Every year, healthcare leaders engage in forecasting — often cautiously, sometimes conservatively. This year, I wanted to understand what experts really believe is coming in 2026, beyond polished soundbites. So I asked some of the sharpest minds across providers, policy, technology, and revenue cycle to share their most candid, even controversial, predictions.

What emerged wasn’t a consensus. It was a striking collection of hot takes: provocative, at times conflicting, but united by a shared acknowledgment that healthcare is entering a period of economic and technological disruption unlike anything in recent memory. Together, these perspectives offer a window into the forces that may define 2026.

The hottest takes in 90 seconds

1. Economic pressure will force innovation, no matter how uncomfortable it is

The affordability crisis loomed over nearly every conversation. Millions of Americans are expected to fall into underinsurance or lose coverage entirely, a trend accelerated by ongoing Medicaid churn and the One Big Beautiful Bill Act (OBBBA). 

Dr. Penny Wheeler, former CEO of Allina Health, argued that constraints (however painful) could spark long-overdue reinvention. She predicted that financial pressure would speed the shift toward models that reward prevention and outcomes rather than volume.

Jamie Bailey, CFO of UTMB Health, took this further. In his view, the OBBBA is only the beginning, and the government can no longer subsidize systemic inefficiencies. Providers, he warned, will need to strip away layers of administrative waste and adopt AI-driven efficiencies at a much faster pace, because the era of relying on reimbursement to subsidize operational complexity is ending.

Others underscored the disconnect between the industry’s digital upgrades and the financial realities patients face. As Cedar President Seth Cohen put it, the industry needs new pathways, rather than new interfaces, because no consumer payment tool can help someone who just fell off Medicaid and owes $10,000 for an unplanned medical event.

2. Administrative waste may finally meet its match

One of the boldest themes that surfaced was the belief that administrative burden — long considered untouchable — may finally face real disruption.

Leaders pointed to examples already emerging, such as AI-enabled workflows that eliminate rote tasks and automated agents that can resolve patient inquiries. Amy Katnik, COO of ApolloMD, shared one real-world case: AI-powered voice agents have already cut average call times by 16% within her organization, freeing staff to focus on patients who need human support most.

Results like these are beginning to appear across the industry, and many believe 2026 could be the year health systems start cutting deeply into the administrative overhead that drags down margins and patient experience. My own view: a 30% reduction in administrative cost is now within reach. Several participants pushed even further, suggesting that once AI evolves from task automation to true problem resolution, the ceiling is far higher than most leaders imagine.

3. Patient loyalty will shift dramatically, much faster than expected

Amid rising financial pressure and growing patient frustration, loyalty in healthcare is being redefined. Peter Banko, CEO of Baystate Health, predicted that by 2026, patient loyalty will no longer be shaped primarily by clinical reputation or brand. Instead, it will hinge on access, answers, and clarity. 

“The health system that figures that out in 2026?” he said. “Game over. No second place.”

Technologist Dr. Geeta Nayyar highlighted the emotional dimension behind this shift. Patients may distrust the healthcare system, but they still trust their clinicians. AI’s role, in her view, is to strip away the administrative friction — confusing bills, endless phone trees, prior authorization delays — that erodes that trust. For patients, access isn’t simply about entering the system; it’s about quickly reaching someone who feels accountable for their care.

4. AI will shift from sharing data to taking action

Former U.S. CTO Aneesh Chopra offered a provocative technology prediction: conversational AI may become the “successor technology” to FHIR as the backbone of interoperability. In other words, the future may not be systems exchanging raw data, but AI agents capable of acting on that data, and initiating the countless tasks like scheduling appointments and confirming benefits that today require hours of manual work.

Nikita Singareddy, CEO and Co-founder of Fortuna Health, extended this to financial counseling. She argued that AI’s most transformative potential is its ability to act as an empathetic, judgment-free guide. When navigating care, many patients must share personal financial information, a process that can feel intimidating or even embarrassing. But AI provides a private, trusted channel to explore benefits, aid programs, and cost-saving options. In her view, AI-driven action doesn’t just improve efficiency; it enables dignity.

5. The biggest risk for AI in 2026 isn’t the technology—it’s the people

Despite optimism about AI, several leaders delivered pointed warnings. Ben Reigle, CEO of Tarpon Health, predicted that many AI initiatives will continue to fail — not because the technology falls short, but because organizations roll out AI without preparing their teams for change. He described a paradox of agency: giving people responsibility while introducing autonomous systems. Without cultural buy-in, training, and change management, even the most sophisticated AI will stall.

Others argued that the hype cycle has conditioned organizations to adopt surface-level tools rather than invest in the domain expertise required for meaningful outcomes. Cedar Chief Strategy Officer Dugan Winkie emphasized that as LLMs and voice interfaces rapidly commoditize, the real differentiation will come from solving the complex affordability and payer-data issues underlying most patient inquiries.

A future defined by tension and possibility

The most striking aspect of these conversations wasn’t the predictions themselves but the candor behind them. They challenge deeply held assumptions: that healthcare changes slowly, that administrative waste is inevitable, or that patients will tolerate complexity.

Whether these hot takes prove entirely accurate or simply directionally true, they reveal a system on the cusp of reinvention.

If you’re a healthcare leader, the most important question for 2026 may not be “What will change?”

It may be: “Who will be bold enough to act on what’s changing?

Florian Otto, MD is CEO and Co-Founder of Cedar