As we wrap up another year and get ready for 2026 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! We reached out to our incredible Healthcare IT Today Community to get their insights on what will happen in the coming year, and boy, did they deliver. We, in fact, got so many responses to our prompt this year that we have had to narrow them down to just the best and most interesting. Check out the community’s predictions down below and be sure to follow along as we share more 2026 Health IT Predictions!
Check out our community’s Revenue Cycle Management predictions:
Heather Bassett, Chief Medical Officer at Xsolis
AI has the potential to transform revenue cycle management, but only if it’s implemented responsibly. Real innovation isn’t just about automation processes; it’s about transparency, collaboration, and data integrity. When clinical, financial, and payer systems speak the same language, everyone benefits from the care teams who gain time back to better serve patients, to the patients who benefit from equitable access and smoother care journeys. In 2026, the most successful healthcare organizations will be those that use AI not just to accelerate processes, but to elevate trust, strengthen compliance, and ensure every financial decision supports better patient care.
Joe Benardello, Co-Founder and Chief Growth Officer at IKS Health
RCM is having a resurgence, and the health system C-suite knows it. As systems brace for potential site-neutral payments and Medicaid reform, revenue cycle is becoming a top strategic priority, not just an operational one. The smartest organizations are doubling down on RCM, including pre-visit, documentation, and coding, because if you don’t understand this part of the engine, you’re about to be left behind. Health systems are also moving aggressively into the ASC space, increasing capital spend, betting on ASC service line outperformance, and, in many cases, partnering with independent groups in revenue-share models.
But hospitals are far behind seasoned ASC operators, setting up inevitable competitive tension as the landscape shifts. Layer on the fact that 60% of CFOs are targeting administrative cost reductions, according to The Health Management Academy, and the message is clear: If you’re not talking about revenue cycle right now, not just spend, but value, you’re missing the biggest swing in healthcare operations in a decade.
Chetan Parikh, Founder & CEO at RAAPID INC
The spreadsheet era is over. You cannot manage audits (RADV, RAC, etc.) with sticky notes, Excel spreadsheets, and email chains. In 2026, the industry will finally shift from chasing every code to defending every code.
CMS expanded RADV audits from 50 health plans to 500+. Explainable and trustworthy AI that links each diagnosis directly to MEAT-based evidence becomes the standard. Plans still running, fragmented, reactive workflows will pay for it in audit findings.
Josh Amrhein, Business Manager, Revenue Integrity at Solventum Health Information Solutions
As we approach 2026, revenue integrity is seeing a shift from retroactively managing denials to proactively safeguarding revenue before claims are even submitted. The driving force? AI-powered predictive analytics.
My prediction: by 2026, predictive analytics will serve as a cornerstone of revenue integrity, transforming the revenue cycle into a proactive, upstream strategy. With AI, organizations can embed intelligent guardrails directly into their clinical and billing workflows. These systems proactively analyze clinical notes, coding trends, and payer rules in real time to flag high-risk claims and potential gaps before submission. Imagine identifying documentation gaps or medical necessity questions as clinical notes are being written, not weeks later. AI makes this possible by prompting clinicians and specialists to address issues immediately.
By 2026, this proactive, AI-driven model will become the standard. Organizations that adopt it will not only achieve stronger financial outcomes but also be able to focus on what matters most: delivering exceptional patient care.
Curtis Anderson, CEO at Nursa
In 2026, the core question posed by health systems will no longer be ‘do we have enough staff,’ but ‘do we have the optimal workforce strategy to drive Operational ROI while building a system for the way that nurses actually want to come to work?’ The One Big Beautiful Bill simply accelerates a shift that was already happening: the goal of staffing decisions can’t just be to stay afloat – operational ROI must be proven as the driving force behind every workforce decision, creating measurable outcomes for patients, and efficiency for health systems.
The new generation of nurses wants flexibility, control, and all of the information transparency they need to drive the best decisions to find work that best fits into their lives. They will no longer accept an outdated model, and with all of the career avenues available to them, why should they? Health systems will need to work hand-in-hand with new technologies and embrace digital natives if they want to win. Flexible nursing staff are no longer a last resort, but a core strategy that replaces poorly planned, costly, last-minute placements with optimized and efficient staffing.
Noah Breslow, CEO at Revecore
In 2026, hospitals will double down on AI-driven revenue cycle intelligence as rising payer friction and expanding IT budgets push leaders toward solutions that deliver immediate financial impact. With labor pressure still high, they’ll prioritize automation that reduces documentation burden, accelerates reimbursement, and improves accuracy across the revenue cycle.
It will also be the year AI is expected not just to automate tasks, but to eliminate the margin-draining friction points, like preventable denials, underpayments, and administrative drag. Health systems will demand technology that produces transparent, measurable results rather than black box promises. Organizations that scale these capabilities will not only protect revenue but fundamentally reshape how their teams manage complexity.
John Chinnici, CEO at Ledger Run
AI will make a measurable dent in clinical trial inefficiency, particularly in study startup timelines. Next year will be a turning point where AI’s promise in life sciences finally meets pragmatic execution. By targeting the administrative bottlenecks that have plagued clinical trials for decades, including contracting, budgeting, and payment processing, AI will begin to demonstrate return on investments and accelerate trials significantly.
Early estimates show AI can reduce study startup timelines by 15-20% on average, saving millions in overhead costs per global trial. AI has proven it doesn’t need to design the next blockbuster molecule to transform the business of clinical research. The future of clinical trials is not just smarter science, but also smarter operations, powered by AI that quietly handles the laborious tasks fast and allows researchers to re-focus on supporting sites and patients.
David DeHommel, VP of Payer Strategies at Reveleer
In 2026, there will be an acceleration of pressures felt in 2025. Rising utilization and pharmacy spend will push health plans to refine their benefit strategies, balancing affordability for members with long-term financial stability through more selective market participation, targeted benefit design, and AI-enabled operational efficiencies.
This financial stress should push AI past pilots and into tactical, outcomes-driven execution, focused predominantly on use cases that directly generate meaningful ROI, such as Stars, risk adjustment, and cost of care savings. At the same time, regulatory scrutiny will require major compliance shifts, anticipate RADV audits to become standard operating procedure, and quality measurement will evolve into a continuous, year-round effort.
Todd Doze, Chief Executive Officer at Janus Health
AI and automation are evolving from simple efficiency tools into intelligent systems that can predict risk, guide decisions, and optimize entire workflows across the revenue cycle. Powered by operational intelligence, these technologies will help health systems prevent denials, streamline prior authorizations, and ensure accuracy long before a claim is submitted. The future is a more predictable, resilient revenue cycle where human expertise is elevated through intelligent automation.
Thomas Ervesun, CEO at Alphaeon
Healthcare providers in 2026 will have to become more creative and flexible in how they manage their revenue cycles and make it easier for patients to afford care. Otherwise, practices risk losing patients who can no longer afford care due to rising costs and premiums. Patients facing expensive treatments will look to providers for help through such measures as third-party financing.
Frank Forte, CEO at EnableComp
Looking ahead to 2026, hospitals will face escalating financial and operational pressures as workforce shortages, cybersecurity risks, and rising reimbursement complexity converge. AI-driven automation will become essential to strengthening revenue cycle accuracy, reducing denials, and improving the patient experience, while advanced analytics will offer insights that safeguard financial stability. The leaders who thrive will be those who combine purpose-built technology with strategic partners who can deliver the expertise and resilience needed for a more demanding healthcare landscape.
Sara Pastoor, MD, Head of Primary Care Advancement at Elation Health
In 2026, we will see a fundamental shift in how revenue cycle management functions inside primary care. AI will replace tasks more than people. In primary care, that means fewer hours on manual transcription, chart summarization, data abstraction for quality, prior authorization paperwork, basic coding, billing operations, and routine inbox or scheduling triage.
Roles will evolve: medical scribes shift to workflow facilitators; revenue cycle teams focus on exceptions; care coordinators spend more time with patients and less time chasing records. The work that remains irreducibly human, like clinical judgment, shared decision making, and trust building, only grows in importance, and our tools must continue to honor that.
There is a very real risk, however, of AI making our current system dysfunction worse through hyperefficiency to drive outsized productivity at the expense of the human experience at the heart of healthcare. The world will be watching.
Roshan Patel, CEO at Arrow
In 2026, AI will ignite an arms race between healthcare providers and payers. For years, insurance companies have held the upper hand with sophisticated automation and data-driven decisioning. Now, providers are fighting back by using AI to spot patterns, appeal denials faster, and reclaim lost revenue.
We’re entering a new ‘cat and mouse’ era in healthcare payments, one where both sides continuously evolve their technology to outsmart the other. The winners will be those who combine human expertise with intelligent, collaborative automation to supercharge their teams and stay one step ahead.
Michael Peluso, Chief Product and Strategy Officer at Rectangle Health
Massive transformation in how insurance payments are processed. Current healthcare payment systems are fragmented, with enormous potential for technological integration between payers and providers. A recent survey revealed that more than two-thirds (67%) of executives and decision-makers in healthcare payer organizations say their firms’ manual payment platforms are reducing efficiency, underscoring how outdated processes directly contribute to today’s operational and cost challenges. Payments modernization is no longer optional; it’s essential.
Looking ahead to 2026, we’ll see system-wide connectivity become the industry standard for accelerating reimbursement cycles and improving transparency. Integrated platforms that connect payers and providers will be pivotal in eliminating inefficiencies, reducing administrative burdens, and strengthening cash flow, addressing a critical strain in providers’ revenue cycles.
Healthcare organizations will be eager to adopt solutions that accelerate the movement of funds and data digitally and securely. They’ll partner with vendors who offer advanced automation, specialized capabilities, and strong connections across the payer-provider ecosystem.
David Schummers, Co-Founder & CEO at Apella
While 2025 was the year artificial intelligence started moving beyond far-off ideas and toward solving real problems, I expect 2026 to bring high expectations for clear financial ROI. For healthcare, this means the decline of self-fulfilling prophecies and the rise of a new standard in measurable results for providers and patients alike.
I predict a continued evolution of pragmatic AI, with an increased focus on context-relevance. In hospitals, so much of decision-making and outcomes are dependent on context and specificity. We will see a prioritization of hardware-based AI innovations and a heavier emphasis on deep learning. These subtle changes foreground novel, contextual, and actionable insights and address healthcare’s most pervasive problems by tying solutions to time, place, and setting.
Mike Valli, Chief Commercial Officer at symplr
In 2026, finance teams will not be siloed, but a part of a unified healthcare team. Finance teams will better integrate across businesses to support organizations as a connected team with clinical, IT, and leadership perspectives to help solve industry challenges. With financial pressures now the top challenge across teams, collaboration is required to build the path forward and break healthcare’s crisis culture. We can better amplify each other’s successes and experienced perspectives to ensure we’re driving outcomes for patients, providers, and the bottom line.
Thank you so much to everyone who took the time out of their day to submit a prediction to us, and thank you to all of you for taking the time to read this article! We could not do this without all of your support. What do you think will happen for Revenue Cycle Management in 2026? Let us know on social media. We’d love to hear from all of you!
Be sure to check out all of Healthcare IT Today’s Revenue Cycle Management content and our other 2026 Health IT Predictions.
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