By JEFF BRANDES

To say healthcare’s safety net experienced tectonic shifts in 2025 would be an understatement. The rapid introduction of multiple and massive policy shifts left many healthcare leaders reeling with more questions than answers.

As the industry turns the corner into 2026 and the dust begins to settle, it’s time for stakeholders to respond by leveraging all resources and tools available. Current industry shifts will necessitate structural and process changes that ensure the best health outcomes for all communities.

Foundational to any strategy is a recognition that AI and automation have found their place in countering administrative burden in healthcare, and mainstream use of these tools will help speed the industry’s race to greater value. Care teams that previously spent hours reviewing documentation, identifying risk-adjustment opportunities and organizing population-level insights can now claw back the time needed to get ahead of care gaps.

In 2026, healthcare leaders must acknowledge that new realities are here to stay and will require reimagining how the industry delivers optimal care for vulnerable populations. Safety net organizations that have not invested in automation for managing routine tasks will get left behind in the new world of managing population health. By leaning into the following three strategies, stakeholders can realize the promise of value-based collaboration.

Keeping Medicaid Patients Connected to Care

Sweeping changes to Medicaid eligibility, financing, and administrative requirements will have far-reaching impacts on coverage. Current workflows that address these challenges are complex and overwhelming for many resource-strapped safety net providers—not to mention patients and families.

On the Medicaid front, infrastructures that lean into unified data and integrated workflows can help providers become more proactive in identifying those at risk of losing coverage. Specifically, tools that pair eligibility data with clinical and social risk insights can guide outreach prioritization and patient assistance. In addition, providers can use automation to build multilingual renewal campaigns that personalize patient interactions such that vulnerable populations understand their healthcare options.

Safety net providers are already seeing success with the right strategy. For example, the California Primary Care Association (CPCA) leveraged automation and analytics to mobilize outreach and support Medi-Cal renewals and new enrollments across 38 counites. From January 2024 to June 2025, the initiative reached more than 1.3 million people, achieving more than 159,000 Medi-Cal enrollments and re-enrollments.

Putting Rural Health Transformation into Action

Some analysts predict that the $50 billion Rural Health Transformation Program might allow America’s struggling rural health landscape to come back from the brink of near destruction—if done right. Now that the awards have been made, the Centers for Medicare and Medicaid Services is homing in on technology initiatives that can become sustainable without ongoing state and federal funding.

The most promising technology initiatives share a common theme: patient-centered connection and collaboration. This means that safety providers must connect to other stakeholders—behavioral health agencies, EMS providers and social-service organizations—in a more cohesive way. When communities eliminate silos and align around initiatives that address local healthcare challenges, the outcomes are notable.

Consider an effort by Waianae Coast Comprehensive Health Center, the largest Federally Qualified Health Center on the island of Oahu in Hawaii, to address key issues for local vulnerable populations. The organization leveraged technology to bring disparate data together across stakeholders and realized significant improvements:

• Increased percentage of patients with documented asthma action plans by 40%, enabling more proactive care management
• Increased depression screening rates from 25% in 2014 to nearly 60% by 2023
• Improved hypertension control rates from 45% in 2014 to 60% in 2022

Evolution of Value-Based Care

Safety-net providers, rural hospitals, and health plans can expect that 2026 will introduce growth of capitated arrangements and higher expectations for better outcomes. Success hinges on stakeholder alignment, especially between payers and providers.

Investments in data integration capabilities that improve collaboration will accelerate, especially as it pertains to utilization insights and achieving unified views of risk and care gaps. In addition, member/patient engagement for chronic disease, behavioral health, maternal care and Medicaid renewals will become a shared effort.

Setting the Stage for a Successful 2026

When it comes to healthcare’s safety net, there is an urgency to finally get things right in 2026. Truly, the stakes have never been higher to turn the tide on a challenging outlook.

The good news is that advanced technology and automation are making it possible to achieve important goals for the industry’s most vulnerable. Rural communities are poised for long-overdue transformation that is characterized by stakeholder alignment and collaboration. It’s not going to be easy in 2026—change never is. But, with the right patient-centric, data-driven strategy, the industry can finally achieve the promise of value-based care.

Jeff Brandes is the President & CEO of Azara Healthcare