy from the IDN down to each site of care. ([Glossary](https://dmand.ai/glossary/integrated-delivery-network-idn))

## Who sits on a hospital buying committee for each type of purchase

A hospital buying committee is the group of people who must agree before a purchase goes ahead. It is rarely one standing committee. The members change with the purchase type, and most deals include five kinds of people.

1. **The requester.** The department head, physician or nurse leader who has the problem and asks for the product.
2. **The evaluators.** The people who test the product against the need: clinical users, biomedical engineering, IT, informatics or a value analysis committee.
3. **The gatekeepers.** Supply chain, procurement, security and legal, who check the contract, the GPO status, the data handling and the terms.
4. **The approvers.** Finance and the executive who owns the budget: the CFO, CIO, CNO or COO.
5. **The final signer.** For large purchases, a capital committee, the CEO or the board.

A peer-reviewed study of hospital equipment purchases found that leaving out a stakeholder is one of the main causes of delay, and that administrative and technical experts carry the most weight.[10] Map all five groups before you pitch any of them.

## How hospitals buy capital equipment through the annual capital budget

Capital equipment is anything the hospital owns and depreciates over several years: imaging systems, surgical robots, monitors, beds. It is paid for out of the capital budget, which most health systems set once a year.

Departments submit requests months before the fiscal year starts. Finance ranks them against the strategic plan and the capital the system can spend. HFMA describes how health systems approve projects that fit the strategy and capital capacity, and sometimes approve a project below its target return when safety, quality or strategy justify it.[4]

Miss the cycle and you usually wait a year. Out-of-cycle requests are possible, but they need a business plan and approval from a central governance committee. In the same HFMA article, OSF HealthCare keeps about 10% of its capital limit in reserve for them.[4]

> **Ask for the capital calendar on the first call**
>
> Ask your champion when capital requests are due, when the committee meets and what the request form asks for. Then help them write the business case, with your numbers in their format.

## How hospitals buy IT software: IT governance, security review and the BAA

Software and IT services compete with medical equipment for the same capital, which has strained hospital capital planning for years.[11] On top of the budget question, IT purchases pass two gates that equipment does not.

The first is IT governance. The CIO's team checks whether the product duplicates something the hospital already runs, how it connects to the [EHR](https://dmand.ai/glossary/electronic-health-record-ehr) and who will support it. Large projects go to an IT steering committee with clinical and finance leaders.

The second is the security review. At Michigan Medicine, for example, procurement confirms the purchase first, then the information assurance team runs an IT security risk review, and new systems that touch sensitive data take longer.[5]

If your product stores, sends or can see protected health information, you are a business associate under HIPAA, and the hospital must sign a business associate agreement with you before you go live.[6] Have your security documentation and a standard BAA ready before the first demo.

## How hospitals buy medical supplies: value analysis committees and GPO contracts

New supplies and devices go through a value analysis committee. A clinician or department leader submits a new product request, and the committee reviews the clinical evidence, the cost, the contract and how the product would change practice. Reps usually cannot submit the request themselves.

Price and contract terms often come from a group purchasing organization. Most hospitals belong to a [GPO](https://dmand.ai/glossary/group-purchasing-organization-gpo), and a product already on the GPO's contract is easier for supply chain to approve than one that needs a new agreement.

Both steps have their own rules and calendars. Read [how a value analysis committee works](https://dmand.ai/blog/value-analysis-committee) and [how GPO contracts work](https://dmand.ai/blog/gpo-contracts) before you approach a supply chain team.

## How hospitals buy staffing: contract labor, MSPs and VMS platforms

Contract labor is one of the largest costs hospitals have tried to control since 2020. The AHA reported that hospital contract labor expenses rose 258% from 2019 to 2022.[8]

Most large hospitals now buy travel nurses and locum tenens through a managed service provider, a vendor management system, or both. The [MSP](https://dmand.ai/glossary/managed-service-provider-msp) runs the program and the VMS is the software where orders go out to approved agencies. An agency that is not on the program sees few orders.

The CNO and nurse managers own the need, HR and finance own the budget, and supply chain or HR owns the contract. See [how MSPs and VMS platforms work in healthcare staffing](https://dmand.ai/blog/msp-vs-vms-healthcare-staffing) for where a staffing firm gets in.

## Who signs a hospital purchase: approval limits from department head to board

Every hospital sets dollar limits on who can approve a purchase, in a policy usually called a delegation of authority. The limit rises with the amount and the risk.

Midland County Hospital District in Texas publishes its policy. Its fiscal 2020 version sends any new kind or brand of supply to its Value Analysis Team, raises the approval level for supply re-orders in steps from under $1,500 to over $100,000, and sends purchased services above $250,000 a year to a Capital Asset Committee made up of the CEO, CFO, COO, the director of supply chain and the senior VP of strategic planning, and on to the board.[7]

Other hospitals use different numbers, but the shape is the same. Small re-orders stop at a manager. New products need clinical review. Large contracts need a committee and an executive.

> **Ask who signs at your deal size**
>
> Ask your champion: at this amount, who approves, and is there a committee that has to see it first? Then ask what that person or committee needs to see.

## Health system or hospital: where the buying decision is really made

With 68% of hospitals inside health systems, the person you call at a hospital may not be the person who decides.[2] Systems often run three things centrally.

1. **Standards.** A system-level value analysis or IT committee picks one product for every hospital.
2. **Contracts.** Supply chain negotiates once for the whole system, often through its GPO.
3. **Capital.** The system ranks capital requests from every hospital against one budget.

The hospital still matters. Department heads and clinicians at each site are the requesters and users, and the system's committee usually wants a local champion. Work both levels: the system's leaders for the decision, and the hospital's leaders for the need.

Knowing which hospitals sit under which system, and who owns each one, is the first map to draw. See [how to find out who owns a hospital](https://dmand.ai/blog/who-owns-a-hospital).

**See every hospital and clinic under a health system**

Open any health system and see its hospitals, outpatient sites and clinics, with the executives and HCPs at each one.

[View the full org tree](https://dmand.ai/platform/hospital-org-chart)

## How long it takes to sell to hospitals, and what slows a deal down

No credible public source gives a typical hospital sales cycle in months, so be wary of anyone who quotes one. The length depends on the path and on where the hospital is in its calendar.

These are the things that most often slow a deal:

- **The budget cycle.** A capital purchase that misses the annual cycle can wait a year.
- **Committee calendars.** Value analysis and IT steering committees meet on a schedule, often monthly.
- **Security review.** New systems that touch patient data can queue behind other reviews.
- **A missing stakeholder.** Someone with a veto joins late and restarts the evaluation.
- **System approval.** The hospital says yes and the health system has to agree.
- **ROI proof.** Health system leaders now favor technology with clear financial returns and a short time to value, according to a 2025 Bain and KLAS survey of 228 executives.[9]

## What sales reps cannot do when selling to hospitals

Hospitals restrict what vendor reps can do on site, and breaking a rule can cost you access to the account.

Most hospitals require reps to register through a vendor credentialing program before visiting. Many do not let reps submit new product requests, leave samples or start using a product with staff before it is approved. Some lock a product out of review for a year after the committee turns it down.

Follow the purchasing policy, work through your clinical sponsor, and keep supply chain informed. A rep who goes around supply chain often wins the clinician and loses the deal.

## How to find the decision makers at a hospital before you reach out

Once you know the path, list the roles on it for your target account. Then find the named person in each role, at the hospital and at its parent system.

1. **Find the parent.** Check whether the hospital belongs to a health system or IDN, and which other hospitals sit beside it.
2. **List the roles.** Use the table above: for an IT sale, the CIO, the CMIO or CNIO, the IT director at the site and the security lead; for a supply, the value analysis lead, the VP of supply chain and the clinical department head.
3. **Find the people at the right site.** A CNO at the system and a nurse director at one hospital are different contacts with different jobs.
4. **Get a working email and direct dial.** Executive and clinician contacts go stale fast, so check them before you send.
5. **Find a warm way in.** A customer, advisor or colleague who knows one of them is worth more than a cold email.

Dmand AI does this in one place. It maps 1.6K+ health systems and IDNs, 6.2K+ hospitals and 997K+ sites of care in one parent-child tree, with 11M+ healthcare executives and 7.4M+ HCPs attached to the site where they work. From any account, the next step is Find decision makers.

**Find the buying committee at a hospital you sell to**

Search any US hospital, open its health system above it, and see the CIO, CNO, CFO and supply chain leaders at each site. 30 days free, self-serve, no credit card.

[Start free trial](https://app.dmand.ai/signup) · [Book a demo](https://dmand.ai/book-a-demo)

## Sources

1. [Fast Facts on U.S. Hospitals, 2026](https://www.aha.org/statistics/fast-facts-us-hospitals), American Hospital Association, February 2026
2. [Fast Facts on U.S. Health Systems 2025](https://www.aha.org/infographics/2025-06-18-fast-facts-us-health-systems-2025-infographic), American Hospital Association, June 18, 2025
3. [The Cost of Caring: Challenges Facing America's Hospitals in 2025](https://www.aha.org/guides-and-reports/2026-03-09-2025-cost-caring-report), American Hospital Association
4. [Capital allocation and planning for a stabilizing healthcare outlook](https://www.hfma.org/finance-and-business-strategy/capital-finance/capital-allocation-and-planning-for-a-stabilizing-healthcare-outlook/), HFMA, February 20, 2025
5. [Purchasing new information technology](https://safecomputing.umich.edu/michigan-medicine/purchasing-it-system), University of Michigan Safe Computing
6. [Business associate contracts](https://www.hhs.gov/hipaa/for-professionals/covered-entities/sample-business-associate-agreement-provisions/index.html), U.S. Department of Health and Human Services
7. [Delegation of Authority, Fiscal Year 2020](https://www.midlandhealth.org/Uploads/Public/Documents/Delegation%20of%20Authority%20Fiscal%20Year%20%202020.pdf), Midland County Hospital District, February 14, 2020
8. [New AHA report finds financial challenges mount for hospitals and health systems](https://www.aha.org/press-releases/2023-04-20-new-aha-report-finds-financial-challenges-mount-hospitals-health-systems-putting-access-care-risk), American Hospital Association, April 20, 2023
9. [Healthcare AI investment focusing on hard-dollar returns and clinical workflows](https://www.bain.com/about/media-center/press-releases/20252/healthcare-ai-investment-focusing-on-hard-dollar-returns-and-clinical-workflows-amid-shift-from-pilots-to-widespread-productionbain--company-and-klas-research/), Bain & Company and KLAS Research, October 9, 2025
10. [Stakeholder identification and salience in purchasing: an empirical study from UK hospitals](https://salford-repository.worktribe.com/output/1360825/stakeholder-identification-and-salience-in-purchasing-an-empirical-study-from-uk-hospitals), International Journal of Healthcare Technology and Management, 2020
11. [How hospitals confront new technology](https://pubmed.ncbi.nlm.nih.gov/19787843/), Coye and Kell, Health Affairs, 2006

## Questions sellers ask about selling to hospitals

### Who makes purchasing decisions in a hospital?

It depends on what is being bought. Capital equipment goes through the annual capital budget and a capital committee led by finance. IT software goes through the CIO, IT governance and a security review. New supplies and devices go through a value analysis committee and supply chain. Contract staffing goes through the CNO, HR and the hospital's MSP or VMS program.

### How long does it take to sell to a hospital?

No credible public source gives a typical length, and it varies by purchase type. What sets the pace is the hospital's calendar: capital requests wait for the annual budget cycle, IT purchases wait for security review, and new supplies wait for the value analysis committee's next meeting.

### Do I need a GPO contract to sell to hospitals?

Not always, but it helps for supplies and devices. Most hospitals buy many supplies through group purchasing organization contracts, and a product that is already on contract is easier for supply chain to approve. Software, staffing and services are often bought directly.

### How do hospitals choose vendors?

Hospitals compare clinical evidence, total cost, contract terms, fit with existing systems and the vendor's support. For supplies, a value analysis committee scores the evidence. For IT, a security review checks how the vendor handles patient data. Above set dollar limits, finance and often the board must approve.

### Who signs a hospital purchase order?

Approval limits rise with the dollar value. A department manager can approve small re-orders, then a director, a vice president, the CFO and, above set limits, a capital committee, the CEO or the board. Each hospital publishes these limits in its own delegation of authority policy.

### Do health systems or individual hospitals make buying decisions?

Increasingly the health system. AHA counts 397 US health systems, and 68% of hospitals belong to one. Systems often set standards, run capital and IT decisions centrally, and sign contracts that cover every hospital, so sellers need the system's leaders as well as the hospital's.

### Can a sales rep submit a new product request to a hospital?

Usually not. Most hospital value analysis policies require a clinician or department leader to sponsor and submit the request. The rep's job is to find that sponsor and give them the evidence the committee asks for.

### What does a hospital need from a software vendor before buying?

Expect an IT governance intake, a security risk review of how your product stores and sends data, integration questions about the EHR, and a business associate agreement if your product touches protected health information. Have your security documentation ready before the first demo.