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 Rising Healthcare Prices and Administration Cost Cutting predictions:
Carrie Kozlowski, Co-Founder and COO at Upfront by Health Catalyst
In 2026, healthcare competition will fundamentally shift, extending well beyond the typical industry players. We’re no longer competing with one another over where someone receives care; we’re fighting to ensure they get care at all. Capturing consumer attention and dollars will be increasingly challenging as macro-economic pressures drive up individual healthcare costs due to disenrollment, MA plan reductions, High-Deductible Health Plan proliferation, and coverage requirement changes.
The financial tradeoffs are real, and consumers will continue to feel them. If we fail to make the case for completing care, those consequences will be equally painful: delayed diagnoses, advancing chronic diseases, more frequent ER visits, and increased hospitalizations. Consumer-driven healthcare isn’t a possibility; it’s here. The question is whether healthcare organizations are prepared to compete for both share of attention and wallet.
Larry Adams, Chief Nursing Officer and SVP of Strategy at CareRev
With the One Big Beautiful Bill looming, virtual nursing, at-home hospitals, and a new, essential collaboration between Chief Nursing Officers (CNOs) and Chief Financial Officers (CFOs) is inevitable, driven by hospitals’ need to save money. It’s a necessity for the CFOs and CNOs to work closely together to manage tight margins and create sustainable plans, a combination of the CNO as the “bedside” and the CFO as the “rev side” to create a well-oiled machine.
Carol Berry, CEO at Health Care Administrators Association (HCAA)
In 2026, the self-funded community is going to demand more transparency, faster responsiveness, and clearer proof of value than ever before. Employers are under intense cost pressure, and they’re looking to third-party administrators (TPAs) to be the partners who can actually deliver flexibility and accountability, not just talk about it.
We’ll see a stronger push toward real-time data sharing, tighter collaboration with providers, and plan designs that prioritize measurable outcomes over legacy processes. Workforce shortages and rising costs won’t disappear, but the TPAs that stay close to their groups and move quickly on operational improvements will stand out. Next year will reward the organizations that are nimble, practical, and willing to rethink how self-funded plans are delivered.
Jeni Burckart, VP, Healthcare & Workforce Services at Tuition.io
In 2026, financial and education-related benefits will be essential for healthcare organizations. In this industry more than any other, education and credentials are integral, at a time when education costs are at an all-time high with no sign of relief. Talent shortages are a chronic issue that will only worsen for nurses, physicians, and medical techs with the implementation of the OBBB. New reductions in federal education funding take effect next July, meaning less funding for medical degrees and even higher student loan payments for those already paying back student loans. On top of all that, the constant policy changes have created more uncertainty about their student loans and paths to forgiveness.
Programs that make education more accessible and ease financial pressure for employees will see more effective recruiting efforts, lower turnover, and can accelerate internal career mobility to fill critical roles. This means aligning education assistance with requisite credentials and increasing awareness so employees can take full advantage of the resources available to them. For example, tuition assistance for certification programs can help current hospital staff upskill into medical technologist and technician roles; tuition-for-service programs can build reliable nursing talent pipelines; and student loan benefits can address the #1 financial expense for early career physicians.
Tray Chamberlin, Principal and Healthcare Lead at Alexander Group
Several regulatory changes took place in 2025, including those to Medicare and Medicaid reimbursement rates, the Affordable Care Act tax credit expirations, and shifts in employer-sponsored insurance coverage. Given these changes, healthcare organizations are preparing for a financially challenging year ahead. Anticipating budget constraints and pricing increases, healthcare leaders will implement cost savings initiatives that emphasize efficiency and drive incremental revenue to offset the margins impacted by policy.
We will see increased investments in AI and other tools that support administrative-related tasks for documentation and billing – improving clinical efficiency to allow providers to see more patients and drive more procedures. These investments and reallocations of spending will also impact continued hiring trends that focus on clinical and non-clinical surgical roles to support targeted areas of revenue increase.
John Fanburg, Healthcare Attorney at Brach Eichler
Reimbursement pressures will intensify, widening the divide between large, well-resourced systems and smaller independent practices. As low reimbursement rates continue to strain health system operations, there may be a push towards more practice consolidation, with mergers and private equity ownership creating new tensions around staffing levels, patient experience, and continuity of care. Federal Medicare and Medicaid reimbursement decisions will continue to weigh down private payer negotiations, with rates remaining misaligned with regional cost-of-living differences. Providers will need to advocate for geographically responsive reimbursement models while exploring efficiency strategies that do not compromise clinical quality or staff capacity.
Tom Furr, CEO at PatientPay
Heading into 2026, ACA-marketplace premiums are projected to spike by an average of 26% (and in some states, north of 30%), the largest rate hike since its inception. Even more troubling: if enhanced premium tax credits expire at the end of 2025, some enrollees may see their premiums more than double. Healthcare providers need to get in front of incoming patient collection challenges with digital wallets, which can be charged for any copays or bills, especially considering that copays already account for the highest percentage of bad-debt write-offs.
We’ll see providers successfully weather this storm by implementing new collection strategies specifically for their ACA-insured patients. This population segment is going to experience unwanted financial surprises in the coming year. Providers need to be prepared to meet that confusion and frustration with empathy, easy payment capabilities, and transparency. Clear communications about coverage limits, cost expectations, and flexible payment options will all be critical to mitigating financial strain in what’s shaping up to be a very challenging year.
Bart Hester, Chief Growth Officer at Paradigm
Health plans are swimming upstream right now. Everyone is scrambling to bend the cost curve, and that urgency is only intensifying heading into 2026. There’s more pressure than ever to manage rising costs, yet no regulatory relief is in sight, which adds another layer of risk. The silver lining is that we’re seeing an uptick in engagement and willingness to have real dialogue. Plans are laser-focused on cost containment, and the bar for demonstrating measurable value continues to rise. In the coming year, we can expect even more aggressive efforts to contain costs as the entire ecosystem looks for sustainable solutions.
Gary Johnson, Chief Growth Officer at Curae
In 2026, the industry’s biggest disruption will be managing an affordability shock that reshapes patient behavior in real time. As enhanced ACA subsidies sunset and Medicaid redeterminations under new requirements continue, millions will slide from insured to under-insured status, including employees in ‘good’ employer plans facing record premiums and high-deductible plans. Many patients in ACA plans will become delinquent on premium payments, and many will not be able to afford the new premiums to enroll for the first time.
The result: routine care will suffer, with emergency departments becoming the de facto primary care home for families who can no longer afford traditional access points. By mid-year, many health systems will be staring at a 3-4% revenue gap driven by rising bad debt and deferred elective care.
The health systems that stay ahead will treat patient financial access as a core capability, segmenting patients in real time, orchestrating flexible payment and financing options, and intelligently tapping philanthropic and third-party funding rails, all embedded into a retail-grade digital experience.
Verlon Johnson, Chief Government & Corporate Affairs Officer, EVP at Acentra Health
Medicaid is entering a moment where modernization finally meets the everyday realities of the people it serves. In 2026, states will use scalable technology, better data, and true interoperability to make decisions that are faster, equitable, and more responsive to individuals and families, especially those who rely on Medicaid the most. Even with tight budgets, states will strengthen eligibility and enrollment systems and improve how information is shared so that people experience fewer barriers and more consistent support. Years of investment will translate into clearer pathways to care, more timely services, and a system that feels more connected and humane for the millions who count on Medicaid every day.
Rami Karjian, Head of Operating Rooms Business at LeanTaaS
In 2026, perioperative services won’t just be asked to do more with less as the macro financial pressures on health systems persist – they’ll either abandon siloed, reactive workflows or watch surgical margin and access erode. Mandatory TEAM bundles will push financial risk onto perioperative performance, putting a premium on rigorous PAT and real patient optimization, starting with site-of-care choice. Site-of-care routing and decisioning – who belongs in the main OR, the ASC, or same-day pathways – will be as critical as block time and can no longer be left to gut feel.
Health systems will need an end-to-end orchestration layer that uses sophisticated math, AI-driven forecasting, and real-time optimization to make these calls: dynamically risk-stratifying patients in PAT, using AI to handle routine outreach and readiness calls, and prescribing the lowest-cost, safest care path. The winners will unify clinics, ORs, PACUs, and ancillary teams into a single intelligent rhythm that unlocks capacity, stabilizes staffing, and proves that the future of surgery isn’t another dashboard. It’s closed-loop, math-first orchestration across the episode.
Oliver Kharraz, CEO and Founder at Zocdoc
In 2026, hospitals and health systems will be forced to confront growing financial strain as Medicaid policy shifts widen the gap between reimbursement rates and the true cost of care. With uncompensated care on the rise, many systems will face mounting losses; to address this, they must move quickly to diversify their patient panels, strengthen their payor mix, and expand access. This is not just a growth strategy; it is a financial imperative to preserve care for all patients, regardless of insurance. No margin, no mission.
As financial pressure increases, systems will grapple with an internal bottleneck of their own making: the accumulation of software, decision trees, and workflow customization that promised to increase provider efficiency but has actually strangled provider access and throughput. The result? Highly paid clinical resources are underutilized, and operational inefficiency is baked into care delivery. In 2026, hospitals will need to dismantle this throughput bottleneck and re-optimize efficient use of their most valuable asset, a provider’s time, or risk letting margins erode past the point of recovery.
Tobias Mezger, Co-Founder and CRO at PayZen
As we look to 2026, health systems will continue to be under mounting financial pressure. They are going to look at any incentive that helps cash flow or efficiency because many are limited in hiring, and some are laying off staff in administrative functions. At the same time, everyone is focused on how to use AI to make things more efficient and automate work, alleviating some of that financial pressure.
We will also see an increase in balances paid directly by patients as costs go up, ACA subsidies are cut back – which will push more people to high-deductible plans – and Medicaid expansion is reduced. That means more self-pay balances, or more people with insurance that only covers catastrophic balances, but in turn has a high out-of-pocket cost. We will also see more applications for financial assistance and more work tied to Medicaid applications and Medicaid requirements.
Health systems will respond by focusing more on patients who can pay through earlier financial conversations tied to estimates and scheduling, stronger upfront payment requirements, and a firmer stance on presumptive charity. At the same time, they will make the charity application process easier for patients who qualify.
Matt Noble, SVP, Head of Patient Cloud at Medidata Solutions
2026 will be defined by a more resource-constrained but technologically empowered clinical research environment, where reduced funding and regulatory uncertainty drive sponsors toward smaller, more complex trials. AI-assisted trial design builders will play a pivotal role, enabling sponsors to efficiently create and adapt intricate studies, optimize protocols, and maximize insights from limited patient cohorts. By streamlining trial setup and enhancing personalization, AI-assistant tools will free up valuable time for study teams to focus on patient-facing care, ensuring that even leaner studies deliver meaningful outcomes for patients and therapeutic innovation.
Dr. Thomas Schenk, Chief Medical Officer at Paradigm
As we head into 2026, health plans are under immense pressure, and that strain is likely going to deepen. We’ll see plans continuing to adjust their case and market mixes, cutting administrative costs wherever possible and doubling down on the programmatic levers they rely on when they’re searching for stability. Some will push automation even further to try to be more aggressive on cost containment. These are the moves we can expect before any meaningful relief arrives.
Vikram Singh, Chief Revenue Officer for Healthcare at Infinite Computer Solutions
By 2026, the healthcare industry’s greatest challenge, delivering high-quality care while containing costs, will intensify. With reimbursements tightening and Medicaid programs under pressure, providers and payers will lean heavily on technology to achieve efficiency without sacrificing care quality.
The next year will mark a shift from chasing every innovation to investing strategically in tools that deliver measurable impact. Application rationalization, retiring underused or duplicative systems, will free up funds for AI-powered automation, telehealth, remote patient monitoring (RPM), and predictive analytics that drive both savings and better outcomes.
Telehealth will remain a core part of care delivery, extending access to underserved regions and helping offset physician shortages. Virtual visits will help close workforce gaps and extend care into underserved regions, offsetting a looming physician shortage. Remote monitoring will expand its footprint, offering continuous data on patient health and enabling earlier, lower-cost interventions.
Behind the scenes, AI and automation will streamline administrative workflows, revenue cycle management, and call centers, reducing costs while improving accuracy and staff efficiency. Predictive analytics will give organizations the foresight to anticipate demand, allocate resources effectively, and personalize care for at-risk populations. In 2026, success in healthcare will hinge on balancing financial sustainability with clinical excellence. Organizations that align technology investments with strategic goals, prioritizing efficiency, interoperability, and patient outcomes, will emerge as leaders in a system where cost control and compassionate care can finally coexist.
Rodd Turnquist, Sales Manager – OEM Division at Watson-Marlow Fluid Technology Solutions
Anticipated FDA cuts and slower approval timelines will push medical device manufacturers to rely on existing approvals to speed market access. Companies will increasingly turn to streamlined pathways like the FDA’s 510(k) process, favoring devices built on established, validated technologies. The shift will shine a light on suppliers with strong compliance track records that can offer fully tested, quality-assured products that reduce risk and accelerate time-to-market.
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 Rising Healthcare Prices and Administration Cost Cutting 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 Rising Healthcare Prices and Administration Cost Cutting content and our other 2026 Health IT Predictions.
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