2026 Predictions: The Year Healthcare Data Infrastructure Goes from Advantage to Imperative
Evidence-backed insights into the trends reshaping interoperability, value-based care, and population health in 2026
As 2025 draws to a close, the signals across the healthcare ecosystem are remarkably consistent: cost pressures are intensifying, interoperability is maturing, and organizations that invested early in clean, connected data are widening the performance gap.
At Opala, we see 2026 shaping up to be a transformational year — not because of new buzzwords, but because of the compounding effects of trends already in motion. These are the same forces that shaped 2025, now reaching critical mass.
Below are our 10 evidence-backed predictions for how healthcare will change in 2026 — and why data infrastructure will sit at the center of nearly every strategic initiative next year.
- FHIR Will Become the Default Standard for All New Integrations
FHIR adoption reached a meaningful tipping point in 2025. Firely’s State of FHIR report found that 71% of organizations now use FHIR in active, operational workflows, up significantly from the year prior.
At the same time, new tools such as the Spezi Data Pipeline (2025) and the FHIRconnect mapping engine demonstrated that FHIR can now support semantic interoperability, enabling organizations to move beyond basic data exchange to deeper standardization.
Prediction:
In 2026, nearly every payer and provider system will require FHIR compatibility as a prerequisite for new integrations, technology contracts, and strategic partnerships. FHIR will shift from “preferred” to expected.
- Real-Time Clinical Data Will Become Essential for Risk Management
The KLAS Digital Health Trends 2025 report noted that healthcare is now “more dependent than ever on real-time and predictive information.” This dependence is being driven by utilization volatility, chronic disease complexity, and persistent workforce shortages.
Prediction:
In 2026, event-driven data — such as ADT feeds, discharge alerts, and transitional care signals — will become indispensable for value-based care teams. Organizations that lack real-time insight will face widening gaps in cost and quality performance.
- Value-Based Care Will Expand Faster Than Expected
Several financial indicators tell a compelling story:
- The American Hospital Association (AHA) reported that hospital expenses grew 5.1% in 2024, outpacing the 2.9% inflation rate.
- Labor — the largest hospital expense — now accounts for 56% of total costs, while shortages continue to escalate.
- PwC projects 2026 medical cost trend at 8.5% for employer plans and 7.5% for the individual market.
These pressures are pushing organizations toward payment reform.
Prediction:
2026 will bring accelerated adoption of value-based contracts and risk-sharing agreements — especially in commercial and Medicare Advantage markets. Data completeness and real-time insight will become the price of admission.
- SDoH + Behavioral Health Data Will Become Standard in Population Health Programs
In 2025, researchers released a groundbreaking dataset that integrated environmental and social factors with EHRs. The dataset demonstrated significantly improved prediction of risk, utilization, cost, and life expectancy when SDoH was paired with clinical and claims data.
Prediction:
In 2026, social determinants and behavioral health indicators will be embedded directly into risk models, care pathways, and population health dashboards. Whole-person data will become the new baseline.
- Automation Will Replace Large Portions of Administrative Burden
Hospitals remain under immense operational strain. As the AHA highlighted in 2025, reimbursement increases have trailed inflation by nearly nine percentage points since 2022. Organizations cannot hire their way out of documentation, prior authorization, or care management backlogs.
Prediction:
Automation — powered by real-time data and standardized formats — will expand rapidly in prior authorization, documentation extraction, quality reporting, and care-management routing. Manual processes will become the exception, not the norm.
- Consolidation Will Accelerate — But So Will Platform-Based Data Strategies
The financial strain on hospitals, especially in rural or low-margin settings, points to more M&A activity. But new research and market signals suggest that consolidation alone cannot solve the systemic data and workflow fragmentation facing care organizations.
Prediction:
In 2026, many merged entities will adopt shared data infrastructure platforms rather than attempting to rebuild or unify legacy systems. “Data infrastructure as a service” will emerge as a dominant model for interoperability and analytics.
- Longitudinal Patient Records Will Become Expected, Not Innovative
In 2025, researchers validated that enriched, longitudinal records — combining clinical, SDoH, behavioral, environmental, and pharmacy data — substantially outperform traditional risk models.
Prediction:
In 2026, health plans and provider organizations will increasingly treat the longitudinal record as a fundamental requirement for value-based care, care coordination, reporting, and population health. Clean, normalized records will become the new industry expectation.
- Precision Population Health Will Move From Concept to Reality
The Intelligent Healthcare Ecosystem (iHE) framework published in 2025 described how continuous data ingestion, interoperability, and AI could collectively optimize the “iron triangle” of cost, quality, and access.
Prediction:
Early adopter organizations — especially large Medicare Advantage plans and integrated delivery networks — will operationalize precision population health models that tailor interventions at the micro-population or individual level. This will mark a shift from broad outreach to precision-guided care.
- Outcomes-Based Pharmacy Contracts Will Expand — Requiring Better Data
Specialty drug spending continues to rise, and gene therapies priced at over $1M per patient are redefining affordability challenges. Outcomes-based pharmaceutical contracts offer a path forward — but require complete, accurate, and timely data flows across PBMs, payers, and providers.
Prediction:
In 2026, outcomes-based pharmacy arrangements will proliferate, and interoperability between pharmacy data sources will accelerate to support them.
- Data Quality Will Become a Board-Level Priority
The cost structure of U.S. healthcare is now directly tied to the quality and consistency of its data. Poor data quality leads to inaccurate risk scores, denied claims, wasted care-management outreach, and inconsistent patient experiences.
Prediction:
In 2026, data quality strategy will formally enter the enterprise risk management agenda for payers and health systems. Leaders will appoint dedicated owners for data governance, interoperability, and insight readiness — recognizing data quality as a strategic asset, not an IT responsibility.
What This Means for 2026 — and Why Opala Is Positioned to Lead
The forces reshaping healthcare in 2026 all point to a common foundation:
Organizations need clean, connected, normalized data — delivered in real time and ready for action.
Interoperability is no longer a differentiator. It is a requirement.
Population health cannot advance without whole-person intelligence.
Value-based care cannot succeed without longitudinal records.
Automation cannot scale without standardization.
Opala sits at the intersection of all these trends — enabling payers and providers to unlock the full value of their data with the reliability, structure, and intelligence today’s environment demands.
2026 will be the year data infrastructure becomes destiny.
We look forward to helping the healthcare system build what comes next.
Wondering about how AI will impact healthcare in 2026? We have several predictions, so read our dedicated post on AI in Healthcare: What to Expect in 2026.
