1: Healthcare affordability: Political pressure and the reimbursement squeeze
Political pressure and the implementation of H.R. 1 will reshape reimbursement models, tighten rates, and shift financial risk across payers and providers.
2: Private equity in healthcare: Betting big on tech and efficiency
Private equity will double down on healthtech and AI as cost pressures mount.
3: AI in healthcare: Scaling innovation amid compliance challenges
AI in healthcare will scale rapidly, with a focus on transparency, compliance, and integration into core clinical and operational processes.
4: Value-based care: CMS TEAMS and ACCESS models redefine risk and outcomes
CMS TEAMS will launch amid skepticism, while the new voluntary ACCESS model—starting July 2026—introduces outcome-aligned payments for chronic condition management, signaling a shift toward tech-enabled, risk-based care tied to measurable results.
5: Distressed healthcare
Cuts to the Medicaid program under H.R. 1 are expected to strain safety net providers and drive closures or consolidation among rural hospitals and other providers.
6: Privacy and wellness in DTC platforms: Navigating growth and scrutiny
Direct-to-consumer (DTC) health and wellness platforms will surge in 2026, blurring the line between healthcare and consumer care while facing heightened regulatory scrutiny over data privacy and engagement practices.
7: Behavioral health: Consolidation surge and private equity investment continue
Behavioral health will see accelerated consolidation and robust private equity investment, with technology-driven models and integrated care shaping a more scalable, efficient, and patient-centered future.
8: Political attention on healthcare: State-federal tensions reshape compliance
From reproductive rights and women’s health to antitrust, AI regulation, price transparency, gender affirming care, and DEI, expect political and regulatory friction to drive complexity in compliance and material transactions.
9: FQHCs under the microscope: Enforcement of executive orders
Expect tighter enforcement of executive orders impacting federally qualified health centers (FQHCs), signaling broader regulatory oversight and accountability across safety-net providers.
10: False Claims enforcement: DOJ/HHS turn up the heat
The reestablished DOJ/HHS False Claims Working Group, along with the whistleblower bar, will sustain aggressive enforcement activity, especially on the administration’s stated priorities.
The healthcare landscape is evolving fast, and these predictions highlight where the biggest challenges—and opportunities—lie. If you’re asking how these shifts impact your organization or what steps you should take now, we’re here to help.