As we enter 2026, healthcare stands at the intersection of transformation and accountability. The past few years have seen AI evolve from a promising experiment to a critical layer in how care is delivered, documented, and reimbursed. The foundations of SaaS and data infrastructure that powered the first generation of digital health innovation are now being reimagined for an era defined by intelligence, automation, and interoperability.
At Oak HC/FT, we’ve spent more than a decade investing in the platforms and people reshaping healthcare – from the early SaaS pioneers like athenahealth and Cotiviti to today’s AI-native companies tackling the sector’s most persistent inefficiencies. In this post, we outline the trends we believe will define healthcare in 2026.
Risk Pool Reprieve
2025 was a year of reckoning for managers of risk. Judging by recent comments, 2026 is poised to look a bit better now that payors have re-priced in ACA and Medicare Advantage. While dramatic membership shifts are likely to result in actuarial surprises in some cases, it’s likely that Medicare Advantage performance will be a bright(er) spot (for payors and VBC providers) after 2025’s turbulence, while Medicaid challenges will continue but bottom out, and ACA will be a mixed bag (increased premiums priced for profitability but flat or lower membership and potentially consumers buying down to leaner plans).
The ICHRA market led by companies like Remodel Health will grow (as it continues to be a much needed release valve for self-funded employers) even if the ACA stagnates, ratcheting up the focus on ICHRA among ACA carriers (and with it the number of ICHRA-specific plan designs filed for 2027).
Molecular Predictions
Since the 1970s, drug developers have dreamed of designing drugs from first principles – moving beyond the crapshoot of isolating soil bacteria, trawling chemical libraries, and screening hundreds of thousands of mostly irrelevant compounds in the lab. We believe that 2026 is the year that in silico drug design goes from proof of concept to reality as newer models yield a growing number of candidates whose designs are not only bindable but developable (a perspective that culminated in our recent investment in Chai Discovery).
Record-Breakers
Most systems of record (EHR, CRM, HRIS, ERP) are legacy software businesses. In ordinary times, lock-in dynamics favor these incumbents and can outweigh some of the advantages that startups might have. But legacy software businesses have had a hard time adapting to the current technological moment. We believe 2026 will see a growing number of threats to healthcare’s record-holding juggernauts, with legacy players moving defensively to shore up their dominance through closer collaboration and distribution deals with disruptors.
AI Frontiers
We're excited about a few emerging areas of healthcare AI that are likely to take meaningful shape in 2026:
- Tabular prediction: While healthcare is rife with unstructured data, many of its most pervasive data elements are actually structured. The models used by data science teams to make inferences on this data today are still largely self-trained (on proprietary data), not pre-trained, a paradigm that we expect to shift in the coming year.
- Analytical orchestration: LLMs are famously bad at directly analyzing data but are great at code generation. We’ve seen the first few examples of companies built around this concept, enabling finance teams to answer questions about contract performance, physician compensation, and provider office profitability through a conversational interface, as well as in payment integrity and revenue cycle automation.
- Voice AI: 2025 was the year that voice AI reached technological maturity and accelerated success for many enterprise-focused voice startups. We think that 2026 will be the year that voice AI becomes more widespread in powering consumer healthcare use cases, from scheduling appointments, to requesting medical records, to dealing with insurance.
The Payor-Provider Parley
The relentless rise of healthcare costs over the past few decades has fueled an escalating tit-for-tat between payment integrity and revenue cycle programs, a major factor in the ballooning ranks of administrative hires in healthcare. AI has the potential either to exacerbate or to help de-escalate this costly grudge match. We think 2026 is the year that a growing number of payors and providers will look to technology platforms to collaborate, allowing them to redirect resources toward patients.