Healthcare industry isn’t financially sustainable | HFMA 2026

National Harbor, Md. - Nine in 10 healthcare leaders say they don’t believe the healthcare system is financially sustainable.

That’s the sobering assessment of healthcare leaders, according to a survey released by Vitalic Health, which is backed by the Healthcare Financial Management Association. The report was released during the HFMA’s annual conference at the Gaylord National Resort and Convention Center.

Most of those surveyed said they saw the long-term viability of the healthcare system eroding in the near future. Over three-quarters (77%) of the respondents said they thought the industry would reach an existential tipping point in the next three years.

Ann Jordan, president and CEO of the HFMA, said that the danger is clear, but it’s going to require effort across the industry to avert a collapse.

“Economic history documents this pattern with uncomfortable consistency,” Jordan said during her keynote address Monday morning.

“Pressure builds, institutions absorb it, until they can't,” she said. “When the tipping point arrives, it rarely comes as a managed transition. It comes as pressure. What follows reorders leadership, competitive advantage and the fundamental logic of how an industry operates. Every industry that believed itself too essential to transform eventually learned otherwise.”

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Jordan has been pushing for action for some time. In an interview with Chief Healthcare Executive® at the ViVE conference in February, Jordan said, “It's now or never.”

“We’ve got to start being serious about where tech is being applied, and whether or not that vision people have, that tech can be the savior that health care is waiting for, can be a reality,” she said in February.

In her keynote address at the HFMA conference Monday morning, Jordan said healthcare organizations have to think differently to ensure their long-term viability. But she also said health systems and providers need to also address the rising cost of care for their patients.

“A few years ago, let's be honest, affordability might not have made the agenda for this event, but the environment is changing swiftly,” Jordan said.

Jordan pointed out that Gallup rates healthcare affordability as the top domestic concern of Americans, and families are delaying or opting against getting care, which threatens their health and also raises the prospect of more costly care down the road.

Speaking to the large audience of healthcare executives, Jordan challenged leaders to honestly question if health systems’ strategies for financial sustainability are genuinely linked to affordability for patients.

“You cannot achieve provider sustainability by shifting costs to patients who cannot bear them, and you cannot achieve patient affordability by dismantling the operating models of the institutions that care for them,” Jordan said.

The new Vitalic Health survey shows some optimism that AI can lead to cost-savings in the industry. Six out of 10 (60%) said AI will actually save money, rather than simply shifting costs. Given the ever-growing adoption of AI and the high hopes it’s engendering to transform the industry, it’s noteworthy that 40% of those surveyed did not share the sentiment that AI would lead to savings.

Healthcare leaders were asked to identify the leading factor driving up costs, and the most common response (50%) was misaligned incentives among providers, payers and employers, followed by administrative complexity (23%) and fee-for-service payment structures that reward volume (20%).

When asked which stakeholder is best positioned to lead the movement toward healthcare affordability, the most common answer (33%) was that no one can do it alone, and a neutral governing body is needed. More than a quarter (27%) said only the federal government has the scale to drive systemwide change.

Jordan said health systems obviously face a formidable environment, with changes in federal policy, payment models, rising costs, and a workforce that is shorthanded and exhausted.

Patients and employers are angry about rising costs, and Jordan said patients are no longer asking for better pricing and more transparency. They are demanding it.

So Jordan said any path to long-term financial stability must include making care more accessible and affordable.

“The most courageous act of leadership available to us right now is to embrace this moment of reinvention and to envision something demonstrably better,” Jordan said. “Financial health at the institutional level must align with financial health at the human level. These are not competing interests, and the leaders who design and build for that alignment deliberately, they will define what this industry becomes.”

Hospitals and health systems have been facing more criticism in Congress about the rising costs of healthcare, and lawmakers in both parties have called on hospitals to do better.

The American Hospital Association released a report last week outlining several recommendations to help lower the costs of care. They called for more investments in primary care and programs to help keep patients healthy so they don’t require lengthy hospital stays, and they say greater innovation in AI and other technologies could lower costs.

They also are asking policymakers to cut back on regulatory demands that add to costs and to accelerate the adoption of value-based care.