Healthcare Financial Management

A slowdown in inpatient admissions was among the 10-year health system volume projections in the annual look ahead from Vizient. The 2026 Impact of Change forecast, released June 30, highlights how shifts in care delivery, patient complexity and site-of-care access challenges are reshaping healthcare utilization and will change the structure of the healthcare continuum. Here are seven of the key projections: Admissions surge over.

Members of Congress said they expect hospitals and health systems to see both financial benefits and losses under a broader rollout of direct contracting. An expansion of direct contracting and direct primary care (DPC) between employers and providers drew bipartisan support at a July 1 congressional hearing that highlighted legislation to boost such arrangements. These arrangements could improve affordability for employers and workers by cutting out payers and driving efficiencies.

Hospitals that receive federal grants are among the entities that would face new requirements under a Trump administration proposed rule. The Office of Management and Budget (OMB) issued the rule, which would increase federal oversight of how grantees apply for and use funds. The intent is for the rule to take effect Oct.

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Recent growth in Medicare Advantage (MA) enrollment is not associated with an adverse impact on the finances of hospitals and post-acute care providers, based on findings of an observational study by the Medicare Payment Advisory Commission (MedPAC). However, the shift of beneficiaries from traditional Medicare to MA is affecting providers operationally and could be skewing payment incentives, according to a chapter in the commission’s June 2026 report to Congress.

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States are implementing a growing number of initiatives to provide funding for rural or otherwise financially struggling hospitals. This push comes amid data showing that a record number of hospitals are financially distressed, and advocates warn that coming federal Medicaid cuts will worsen the situation. Indiana hospitals celebrated a new arrangement within long-standing, federal-state funding arrangements, known as Medicaid state-directed payments (SDPs).

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Medicare payment for 340B drugs and imaging services would undergo notable reductions under CMS’s 2027 proposed rule for the hospital Outpatient Prospective Payment System (OPPS) and ambulatory surgical centers (ASCs). Payment for many services would increase due to budget neutrality requirements, but the net impact of the various changes projects to be negative for most hospitals.

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