Healthcare is entering another period of significant change. Financial pressure continues to build, while new technologies are moving decisively from pilots to practice. At the same time, policy decisions are playing a growing role in determining how care is delivered and sustained.
At this moment, leaders are contending with rapid innovation alongside persistent access and capacity challenges. Uncertainty surrounding Medicaid, Medicare and regulatory direction adds another layer of complexity, all within an increasingly constrained operating environment.
In this Becker’s Healthcare Leadership Council group column, health system leaders reflect on the changes they believe now warrant the greatest attention and the policy shifts they expect will create the most meaningful disruption in the year ahead. Together, their perspectives reveal how healthcare leadership is recalibrating as the field enters its next phase.
Question: What change in the healthcare landscape do you believe leaders can’t afford to ignore right now — and which 2026 policy shift do you expect will create the greatest disruption around it?
Amy Perry, President and CEO, Banner Health (Phoenix)
We can’t ignore the health of our communities. The changes to Medicaid eligibility and the ACA subsidy cuts will result in more Americans uninsured next year. Policy changes are needed to make it easier for health systems to succeed with risk-based revenue and earn a reasonable margin keeping people healthy. It’s vital to creating a sustainable cost curve and allowing investments in public health.
Anne Klibanski, MD, President and CEO, Mass General Brigham (Somerville, Mass.)
In 2026, leaders must continue integrating AI into every facet of care delivery while building the organizational frameworks and competencies to enable it. AI is becoming an operational necessity, with great promise in diagnostics and therapies. At Mass General Brigham, we are using AI to reduce clinician burnout, extend access and improve the patient experience.
We are deploying AI to support appointment note‑taking, scheduling, triage and research, including clinical trial screening. Last year, we launched Mass General Brigham Care Connect, which uses AI to triage patients and link them with virtual primary care physicians; more than 1,400 patients have already accessed primary care from home. We have also expanded ambient documentation, now used by roughly 4,000 providers to reduce administrative burden and increase face‑to‑face time with patients.
At the same time, we anticipate more debate and potential regulatory policy changes around AI in healthcare. Frameworks that balance innovation with patient safety and privacy are critical. Additional questions remain on provider reimbursement and funding to support widespread adoption of AI tools across health systems. Ensuring AI is deployed responsibly and with measurable benefit to all patients will define the next era of healthcare leadership.
Bradley Haws, CEO, Clinical Enterprise, and Associate Vice President, University of Iowa Health Care (Iowa City)
We are at a pivot point around the overall cost of care. In 2026, the interplay between rural transformation funds and policy shifts around Medicaid eligibility and payment structures will likely cause the greatest disruption. Healthcare leaders recognize this is a once-in-a-generation opportunity to transform rural health care delivery, creating tension between the prioritization of financial stabilization and long-term system building. We have the opportunity to partner with rural healthcare providers to significantly improve access to local care delivery in our state, and this will largely be determined by the allocation of rural transformation funds.
Damond Boatwright, President and CEO, Hospital Sisters Health System (Springfield, Ill.)
The continued adoption and use of AI technology must be a focus for healthcare leaders in 2026. The benefits are far reaching. There has been accelerated use in clinical diagnostics, ambient scribe technology and predictive analysis, as well as operational efficiencies gained in areas like revenue cycle, scheduling and HR. AI automation of administrative tasks can combat physician burnout as well. While AI has its benefits, we need to ensure the technology is free from bias, fair, ethical and secure.
We anticipate the most disruptive policy shift being the conflict between the federal AI executive order signed in December and state-level AI healthcare regulations as they will potentially send confusing messages regarding how health systems should address emerging technologies.
Lisa Shannon, PhD, President and CEO, Allina Health (Minneapolis)
Medicare Advantage and traditional Medicare are entering a period of meaningful change. In 2026, there will be an influx of both voluntary and involuntary federal payment model updates, including efficiency penalties, stronger incentives for outpatient care and payment shifts favoring value-based, lower‑cost settings. At the same time, many health systems are reassessing Medicare Advantage participation due to authorization challenges and unsustainable reimbursement.
Leaders need to proactively lead changes aimed at affordability and access including accelerating ambulatory care models, investing in technology and operational efficiency, and reevaluating payer partnerships. Acting now builds stability and positions organizations to navigate a rapidly evolving reimbursement landscape with confidence.
Robert C. Garrett, CEO, Hackensack Meridian Health (Edison, N.J.)
Making healthcare more affordable is an issue that can’t be ignored. More than 1 in 3 American households report medical debt, and reducing the cost of care is a complex issue that all stakeholders need to address. The expiration of subsidies has caused disruption. So far, 1.4 million fewer people have enrolled in Obamacare due to soaring premiums. More people are likely to forgo coverage. As an industry, we must focus on what we can do to lower costs: shifting to value-based care models; expanding access to care while making it more convenient; and continuing to invest in prevention, well-being and transformative technology.
Robert Stone, CEO, City of Hope (Duarte, Calif.)
One change leaders can’t afford to ignore is the growing necessity of meaningful partnerships to preserve access to expert care while keeping costs sustainable. With more than 2 million new cancer cases annually and lifetime treatment costs nearing $1 million for some patients, no single organization can solve this alone. Collaboration across providers, payers, employers and philanthropy is essential to ensure patients get the right care at the right time. At the same time, policy shifts around site neutrality, 340B and rising premiums will create real disruption in 2026. Those pressures will either push organizations together to innovate — or force them to hunker down in the face of uncertainty.
Wendy Horton, PharmD, Senior Vice President and President of Adult Services, UCSF Health (San Francisco)
The capacity crisis in academic medical centers isn’t just about beds. It’s about whether we’ve built operational leaders who can navigate what’s coming. With 2026 bringing new Medicare payment pressures, we can’t afford to keep operating the way we have been, constantly reacting instead of getting ahead of the curve. That’s why we’re using the runway we have right now to go back to basics: making sure every nurse and operational leader in our organization knows their numbers, understands their levers and feels genuinely empowered to make the calls that matter and adjust the sails as needed.
Our goal is to have our leaders diving deep into productivity metrics, staffing ratios and the story behind every operational decision. We’re sitting together, learning together, building the muscle memory that lets you adjust your sails when the wind shifts. The academic medical centers that will lead through this moment aren’t the ones with the fanciest strategy. They’re the ones investing in operational leaders who can create access and capacity through hundreds of small, smart decisions every single day.
William Morice, MD, PhD, President and CEO, Mayo Clinic Laboratories (Rochester, Minn.)
Leaders cannot ignore the rapid integration of new AI and digital tools across the healthcare ecosystem. What began as pilots is now moving into scaled implementation, with major implications for workflows, staffing models, operational efficiency and the patient experience.
From a policy perspective, potential funding cuts represent the most disruptive shift to watch in 2026, as reductions would strain healthcare organizations and have implications on access, capacity and long-term sustainability.
The post A narrowing margin for inaction: Healthcare leaders on the shifts shaping 2026 appeared first on Becker's Hospital Review | Healthcare News & Analysis.
Source: Read Original Article
