Hospital Executives Signal 2026 as Strategic 'Reset Year'
Black Book Pre-Thanksgiving Flash Survey shows expectations for improved stability, leadership continuity, and returns on AI and technology investments
NEW YORK, November 26, 2025 (Newswire.com) - As hospitals across the United States navigate another demanding year, a new Thanksgiving week flash survey from Black Book finds hospital executives increasingly viewing 2026 as a strategic "reset year": a period to stabilize finances, solidify leadership teams, and realize the benefits of recent policy and technology investments.
In a rapid-response poll of hospital and health system leaders conducted over the past week and weekend, 71% of respondents said they expect their organization's overall position to be somewhat stronger or at least stable by the end of 2026, while only 16% anticipate being in a worse position.
"Our respondents aren't ignoring the headwinds, they're living them every day," said Doug Brown, President of Black Book Research. "But what stood out in this survey was the consistent theme of resilience and the belief that there are now multiple lights at the ends of multiple tunnels: policy momentum, community collaboration, technology-enabled innovation, and new delivery models that put patients at the center."
Hope in Policy and Pending Legislation
Hospital leaders surveyed noted that both federal and state policymakers appear more focused than in recent years on stabilizing hospitals and improving access to care:
77% of respondents believe pending federal and state policy changes have the potential to positively impact hospital sustainability by Q4 2026.
64% see "moderate or strong" bipartisan interest in protecting access to essential hospital services, including rural and safety-net care.
58% say new or expanded waivers, demonstration projects, and pilot programs could give them meaningful flexibility to redesign care for high-need populations.
Many respondents described 2026 as a "reset year" in which policy decisions over the next 12-18 months could either deepen current challenges or accelerate stabilization and innovation.
Strength in Community and Care Models
The polling revealed that hospital executives are increasingly drawing hope from initiatives they can lead locally, regardless of the broader policy environment:
55% report expanding or planning new community-based partnerships with public health agencies, social service organizations, educators, and local nonprofits.
79% are investing in or piloting new care models, such as hospital-at-home programs, enhanced primary care coordination, and integrated behavioral health services.
41% are engaged in regional planning efforts with other hospitals and care organizations to coordinate capacity and protect access in vulnerable communities.
"Even where finances are tight and staffing is stretched, we heard over and over that mission has not wavered," Brown added. "Leaders are rethinking how to use every dollar and every caregiver in ways that deliver the most value to patients and communities, not just to balance this year's budget."
Workforce: From Burnout to Rebuilding
While workforce pressures remain intense, leaders see signs that 2026 could mark a gradual turn toward rebuilding:
51% are "somewhat or very optimistic" that targeted state and federal workforce initiatives will improve recruitment, training, and retention over the next three years.
81% report implementing or planning innovative staffing models - including team-based care, flexible scheduling, expanded roles for advanced practice providers, and virtual support tools.
37% say their organizations have launched new or enhanced programs focused on clinician well-being, safety, and resilience in the past 12 months.
Several executives described 2025 as a "learning and adjustment year" for workforce issues, and 2026 as a year to apply those lessons, rebuild trust, and restore a more sustainable work environment.
Leadership Stability and Continuity at the Top
After several volatile years marked by accelerated C-suite turnover, the survey indicates that hospital boards and senior administrators are turning their focus toward stability and continuity:
70% of respondents expect C-level turnover to decline in 2026 compared with the previous two years.
80% say their boards are placing greater emphasis on continuity of leadership to ensure that multi-year strategic and transformation projects reach meaningful milestones.
23% report that their organizations are intentionally slowing major leadership restructurings to reduce disruption, preserve institutional knowledge, and rebuild culture.
Executives cited several reasons for the anticipated stabilization at the top: the need to see technology and care delivery transformations through to implementation, the importance of rebuilding trust with clinicians and staff, and the recognition that frequent leadership changes can delay or derail critical patient-centered initiatives.
"Boards are signaling that the era of constant turnover may be easing," said Brown. "There's a growing recognition that steady, aligned leadership is essential for hospitals to execute on their long-term commitments to quality, access, and innovation."
Technology, AI, and Innovation as Force Multipliers
Beyond policy and leadership stability, the survey found strong optimism around the role of technology and innovation - particularly AI - in improving care and operations by 2026:
88% of hospital leaders are planning or accelerating investments in AI and advanced analytics to support clinical decision-making, capacity management, and revenue cycle performance.
89% expect meaningful improvements in patient access, care coordination, or experience as a direct result of digital health and AI-enabled tools over the next 18-24 months.
94% say their organizations are prioritizing IT projects that demonstrate clear, near-term value in reducing clinician burden, streamlining workflows, and improving documentation quality.
Respondents highlighted a shift from "technology for technology's sake" toward targeted, outcome-focused deployments of digital tools, including:
AI-supported clinical decision support and risk stratification.
Predictive analytics for staffing, bed management, and patient flow.
Virtual care expansion, remote monitoring, and hospital-at-home programs.
Automation of repetitive administrative tasks to free clinicians for direct patient care.
"Hospital leaders told us they are not chasing every new trend," Brown noted. "Instead, they are focusing on innovations that can deliver tangible, measurable benefits for patients, caregivers, and communities. The expectation is that, by 2027, the payoff from today's IT and AI investments will be clearly visible."
Looking Ahead to 2026
The survey concludes that while hospitals expect another year of tight margins and complex decisions, hope and determination are clearly present:
Seven in ten leaders (70%) believe that a combination of policy change, new payment models, technology innovation, and community partnerships can meaningfully improve patient access and care quality by 2026.
Over half (52%) expect their organizations to make measurable progress on key priorities such as health equity, behavioral health integration, and chronic disease management.
Black Book will continue to track how these expectations evolve through 2026, providing policymakers, hospital boards, and community stakeholders with data-driven insights into what's working , and where more support is urgently needed.
About Black Book Market Research
Black Book Market Research LLC is an independent healthcare research, surveying, and consulting firm that delivers unbiased, crowd-sourced insights from thousands of healthcare leaders, professionals, and consumers. Since 2011, Black Book has provided strategic intelligence to hospitals, health systems, physicians, payers, and technology vendors navigating the rapidly changing healthcare landscape. Industry stakeholders can download dozens of gratis 2025 and 2026 research reports at https://www.blackbookmarketresearch.com.
202 respondents were sourced from 195 health systems at the VP level or higher. 84 board of trustees members also participated. Results reflect a margin of error of approximately ±5.5 percentage points at the 95% confidence level for proportion estimates, assuming a random sample of eligible hospitals.
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Source: Black Book Research
