Every year, hospital leaders return to familiar issues: expanding access, protecting margins, and ensuring sufficient staffing. Often, these challenges are treated as separate workstreams, owned by different teams and solved in isolation. But in practice, they converge in one place—the patient’s ability to move through the system safely, efficiently, and at the right time. And in 2026, it will be impossible for hospitals to ignore this reality.
Why 2026? Health systems are entering a period where demand accelerates, reimbursement pressure tightens, and building new capacity becomes a distant solution. That’s why the next phase of performance will not be decided by who hires faster or cuts deeper, but by who moves patients through the system better.
That leads to an uncomfortable truth: many hospitals haven’t fundamentally redesigned how patients enter, move through, and exit care in more than two decades. Commonly, what shows up as a patient experience problem is, in reality, a system performance problem. And the cost of postponing the root-level overhaul of care management is starting to surface.
Prediction #1: Throughput Becomes the C-Suite’s Most Important Financial KPI
In 2026, throughput will surpass cost-per-case and staffing ratios as the most important indicator of hospital performance.
This shift is already underway. MedPAC has warned that rising inpatient utilization and extended stays place hospitals at growing financial risk under current Medicare payment structures. Medicare Advantage friction continues to grow. And according to tracking by the Cecil G. Sheps Center for Health Services Research, rural hospital closures are steadily pushing more patients into fewer facilities, intensifying access and capacity pressure across surrounding health systems. Under these conditions, throughput transcends from an operational focus to a financial imperative.
In reality, many hospitals measure throughput today. However, they do so inconsistently and without clear ownership. In most organizations, it lives too far down the org chart and too far away from the balance sheet. That will change.
CFOs will begin demanding standardized throughput dashboards across every facility, reviewed with the same rigor airlines apply to on-time departures. Boards will ask how quickly beds turn, how long patients wait for placement, and how much capacity gets stranded by delays outside the four walls. Executive incentives will follow.
Throughput will emerge as the clearest leading indicator of margin recovery, access, and growth. And the systems that recognize this early will outpace those that remain status-quo.
Prediction #2: The Access Crunch Triggers the First Real Patient Flow Redesign in 20 Years
Hospitals have spent years layering workarounds on top of broken patient flows. In 2026, that approach takes a toll.
As capacity constraints continue to tighten across the industry, with the American Hospital Association reporting longstanding workforce shortages that delay discharges and limit bed availability, leaders are realizing that cost control and staffing optimization alone can’t solve access problems. The only remaining lever is redesigning how care actually moves through the system.
The solution will not look like another platform rollout or a reorganization. It will look like a simplified, more harmonious tech stack that brings clarity through data.
Executives will begin mapping patient flow end to end, not as an IT exercise, but as a core operating discipline tied directly to access, cost, and accountability, surfacing where work is duplicated, decisions stall, and ownership breaks down. They will notice that many discharge and placement processes are still bespoke, with dozens of possible paths and little consistency. That variability creates delay, confusion, and waste.
The systems that succeed will standardize the rules of engagement across departments and sites. They will define what happens, when it happens, and who owns each step. They will stop treating patient flow as a series of local problems and start managing it as a system-level responsibility.
Though some might opt out of this transformation, it will eventually become mandatory. In fact, it might be the defining operational shift of the decade for healthcare.
Prediction #3: Care Management Moves From the Basement to the Boardroom
The year 2026 is when care management becomes the center of gravity for hospital performance.
At times, care management has been treated as overhead rather than as a key influencer of outcomes. That view is no longer defensible.
The reason is simple. Care managers engage at the point where some of the most consequential (and potentially costly) decisions in healthcare are made: where care happens next, how quickly patients move, which care partners patients choose to reward with volume, and how quality is experienced beyond discharge. Every delayed discharge, misaligned placement, or stalled authorization creates stranded revenue and avoidable cost, often invisible until it shows up in length-of-stay metrics. Together, these decisions shape capacity, margins, outcomes, and community trust, all core drivers behind solvency pressures health systems face today.
As payment models place greater responsibility on hospitals for what happens after patients leave, care management teams will be accountable for coordination across an ecosystem they do not control. That pressure will create a ripple effect from the team level to the boardroom.
Leading systems will elevate care management as a core operating lever, not a support function. They will invest in visibility, authority, and process discipline, listening to care management insights and acting on them. Hospitals that take this approach will outperform peers on access, flow, and financial stability. Those that don’t will keep leaking capacity in ways no staffing plan can fix.
Prediction #4: Intelligent Patient Placement Replaces “Referrals”
The word “referral” no longer describes what is actually happening during care transitions.
Choosing where to go for post-acute care after a hospital discharge is one of the most complex decisions a person will ever make. Most individuals are forced to make this choice under stress, with limited information, and on a compressed timeline. At that moment, hospitals largely control the available options, yet many systems still default to placing patients with whoever responds first rather than directing them to partners that can deliver the best outcomes quickly.
In 2026, that approach becomes unacceptable.
Health systems will begin treating patient placement as a structured, intelligent process. That means setting clear expectations with care partners on acceptable response times, creating standardized workflows with post-acute care partners, and conducting fair, market-wide searches so patients receive meaningful, needs-focused choices in a timely fashion that are backed by transparent quality and performance data.
Hospitals will recognize the influence they have in shaping the larger ecosystem of community-driven care. By setting clear standards and rewarding high-performing partners, they will raise quality across their ecosystem and improve flow within their hospitals, helping providers control the pace of throughput.
Systems that embrace intelligent placement will reduce delays, free up capacity, and strengthen their market position. The rest will continue to let avoidable friction dictate outcomes.
The Bottom Line for Hospital Leaders
The year 2026 will clarify what many health systems already suspect: patient flow and throughput are the most immediate levers for recovering margin, increasing access, and protecting growth trajectories.
Throughput, transitions, care management, and placement can no longer be strategized on the margins. They must sit at the center of financial performance, patient experience, and access to care. And key stakeholders carrying out this day-to-day work will need a seat at the table.
The good news? Health systems do not need another large-scale transformation to improve performance in 2026. Rather, they need to take seriously the care management work already happening every day and operate it with greater clarity, consistency, and intent.
Capacity is not something we can out-recruit. It is something we have to manage our way into, before our outdated systems force the outcome for us.
Russell Graney
Russell Graney is the Founder and CEO of Aidin, a platform dedicated to simplifying care management and improving care transitions. He began his career at Bain & Company, advising Fortune 50 companies, and later co-founded a charter school in Brooklyn that now serves over 600 students annually. Motivated by his uncle’s diagnosis of early-onset Alzheimer’s, Russell left private equity to create Aidin.
