HFMA 2026 Takeaways: Affordability, AI, and surprising optimism

For those seeking insights on the healthcare industry, it makes sense to attend a gathering of the leaders focused on paying the bills and helping health systems grow.

About 3,500 leaders attended the Healthcare Financial Management Association’s annual conference in National Harbor, Maryland.

The HFMA’s 2026 conference provided some valuable insights.

Here’s a roundup of several key takeaways from the conference.

Affordability

C. Ann Jordan, president and CEO of the HFMA, said in a keynote address that affordability may not have been a dominant topic at the group’s conference a few years ago. But it certainly dominated many of the discussions at the conference.

“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.

Mike Marks, executive vice president and chief financial officer of HCA Healthcare, said during a panel discussion that reducing bureaucracy and better standards to accelerate the exchange of information would have a real benefit to patients.

“This is an affordability play, and a play to ensure that we serve our patients more effectively and more efficiently over time,” Marks said.

Healthcare leaders also said they are worried about the impact of Medicaid cuts in the coming years, with millions of Americans projected to lose coverage. Without Medicaid, many won’t be able to see doctors or buy medications, and they could end up in hospitals with more costly conditions.

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Sustainability

Most healthcare leaders are worried about the system’s long-term viability, with 9 out of 10 saying they don’t see the industry as financially sustainable, according to a survey released by the HFMA’s Vitalic Health. Most of those surveyed said they think the industry is reaching a tipping point within the next few years.

Jordan urged healthcare leaders to find new solutions, but she also warned against simply passing on higher prices to consumers.

“You cannot achieve provider sustainability by shifting costs to patients who cannot bear them,” she said.

HFMA’s Vitalic Health has been created to help galvanize stakeholders across the industry to find solutions to ensure the sustainability of the industry.

Artificial Intelligence

At times, the HFMA conference felt more like a healthcare technology conference, due to the frequent and robust conversations about AI adoption.

Healthcare financial leaders generally expressed a great deal of enthusiasm about AI. James Lee, the executive vice president of population based care and chief financial officer of the Multicare health system in Washington state, says his system and others have been using AI in revenue cycle management for years.

Financial leaders say they’re seeing strong results from ambient documentation in helping doctors and nurses save time - and headaches - in their daily work. Some say AI-powered documentation tools are helping organizations hold onto top talent and avoid replacing staff, which is usually a costly proposition.

Hani Judeh, MD, Chief Medical Information Officer of Accuity, said the conversations around AI are changing.

“The question now is whether AI-generated recommendations can be trusted, explained, and defended when they impact reimbursement, quality reporting, or compliance,” Judeh said. “As AI becomes more embedded in revenue cycle and clinical operations, organizations are demanding greater transparency, stronger clinical governance, and a clear evidence trail behind every recommendation.”

Frank Forte, CEO of EnableComp, said automation alone is only part of the answer.

“Health systems are trying to solve two things at once: they need more automation, but they also need a better way to protect revenue stuck in complex claims,” Forte said. He said the opportunity is finding that revenue “that is still recoverable and addressing it before it ages, is reduced, or is written off.”

Many leaders, such as Anurag Mehta, CEO and Co-Founder, Omega Healthcare, say they’re looking to see the ROI in AI.

"At the HFMA Annual Conference, everyone was talking about AI, but the more important question is who is actually delivering measurable results,” Mehta said. “Healthcare organizations should not have to dedicate critical time or resources they don’t have to run endless AI pilots, evaluate countless vendors, or become AI integrators themselves. Rather, their time should be focused on delivering exceptional patient care and improved operational performance.”

Prior Authorization Pain

Hospital financial leaders continue to bemoan prior authorization, the process of securing the approval of insurers for treatment, medications and procedures.

Dr. Mehmet Oz, the administrator of the Centers for Medicare & Medicaid Services, spoke at the HFMA conference and said that he sees more interest from insurance companies in reforming prior authorization.

But hospital executives say they don’t see much change coming in prior authorization without tougher regulations designed to curb pre-approval requirements for routine procedures.

Billie Jean Mounts, chief revenue officer at Bon Secours Mercy Health, echoed the sentiments of other hospital leaders during a panel discussion at the conference when she referenced prior authorization.

“I think it’s getting harder,” she said.

Seema Verma, executive vice president and general manager of Oracle Health & Life Sciences, formerly ran CMS. She says the friction between providers and payers remains intense.

Hospitals and doctors are frustrated by delays and denials from insurers, while payers say they need to curb spending on procedures and treatments that may not be medically necessary.

“There’s still a mistrust,” Verma said.

Getting Down to Business

With hospitals facing Medicaid cuts, changes in federal policy, rising costs, and supply chain issues, it was fair to wonder if the mood at the HFMA conference may be dour. After all, chief financial officers are the ones steeped in the numbers.

So it was a bit surprising to see at least measured optimism from a number of healthcare financial leaders who spoke to Chief Healthcare Executive.

To be sure, many are worried about the impact of Medicaid cuts in the coming years. They’re also looking at an aging population and an aging workforce, with plenty of doctors and nurses getting closer to retirement age. And they’re frustrated by the persistent clashes with payers, but some leaders say they’re anxious to work on solutions.

Kirsten Largent, chief financial officer of the OSF Healthcare System, said health systems and insurers are going to have to find ways to collaborate to improve the system.

“We're going to have to partner with payers to make this crazy world … much more simpler and easier to navigate,” she said.

Those who spoke with us said they are playing with the hand they are dealt, and they are looking to make the best of it. Most showed a spirit of optimism, or at least pragmatism.

Melinda Hancock, chief financial officer of Sentara Health, tells Chief Healthcare Executive that she’s focusing on developing strong, long-term plans going into 2032. By acting now, Hancock says it’ll be easier to react later.

She says she’s looking forward to making it easier for patients to use the healthcare system.

“It's very challenging what’s forcing it, but in some cases, we're past due in some of these areas,” Hancock says.