The U.S. healthcare industry is undergoing a critical transformation. Changing funding dynamics, rising costs, and eroding trust force healthcare stakeholders to rethink long-held assumptions. In Advisory Board’s 2026 State of the Industry, we discuss the impact of the following changes to access, spending, and decision-making as well as their impact on the healthcare industry.

• Safety net access is moving away from a baseline public subsidy to a utilitarian patchwork where access hinges on private support driven by business relevance.
• Payer and employer spend management is shifting from generalist gatekeeping to niche delegation, with targeted solutions for high‑cost treatments and conditions.
• External voices and advisors — ranging from AI to social media — now play a more prominent role in how consumers make care decisions, lessening the primacy of the traditional one-on-one, clinician-patient decision-making model.