2025 was a heck of a year. 2026 has not altered the trendline…
Chaos abroad, stubborn inflation, and shaky consumer confidence have set the mood for 2026, and yet the markets keep climbing. Are we living in a house of cards or about to lift off for Mars? Time will tell on the midterms later this year, but you all think the GOP will keep the Senate and that the impending Medicaid funding cliff will cause lots of pain.
Last year, 42% of you expected a health tech IPO in the first half of 2026 and we were right there with you. Dear reader, it did not happen… And the mood has since shifted as almost no one expects the IPO window to open in 2026, with the crowd being split between 2027 and 2028. Some additional insights from this year’s results: consumer peptides are at the “Peak of Inflated Expectations,” AI is eating budgets faster than it's fixing anything, and 73% of you have warmed up to AI-assisted care.
As always, we're grateful to the hundreds of healthcare experts who take the time to share their views and opinions with us. Our commentary on the most interesting findings, followed by the full results, is below.
AI Everywhere, All The Time
The AI revolution in healthcare is generating equal parts excitement and anxiety, but not necessarily in the ways you’d expect.
THE AI WILL SEE YOU NOW
Healthcare desperately needs AI. Forever, the industry has hired more and more people into an increasingly complex healthcare industrial complex – driving ever higher price tags, without awesome improvements in quality. AI can help, as long as there is not a patient safety deep freeze event. Unlike banking (Meta Libra debacle), incumbents largely appear to be on board given the P&L opportunity; and user norms are evolving (73% positively) at the same torrid pace as LLM capability improvements. Tactically, many of us are spooked by the commoditization rate of every new AI-native product… as they rapidly become features in Anthropic/OpenAI.
WORKING THE MIDDLE
44% of participants believe EHR vendors and health AI startups have the upper hand as they extract value from both payors and providers, monetizing data access and workflows. Meanwhile, 33% of you see payors benefiting from AI’s strength in prior authorization automation, claims adjudication, and fraud detection.
Health Policy Chaos
Where the optimism is real, so is the skepticism. If you have been banging your head against the wall over health policy, the turmoil continues with lots of questions around the impending reduction of Medicaid funding.
SLOW MOTION COLLAPSE
The 65% of you who chose "all of the above" aren't just hedging, you’re signaling that the Medicaid cut fallout will be too broad and too visible to contain, and that the political backlash will arrive right before midterms. Everyone predicts a train wreck.
A WIN THAT FEELS LIKE LOSING
The 2027 Medicare Advantage rate increase looked like a lifeline on paper, but you aren’t buying it — over half of you see it as a one-year Band-Aid on an arterial wound that no single rate announcement can close.
Making America Slim & Buff Again
GLP-1s are slimming us down while peptides are “promising” to help us revisit our 20s, but both sit at a crossroads between hype and reality… Oral GLP-1s command genuine excitement, though payor battles may prove just as limiting as the needle. Peptides face a far more skeptical verdict.
GLP-1 CRAZE: EARLY INNINGS?
We think GLP-1s move to a cross between erectile dysfunction drugs (consumer pull and huge rebates) and cholesterol-lowering drugs (broadly available, cheap generics, and pricey, "high efficacy" niche players).
PEPTIDES: THE SUPPLEMENT AISLE WITH A BETTER PR TEAM
The peptide hype cycle is loud, but the industry's verdict is quietly skeptical. The RFK-fueled renaissance may generate headlines and direct-to-consumer revenue, but the gap between peptide enthusiasm and mainstream medical legitimacy looms large.
The Midterms 😬
One thing is certain: Americans are heading into this election cycle with deep uncertainty — about the maps, the rules, and whether the results will be accepted.
PAIN WITHOUT PUNISHMENT
You see a weakened economy, gas prices, and Middle East wars as the Republicans' biggest midterm liability — but don’t expect it to cost them the Senate. Voters may be feeling the pain but won’t be ready to fully punish the party currently at the helm. Then again, when we asked this question 4 years ago, only 27% predicted Democrats would lose the House but hold the Senate.
IPOs, Acquisitions, and Shakeups — Oh My!
One of these years, we look forward to having this section overflowing with optimism or at least an upside surprise. Maybe a twist of events that creates a tailwind. 2026 is not that year.
EVERYONE ON DECK
Almost nobody thinks we will see the IPO window open up for health tech companies in 2026. Here’s hoping that the mega-IPOs can pave the way, but results are split on whether that comes in 2027 or drags into 2028.
ACQUI-REGRET
Aetna's 2023 acquisition of Oak Street Health stands out as most likely to be unwound, with 41% of you expecting a divestiture after only 3 years — a pointed verdict on what happens when a CEO promises the Street a transformative acquisition (and the V24 gravy train halts). Maybe the great healthcare consolidation era of 2019-2022 is entering its hangover phase?
THE $12B QUESTION
Only 14% of respondents see OpenEvidence as a standalone company long-term. Nearly half see Anthropic or OpenAI as an existential threat and an equal share think the $12B valuation is already a cautionary tale. That’s probably why it was the top choice to be acquired in the next 12 months…[not that the narrators agree — too much cash in hand to give up that quickly].
FULL SURVEY RESULTS
Over 200 respondents from health tech startups, investors, high-growth private companies, healthcare providers, healthcare payors, academics, life sciences and more conducted the survey between April 22, 2026 and May 5, 2026. If you would like to view the results of our previous surveys, you can find them here:
2025 Healthcare Prognosis
2024 Healthcare Prognosis
2023 Healthcare Prognosis
2022 Healthcare Prognosis
2021 Healthcare Prognosis
2020 Healthcare Prognosis
2019 Healthcare Prognosis
2018 Healthcare Prognosis
2017 Healthcare Prognosis
1
Where is AI actually going to move the needle in 2026? [Select up to two]
| 56% | Ambient documentation — giving doctors their evenings back in exchange for more patients in their clinics |
| 67% | Revenue cycle and denial management — since money pays the bills in low-margin businesses |
| 27% | Clinical decision support that actually changes care outcomes |
| 25% | Drug discovery and R&D — more than just Recursion |
| 9% | Other (please specify) |
2
What's the biggest way AI could go wrong in 2026? [Select one]
| 19% | AI hallucination causes a real patient harm event |
| 9% | We fall months behind competitors while our AI governance committee debates safety, ethics, and use cases |
| 24% | A big HIPAA breach traced back to an AI vendor |
| 11% | Clinicians over-relying on AI tools at the expense of diagnostic skills and clinical judgement |
| 28% | We waste a lot of money on healthcare-specific AI platforms and partners when we could have done everything in Claude faster and cheaper |
| 9% | Medvi and more "$1.8 billion and just two employees" scams |
3
It's April 2027. Which AI use case from 2026 turned out to be real — one that most people back then would have dismissed as "not a chance"? [Select one]
| 23% | Fully autonomous AI running prior auth appeals with a better win rate than today |
| 23% | Fully autonomous AI running revenue cycle management with better performance than today |
| 23% | Real-time AI claims adjudication between payors and providers |
| 19% | AI triaging the majority of urgent care encounters — no physician in the first loop |
| 9% | AI flagging surgical errors in real-time while the procedure is happening |
| 3% | Other (please specify) |
4
How will AI reshape the reimbursement landscape over the next 18 months? [Select all that apply]
| 13% | CMS Access will result in a bunch of successful low-cost AI care businesses |
| 23% | CMS Access will enable even more fraud at scale with hard-to-cancel subscriptions sold to vulnerable seniors |
| 63% | Payors use AI to deny faster; providers use AI to appeal faster — result: expensive arms race and zero value created |
| 28% | Direct-to-Consumer AI doctors are better and cheaper than telemedicine and wipe out the remnants of Covid-era telemedicine (TDOC, Amwell, and MDLive) |
| 38% | AI-driven prior auth automation, real-time eligibility verification, and real-time payments eliminate billions in administrative waste |
| 4% | Other (please specify) |
5
The AI arms race between payors and providers is accelerating. Who holds the upper hand? [Select one]
| 33% | Payors — a decade of training denial models on structured claims data gives them a real head start |
| 23% | Providers — clinical data plus ambient AI is closing the gap fast, and clinical intelligence is the real moat |
| 44% | Neither — EHR vendors and health AI startups are the actual winners, extracting value from both sides |
6
What separates the AI winners from the hype machines? [Select one]
| 17% | Proprietary data nobody else can access |
| 7% | Regulatory moat — FDA clearance or CMS validation |
| 21% | Deep clinical workflow integration (not a UI slapped on top of a foundation model) |
| 23% | Partnerships with dominant incumbents — Epic, BUCAs, health systems with market power |
| 7% | Physician trust and brand credibility |
| 25% | Deep integration into a full-stack services business |
7
How has your trust in AI assisting with YOUR medical care changed over the past year? [Select one]
| 34% | Grown — I'm now comfortable with AI playing a significant role in my own care |
| 39% | Grown — but only if a physician reviews AI recommendations before they impact me |
| 13% | Unchanged — I've always been comfortable with healthcare AI |
| 12% | Unchanged — I've always been skeptical, and 2026 has not helped |
| 2% | Decreased — I'm less comfortable than I was 12 months ago |
8
OpenEvidence is now valued at $12B with lots of physician users and revenue mostly from pharma ads. In 5 years, the most likely outcome is... [Select all that apply]
| 11% | Acquired by a major pharma company that sees it as the best physician access channel since brunch donuts |
| 22% | Acquired by an EMR (i.e., Epic, Oracle, Athena) that needs clinical decision support |
| 14% | IPO — it becomes the Bloomberg Terminal of clinical medicine |
| 47% | Disrupted by OpenAI or Anthropic who can generate similar responses and use cases |
| 45% | The $12B becomes a cautionary valuation tale — pharma ad revenue has a ceiling and it's lower than the current cap table thinks |
9
The ambient scribe market is crowded and prices are falling. What happens? [Select one]
| 30% | Major consolidation — 2-3 players dominate, the rest get acquired, acqui-hired, or quietly shut down |
| 44% | EHR commoditization — Epic and Oracle succeed at bundling it in and the standalone market collapses |
| 10% | The market stays fragmented because health systems will not standardize, ever. Full stop |
| 16% | The category evolves from documentation into full clinical workflow automation (scheduling, referral management, revenue cycle) — and pricing actually increases |
10
Oral GLP-1s are officially here — Novo Nordisk's pill launched in January; Lilly's Foundayo (orforglipron) got FDA approval April 1. How does adoption play out? [Select one]
| 31% | Rocket ship — oral dosing removes the last major barrier; net-new patients flood in |
| 29% | Slower than the headlines suggest — payor coverage battles are the new injectable adoption barrier |
| 19% | Mostly injection switchers — convenience improves but net-new patient volume doesn't explode |
| 21% | Strong demand, brutal dropout rates — adherence was always the real problem, not the needle |
11
RFK Jr. just restored most compounded peptides to legal access. In 12 months, peptide therapy will be... [Select one]
| 12% | The hottest new DTC play in healthcare — every men's and women's health and longevity platform pivots to peptides |
| 14% | On its way to mainstream — outcomes data builds and cautious physicians start engaging |
| 44% | A niche that stays a niche — mostly appealing to the biohacker, quantified self, and PED crowd |
| 12% | Quietly rolled back after adverse event reports begin to accumulate |
| 18% | Scary — lots of risky compounded medications that makes "looksmaxxing" look sane |
12
At least one major commercial insurer will add coverage for at least one peptide therapy by the end of 2026. [Select one]
| 20% | TRUE — This is their hack to offer lower cost weight loss drugs |
| 80% | FALSE — Are you kidding? These are not FDA-approved |
13
Biggest underrated risk facing health tech startups right now? [Select one]
| 14% | Reimbursement rates collapsing after H.R.1 Medicaid cuts, IRA ACA subsidy expiration, low MA rate increase, and super high commercial trend |
| 23% | Platform dependency — they built on someone else's EHR, cloud, or AI model and the platform decides to compete |
| 9% | A cyber-attack or data breach that ends the company |
| 27% | Overpromising AI to health systems that does not deliver ROI |
| 25% | Warring with big tech — Google, OpenAI, Anthropic, and Microsoft either release capabilities that commoditize your business or steal your talent |
| 2% | Other (please specify) |
14
H.R.1 is law — $1.15 trillion in Medicaid cuts over 10 years, estimated 17 million Americans losing coverage. By next year, what's the most visible fallout? [Select one]
| 17% | Rural hospital closures — the rural stabilization fund was way too small and the math was obvious from day one |
| 7% | Medicaid managed care plan exits — the economics collapse in high-expansion states |
| 5% | States quietly backfill with their own budgets — the federal cuts land softer than advertised |
| 6% | Safety net health systems in blue states absorb the heaviest blow |
| 65% | All of the above — and it gets loud right before the midterms |
15
CMS finalized 2027 Medicare Advantage rates at +2.48% — a $13B reversal from the 0.09% proposed rate. What does this actually mean? [Select all that apply]
| 31% | The Trump administration blinked — a clear win for UHC, HUM, ELV, and their Hill relationships |
| 26% | Insufficient — medical cost trend is running 2-3x this rate; expect further benefit cuts and plan exits |
| 20% | Just enough to stabilize the market and stop further exits from rural counties |
| 28% | Good for plans and bad for beneficiaries — premiums hold but benefits keep getting cut to regain historical levels of margin |
| 52% | A one-year Band-Aid on a structural problem that MedPAC will keep declaring, and politics plus economics makes super hard to fix |
16
Dr. Oz is 12 months into running CMS. What does his legacy look like from here? [Select all that apply]
| 7% | A genuine reformer — cuts waste, expands VBC, reforms MA, and earns grudging bipartisan respect |
| 41% | An effective policy messenger — more brand ambassador than bureaucrat, which was kind of the point |
| 39% | An ineffective talking head – who does not grasp or care about policy details |
| 19% | Still dispensing supplement advice, just with a federal seal on the stationery |
| 32% | CMS was a great stepping stone to HHS Secretary |
17
Which policy moves will most define healthcare in 2027? [Select up to three]
| 70% | H.R.1 Medicaid cuts fully kicking in — the biggest coverage rollback since before the ACA |
| 37% | MA rate volatility forcing plan exits and major benefit redesigns |
| 36% | Drug pricing moves beyond the Inflation Reduction Act — or a quiet retreat from them |
| 11% | Mandatory data interoperability requirements that actually have teeth this time |
| 24% | CMS paying for AI – the ACCESS model is a successful innovation |
| 5% | Weed becoming a covered MA benefit |
18
What will be most damaging for the Republican Party ahead of the 2026 midterm elections? [Select one]
| 32% | The Iran war |
| 53% | An economy weakened by tariffs, trade wars, higher energy costs, and immigration crackdowns |
| 1% | Medicaid and Medicare Advantage cuts hurting the voters who elected them |
| 3% | Erosion of democratic norms and rule-of-law concerns |
| 0% | Trump vs. The Pope |
| 6% | All of the above are outweighed by positive Republican policy moves: tax cuts, less illegal immigration, hawkish stance towards China, and Europe spending more on drugs and defense |
| 5% | Doesn't matter — the midterm map strongly favors Republicans regardless |
19
The 2026 midterm elections will result in... [Select one]
| 7% | Republicans keep both the House and Senate |
| 23% | Democrats win back both the House and Senate |
| 65% | Republicans lose the House but hold the Senate |
| 5% | Republicans hold the House but lose the Senate |
20
Pharmacy Benefit Managers (PBMs) kicked off 2026 getting hit with oversight hearings, calls for transparency and reform bills (that died in committee). Will anything actually change? [Select one]
| 5% | Real savings — rebates are passed through and nuisance fees are swapped for a transparent Per Member Per Month admin fee |
| 40% | PBMs invent new fees and call it a service — same game, new name |
| 22% | Innovators route around legacy PBMs entirely — transparent pharmacy benefits platforms gain rapid adoption and make the traditional PBM model irrelevant before Congress ever acts |
| 33% | Ask me again in 2028 when there is a new Administration and Congress... |
21
With tariffs, H.R.1 cuts, rising labor costs, and MA compression hitting simultaneously — what's the financial prognosis for the average U.S. hospital by year-end 2026? [Select one]
| 19% | Code Red: 20%+ of hospitals operating in the red; rural and safety-net closures pick up sharply |
| 39% | Yellow Alert: margins compress further but most systems survive through layoffs and service cuts |
| 3% | Green Light: the H.R.1 rural fund plus MA rate stabilization creates an unexpected floor |
| 39% | Bifurcated: market dominant systems are fine; rural and safety-net hospitals are not |
22
When will health tech IPOs actually be hot again — defined as 3 or more IPOs pricing above the initial range? [Select one]
| 3% | 2026 |
| 46% | 2027 |
| 51% | 2028 or later |
23
Which health tech subsectors will have the most promising exits in the next 12 months? [Select up to three]
| 12% | Value-based care / risk-bearing provider platforms |
| 54% | Revenue cycle management and AI-powered administrative tools |
| 22% | Behavioral and mental health |
| 53% | GLP-1 and metabolic health platforms |
| 25% | Ambient AI and clinical documentation |
| 11% | Health insurance / tech-enabled payor |
| 17% | Genomics and precision medicine |
| 23% | Specialty care and virtual-first models |
| 31% | Clinical AI and diagnostic AI |
24
Which of these companies gets acquired in the next 12 months? (excluding Venrock portfolio companies) [Select up to three]
| 14% | Abridge |
| 9% | R1 RCM |
| 11% | Sword Health |
| 18% | Komodo Health |
| 3% | Waystar |
| 9% | Spring Health |
| 21% | OpenEvidence |
| 4% | Qualified Health |
| 5% | Oak Street Health (sold) |
| 10% | Judi (formerly Capital Rx) |
| 46% | None of these — M&A focuses only on things that are cheaper... |
25
Value-based care has been "the future of healthcare" for 15 years. In 2026, it is... [Select one]
| 11% | Gaining momentum — VBC is outperforming fee-for-service in measurable ways |
| 35% | Contracting — H.R.1 and MA pressure are pushing providers back toward fee-for-service |
| 42% | Being reinvented by AI with better margins and more Medex savings |
| 12% | Declared dead with payors divesting and PE sweeping up the carnage |
26
Will more incumbents give up on their pricey acquisitions of the last 5 years and divest? Which acquisition is most likely to be jettisoned? [Select one]
| 41% | Aetna divesting Oak Street Health |
| 15% | Amazon divesting One Medical (Iora doesn't count) |
| 3% | Elevance divesting CareBridge |
| 13% | United divesting Change Healthcare |
| 10% | Humana divesting Kindred |
| 13% | Centene divesting Magellan |
| 5% | HCSC divesting Cigna's MA business |
27
What is the single most overrated trend in healthcare right now? [Select one]
| 9% | AI in healthcare — it's like Pets.com with an AI label |
| 18% | Value-based care — it has been coming for 15 years |
| 24% | Longevity — wellness for rich people |
| 28% | Peptides — see above |
| 21% | DTC AI doctors — just because you can make it doesn't make it a good business |
28
Most promising or exciting early-stage (seed or Series A) health tech company right now? [Open field]
| [Open field] |
29
What will the price of a barrel of oil be by the end of the year? [Select one]
| 40% | Under $100/barrel |
| 32% | $101-$115/barrel |
| 19% | $116-$130/barrel |
| 6% | $131-$150/barrel |
| 3% | Over $150/barrel |
30
Which category best describes your employer? [Select one]
| 7% | Academia |
| 1% | Government |
| 20% | Investor / VC |
| 28% | High-growth private company / startup |
| 6% | Healthcare provider |
| 4% | Healthcare payor |
| 16% | Life sciences / pharma / biotech |
| 8% | Professional services / consulting |
| 1% | Banking / advisory |
| 9% | Other |