🏥 YOUR 2026 Predictions for Healthcare

"Following the money," the "Three Cs," and a "credit crack" — here's what the Hospitalogists had to say about 2026

Hey Hospitalogists,   On Thursday, Parth Desai and I shared what has become the annual Hospitalogy Soothsayer Special, but I also asked the Hospitalogy family to share their predictions for healthcare in 2026. We're including YOUR predictions today. Thanks to everyone who participated.   Have you been asking your questions or responding to others in the Hospitalogy Membership? We're seeing some very thoughtful discussions and helpful answers. Help me keep the Q&A flowing!   Let's see what you had to say about 2026.   (Heads up: the next issue will arrive Friday instead of Christmas Day.) Was this email forwarded to you? Subscribe Here ASK HOSPITALOGY 2026 Predictions from Hospitalogy Membership Blake asked, "What's your spiciest prediction for 2026?"  THE "FOLLOW THE MONEY" TAKE Yoav Fisher - Head of Strategic Innovation   "To quote Wu-Tang - 'Cash Rules Everything Around Me'... My predictions are pessimistic if you follow the money...   Profit compression is going to further shrink MA, leaving millions of elderly in the lurch scrambling around trying to figure out if they are eligible for some SNP program - let alone what is an SNP program. I am going to create a P-SNP program for pickleball injuries, and an M-SNP program for Mahjong related complications.   The massive disconnect between private market valuations and public market valuations is going to finally blow up - which will rattle the investment environment (but also creates opportunity for smaller more nimble players... there are already some of these who are doing interesting moves).   The bottom 80% of provider systems who are on fumes or negative margins will be squeezed even more, as they don't have the resource or capital to access revenue generating or cost reducing innovation. Cue PE roll-ups...   The care gap between haves and have-nots will widen even more...   Unfortunately, I think 2026 is going to be a tough one... but it does create opportunity for those who can strategize correctly through the tea leaves." THE "THREE Cs" TAKE Patrick Allen - VP of Business Development   "2026 is going to be a pivotal year for our industry. I believe we can sum the trends to three Cs:   Consolidation: this trend will continue throughout the sector. I expect we'll see more regional health plans combine. What isn't as discussed these days is the pending consolidation / exit of some of these AI / health-tech companies.   Those that have solid use cases, customer bases, and ARR will acquire the weaker ones. Health system consolidation (especially in the rural space) will continue.   Consumerization: now that the buying public is more exposed than ever to the true cost of healthcare, prescription drugs, and insurance (and those costs are increasing rapidly), I believe there will be more price sensitivity and emphasis on experience and quality. Some providers are doing this very well; others aren't and will have a steep learning curve.   I'm also curious to see if the historical trend of independent practices selling to PE platforms, health systems, or Optum starts to reverse.   Cost containment: this will happen across the board and will take a few forms, including further layoffs, decreased or delayed capital spending, and ongoing continuous improvement (near and dear to my heart) efforts.   I'm also watching the proliferation of ICHRA health plans. Similar to how pensions and other defined-benefit retirement plans are mostly gone (replaced by the defined-contribution plans we know today), I believe employers will start to shift risk to employees in the healthcare space as well with ICHRA plans being a tool to do so.   On a final note, I'm curious to see how the various 'innovation' and 'venture' programs at large providers will fare. To some, these are an unnecessary distraction (of both talent and capital). To others, these are an important diversification tool, and they're the reason some health systems can report positive net income. We shall see!" THE "BACK TO INDEPENDENT PRACTICE" TAKE Taylor Rogers - EVP/Partner   "Increased transparency and uniformity of reimbursements, particularly for pro fees, will open the door for physicians to stand on their own and leave hospital or PE backed employment.   This will take time, but if physicians migrate back to independent practice, it will allow for a more consumer driven system.   Expansion of HSA eligibility (if it ever actually happens) would also accelerate this.   5-10 year pipe dream: Death to networks!" THE "CREATIVITY IN INNOVATION" TAKE John Shallman - President   "Healthcare, or more specifically hospital based innovation programs, have plateaued. There is no creativity nor innovation in innovation. Programs do much of the same nationally. Many programs will be audited internally and be phased out. Innovation programs have to have a path to sound rev generation." THE "ACA SUBSIDIES FALLOUT" TAKE Rachael Robinson - Rehabilitation Manager   "1. With the potential for ACA subsidies ending, it could cause ACA plan rates to jump over 75% for many enrollees. 2. Employers and individuals could see health premiums outpace inflation with hikes of 6-10%. 3. Potential for more rural and small hospitals to face closure or drastic cutbacks." THE "HOT DEBATE" TAKE John Self - Founder   "The bigger issue is our extraordinary costs and our bad outcomes. Healthcare, because it touches so much of federal operations and spending, will find itself in the nexus of what will become a very hot debate over affordability and our unsustainable national debt. In one 70-day period since Trump took over, our national debt increased by $1 trillion dollars. That is on top of the $38 trillion we have already logged in. We are facing a credit crack and that would have devastating consequences. As an industry we can take the lead, or let Washington do it. If your response is let Washington do it, you will deserve all the hell you get." THE "STAFFING" TAKE Craig Premo - Senior Brand Manager   "OK, here are my thoughts: Staffing firms will continue to consolidate through acquisition, others will downsize due to too many firms chasing too few clinicians to place. Pay rates for travelers will normalize enough to be competitive with full-time clinical staff, leading healthcare systems to rethink their talent strategies. Virtual nursing will go mainstream and be adopted by more healthcare systems. AI scribing will be the common practice in most systems." THE "EMERGING TECH" TAKE Rebecca Morgan - Certified Surgical Technologist   "[On LinkedIn,] I found the Dexter general laparoscopic robot from Switzerland. The company is Distalmotion. Just like the DaVinci robot, I have a gut feeling this is about to take off! Also, our ASC may be a little behind the times as money for facilities buying new things is always an issue. But, when the rep brought in the Clear Petra for Urology, I was all in at 100%. It's interesting the more hype I made intra-op about how great it was for the surgeon, the more the surgeons loved it! Honestly, it was more for me. Using the stone basket to retrieve kidneys stones should be archived. Just say'n." THE "PBM AND PRICE REFORM" TAKE Jeremy Shane - CEO/Founder   "1. PBM Reform ... Cuban wins: Legislation signed to require PBMs to publish net price schedules for their drugs and use net price to set all other %age-based fees to manufacturers, wholesalers, pharmacies, or payors. Likewise, fix net price as the basis for consumer OOP payments for deductibles and co-pays.   2. 340B will be next after PBMs, with threats, although no passage of legislation, allowing physician-owned hospitals and limits on 340B outlays.   3. Lilly deploys subscription pricing to employers for GLP-1s, allowing purchase of any dosage/form at a fixed PMPY price, along with recommended list of virtual weight loss clinical/counseling services.   4. Clinical trial results for CAR-Ts in autoimmune will threaten another explosion in health insurance premiums and calls for gov't program for CGTs (including CAR-Ts)."   Hospitalogy members can join this discussion here. Not a member yet? Apply to join here. SPONSORED BY CHEGG SKILLS AI can help your healthcare organization drive revenue, but you have to drive AI's adoption and implementation. Getting that step in the process right means providing your teams with practical, role-specific AI training. In collaboration with Chegg Skills, I've written a report that breaks down how online programs purpose-built for healthcare help you close the AI skills gap so you can stop leaving ROI on the table. See what's missing from your investment in AI. Get the Report HEALTHCARE STRATEGIES Holidays can be high-risk for healthcare staff Every year around the holidays, hospitals brace for the predictable stuff: higher volumes, thinner staffing, and whatever flu/RSV decides to do next. What's harder to accept is the less-discussed surge that comes with it. More stress, more burnout pressure, and too often, more workplace violence directed at the very people showing up to care for everyone else.   Since piling holiday strain on top of baseline exhaustion can push clinicians from "hanging in" to "not sure I can do this anymore," I thought it was worth sharing five priorities most experts agree are essential to protect clinician wellbeing and safety: Deploy staff duress alert systems. Real‑time‑location systems (RTLS) with wearable panic‑button tags allow staff to silently signal for help, while instantly sharing their precise location to reduce response time. Build a culture of safety before a crisis happens. Show leadership's commitment to employee safety with adequate staffing and resources, including training staff in de-escalation. Give employees access to behavioral health resources. Explore peer support, mindfulness, or resilience program options and keep communication open about stress and burnout. Reorganize workflows to reduce stress and crowding. This article suggests practical steps to plan ahead for holiday surges and provides links to additional resources. Encourage reporting of all incidents (verbal, threats, near‑misses), then analyze patterns (time of day, unit, staffing levels) and adapt staffing, security, and protocols accordingly. ON YOUR RADAR Read: Speaking of predictions, check out 10 predictions from clinical and executive health system leaders, researchers, and analysts describing how the AI conversation will change in 2026. Read the article in Becker's Health IT. Breakdown: Systematically identify and manage patients' behavioral health needs with a platform that embeds patient screening, referral management, and analytics directly into your EHR. See how in my article.* Roundtable: Join us for the first Hospitalogy roundtable of the year! January Roundtable for Plus Members, Friday January 23 at 1pm EST. *This read is brought to you by one of my brand partners who help make this newsletter possible! RECENT HEADLINES  Trinity Health is expected to become the largest single-instance Epic user in the country by spring 2026, wrapping up an $800M EHR rollout. Trinity Health aims to extract maximum value (citing innovation, interoperability, standardized workflows, and deeper data insights) from a unified platform. Read the full story from Becker's Hospital Review. Premier data paints a not-so-pretty picture of the One Big Beautiful Bill Act, showing the OBBBA will trigger a $68B hospital revenue impact over the next two years. See the key takeaways and breakdown here. Nearly 1 in 4 Americans believe US healthcare is in "crisis" and 29% (up from 23% a year ago) cite healthcare cost as the most urgent national health problem, according to a West Health-Gallup survey. The survey also shows 47% of respondents "see major problems" with the healthcare system. See the breakdown from Gallup. I hope you enjoy the holidays!    — Blake   🏥 Hospitalogy Membership I'm building a community of leaders in strategy, finance, and ops at hospitals and health systems to help us connect, learn, and grow together. Apply for free membership here. Get your brand in front of 50,300+ executives and healthcare decision-makers. Let's Partner → Workweek Media Inc.  1023 Springdale Road, STE 9E Austin, TX 78721   Want to ruin my day? Unsubscribe.