Healthcare has experienced a whirlwind of developments over the last year, from shifting national healthcare policies to rising costs and major technological advancements.
Five physicians recently joined Becker’s to discuss the most important lessons they learned in 2025 and what trends they’re watching in the year ahead.
Editor’s note: Responses have been lightly edited for clarity and length.
Q: What is your No. 1 takeaway from 2025? What trends are you following closely in 2026?
Walter Allen Fink, DO. Associate Vice President and Chief Medical Officer at UT Health San Antonio: Looking back at 2025, the thing that really stands out to me is how care continues to drift out of the hospital and into outpatient settings, and how much that exposes the value of having physicians truly moving in the same direction. When the practice is aligned, everything works better — patients get in sooner, care feels smoother and the whole system operates with a lot less friction. When it’s not, you feel it in every corner of the operation. This year made it pretty obvious that the outpatient side is the backbone of the whole enterprise, and the strength of the physician group is what makes that sustainable.
For 2026, what stands out to me is how quickly these new digital AI tools are starting to help with the actual thinking and organizing that used to fall entirely on clinicians. We’re moving past the phase where AI just sorted inboxes or moved messages around. Now we’re seeing tools that can help make sense of what’s happening with a patient, point out something that doesn’t fit or help a provider get through a busy clinic day without feeling buried. It’s less about replacing anyone and more about taking some of the mental clutter off the plate — reminders, prioritizing, catching things early, nudging the team when something needs attention. When these tools work well, they make the day feel more manageable and leave clinicians with more space to focus on the people in front of them. That’s the shift I’m watching closely this year.
Bruce McNulty, MD. Chief Medical Officer at Swedish Hospital (Chicago): Lots of different things in 2025-26 that have my attention, but I would say that the pressures on hospitals on reducing observation and inpatient care are increasing. The financial pressures on hospitals and organizations that are overly reliant on inpatient care has resulted in either hospital closures or increased pressures to join a system if small or independent. As COVID-era subsidies expired, the pressure on smaller vulnerable community hospitals has increased with continued hospital closures nationwide. These closures put additional strain on the existing facilities to serve these patients in an economically feasible way. I was pleased to see the legislation extending the “hospital at home” program so that organizations can continue to find creative ways to care for patients outside of the costly and limited inpatient side of medical care.
Scott Needle, MD. CMO of Woodland (Calif.) Clinic Medical Group: Higher labor and supply costs, and the diminishing availability of staff and specialists, are making it increasingly difficult for community hospitals to deliver all services for all people. Reliance on a hub-and-spoke model, where specialty services are centralized at one dominant institution, will continue to marginalize rural institutions and make it harder for them to have any revenue stream. One way to increase viability while reducing duplication is by having local hospitals specialize in particular programs of excellence within distributed regional networks that share costs and savings. For services that can’t be provided locally, specialty support can be enhanced through telehealth visits with remote specialists and peer-to-peer e-consults.
The upcoming reduced federal funding for Medicaid, uncertainty on Affordable Care Act subsidies, and restrictions on immigrants receiving publicly funded healthcare coverage should be of concern for everyone. When insurance coverage is taken away or becomes unaffordable, people defer or forgo ambulatory care. Manageable conditions worsen, complications develop, and people end up presenting to the emergency department for their care. Hospitals will be under more financial strain from increased uncompensated care costs while emergency departments become more crowded with longer wait times for everyone. The cutbacks won’t reduce healthcare expenditures, they’ll simply shift costs away from the federal government and onto the states, community hospitals, and individuals — while making our communities less healthy.
Marc Shelton, MD. Associate CMO for Strategic Initiatives at the University of Missouri Health System (Columbia): Uncertainty.
Given the fractious and capricious nature of work/words out of D.C. and threatened or real changes in the regulatory and reimbursement environment, making a good five-year strategic plan now can at best be what I would term a “WAG” – a wild, audacious guess. Nonetheless, our services are needed, and it remains self-fulfilling to take care of patients for the most part. But, it shouldn’t be this hard. 2025 was a challenging year.
James Souza, MD. Senior Vice President and Chief Physician Executive at St. Luke’s Health System (Boise, Idaho): My No. 1 takeaway is that we are at the beginning of a tectonic shift in U.S. healthcare. There are many drivers, but the main driver has been the federal changes we have seen, making it clear that the government will no longer be our true north on healthcare clinical standards, public health standards or funding. This progressive shift in priorities by the largest payor with the most consistent clinical organizing principles for U.S. healthcare will lead to the emergence of a new order. I’m not sure what that is going to be, but I think we can name some of the features that will be required for the successful survivors. It’s a really challenging time to be leading in healthcare.
