Predictions for US Healthcare in 2026: AI, Discontent, and Health Equity
TL/DR –
The US healthcare industry will face significant turbulence in 2026, with a particular spotlight on the adoption of AI, alternatives to traditional care and the cost pressures of healthcare. Discontent among patients and clinicians will rise, and smaller healthcare organizations will continue to lose ground to larger competitors. Furthermore, while there will be many legislative proposals to address these issues, it is predicted that the healthcare industry will see little change overall.
Predictions for the American Healthcare Industry in 2026
As 2026 approaches, the future of the American healthcare sector seems to be defined by tumult and change. Public discontent with increasing costs combined with dissatisfaction with patient experiences is set to fuel legislative activity. However, most of these legislative efforts may not result in significant transformations.
The healthcare landscape will witness a mix of winners and losers, heroes and villains, underlying a spirit of revolution. AI adoption in US healthcare is likely to encounter challenges, despite its potential for success.
Healthcare’s AI Revolution Experiences Speed Bumps
The healthcare industry in the US leads in AI adoption, largely due to cost pressures. However, the integration of AI in certain domains might be challenging, causing rewards to appear slower than anticipated. AI’s potential is substantial but will face resistance from embedded processes, values, and attitudes.
MAHA Goes Mainstream: Growth of Alternatives to Traditional Care
The Make American Health Again (MAHA) movement, led by US Secretary of Health Robert F. Kennedy Jr, redirected US interest towards prevention and wellness. Function Health and Prenuvo, which offer direct-to-consumer laboratory testing and radiologic screening, respectively, are expected to become more prominent.
GLP1 Revolution Continues with Some Detours
Real-world data on GLP1s will stimulate increasing interest in this class of drugs. However, these studies may highlight safety signals causing more caution around these drugs. The opportunity lies in identifying novel clinical indications and sub-populations where these drugs offer additional benefits.
Medicare Advantage Retains Popularity Despite Critics
Despite criticism, Medicare Advantage continues to grow due to its lower out-of-pocket costs and more generous coverage. Traditional Medicare is increasingly becoming a feasible option only for the affluent seniors, making Medicare Advantage an important part of the US social safety net.
Patient and Clinician Discontent Expected to Rise
Issues like medical debt, surprise billing, insurance denials, and escalating medical premiums and drug costs will lead to increased patient dissatisfaction. Healthcare professionals may also express discontent due to stagnating wages, corporatization, and labor arbitrage effects.
Small Players in Healthcare Likely to Continue to Struggle
Changes to reimbursement and higher than anticipated medical utilization have led to significant losses for national and regional health plans. This trend is likely to continue, forcing further consolidation or sale of such health plans.
Digital Health IPOs Remain Steady Amidst Increased Transaction Volume
The year 2025 marked the return of the digital health IPO, a trend expected to continue into 2026. Alongside these IPOs, other transactions will occur as startups strive to avoid failure and seek liquidity.
Pharma Pricing and PBMs Remain Under Scrutiny
Public antagonism towards the pharmaceutical industry is expected to peak in 2026. Amid this public scrutiny, pharma industries and PBMs will need to evaluate their public engagement strategies. Despite producing significant health innovations, the industry continues to grapple with pricing and payment issues.
Legislative Activity Increases, but with Little Impact
Despite numerous healthcare bills and promises of a new healthcare solution, actual legislative changes will likely be minimal. The contentious and divisive nature of healthcare policy makes even simple reforms challenging. Most changes will likely emanate from regulatory efforts by the executive branch.
Health Equity Poised for a Modest Comeback
Despite fading from the public imagination in the past, efforts to address health equity are expected to resurge in 2026. Not only because it’s ethically correct, but also because it can be good business in certain settings.
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