In this episode, BESLER’s President and CEO, Jonathan Besler reviews 2025 and discusses potential trends and challenges for 2026.
Podcast (hfppodcast): Play in new window | Download
Learn how to listen to The Hospital Finance Podcast® on your mobile device.Highlights of this episode include:
- 2025 Highlights
- Highlights and challenges with AI.
- What Jon is excited for in 2026
- Challenges we might have in 2026
Kelly Wisness: Hi, this is Kelly Wisness. Welcome back to the award-winning Hospital Finance Podcast. We’re pleased to welcome back BESLER’s President and CEO, Jonathan Besler. In this episode, we will review 2025 and discuss potential trends and challenges for 2026. Welcome back and thank you for joining us, Jonathan.
Jonathan Besler: I’m very, very happy to be here. Thanks for having me back, Kelly. I always look forward to our year-end wrap up and sort of our looking ahead pontification episode. So, this is a special treat right around the holidays. Thank you.
Kelly: Definitely. Yeah, let’s go ahead and jump in then. So, 2025 was an interesting year. What were some highlights from it? And this can be from a company or an industry perspective.
Jonathan: Sure. Great question. Yeah, we certainly had a lot going on here at BESLER, as well as many of our hospital clients had a lot going on as well. Some of the highlights, and I think this really kind of cuts both ways, is we’ve been able to do a lot with artificial intelligence and AI. And so really embracing some of the things that technology has to offer, we’ve certainly done it. We know that our clients have really taken a big step forward in some of the automation things that they have done. So, I would say that that’s a very high-level highlight.
Certainly, from a personal and professional standpoint, this year I was our local HFMA chapter president. And so, with that, there were a lot of things that we had going on, both with the company, with HFMA, that really layered into each other. And we just had a very, very successful conference. So that was really a personal highlight of mine as I think about my career and professional development and really getting involved and practice what I preach, because I often tell our clients and certainly our people internally to get involved in as much of the industry as they can.
So that was a personal highlight of mine as well as just networking with a bunch of our clients and really getting to know them, certainly on a deeper level. From an overall industry perspective, I think 2025 was a little bit of a challenge, and I think we’ll see this carry over to 2026 as well, with just the uncertainty around what’s going on from a federal funding standpoint. We certainly saw some significant amounts of cuts. I would say that that was both a highlight as well as a low light simultaneously. But I do think that our providers are rising to the challenge. I’ve seen a lot of them get very creative with how they approach the market, how they engage their own customers, and continue to add value. So, I really look forward to seeing a lot more of that in 2026 and certainly helping be a part of that solution as well.
Kelly: Definitely. I mean, I agree with a lot of that. I know AI was just such a hot topic everywhere this year. And as we conclude 2025, let’s review some of the challenges from this past year. And I know that some of these things can be kind of highlights and challenges such as AI. So, what did you learn, Jonathan, and kind of what do you think those challenges are?
Jonathan: Sure. So really some of the challenges, I think, does come down to overall funding from a government standpoint and really helping providers continue to provide care. And I think that that really does have a ripple effect throughout the industry. I mean, obviously, the old adage of no margin, no mission still rings true. And so, for a lot of the healthcare community, as they continue to really survive very, very close to a breakeven status, I think that there’s some hesitation in the marketplace to take risks, right?
I mean, it’s sort of natural to kind of hunker down and say, “Well, I’m going to try to protect what I have or do what I can with what I have.” And so, I think some of the challenges were just working with our customers, working with the industry, and continuing to demonstrate that what we do and certainly what other channel partners can do for the hospital community is, in fact, add value in different ways.
And so it was a challenge, I think, to really help providers and really reassure them that not only what we’re doing is valuable but to also take a look at some new ideas and new things that can really help them execute on a more efficient basis, certainly from a revenue recovery standpoint, looking at new and different opportunities to continue to bring those dollars in the door. And so, something very key that I learned is really comes down to helping educate the community and educate the industry on ways for different improvement opportunities that they have.
Sometimes we take for granted that we all sort of operate and live in our own very specific bubble of what we know and the expertise that we provide. And sometimes we take for granted that other people and other folks in the industry might not know that to the depth that we do. And so, I don’t think that we can really take for granted the expertise that we all know as individuals and kind of overshare and over educate to really help the industry improve. I like to say when the tide comes in, all boats rise. And I think that the healthcare community and specifically is really a team effort.
Kelly: Completely agree. Yeah, it’s a pretty small universe that we’re in. So, thank you for all of that around 2025. But 2026 is just around the corner. So, what are you excited for in 2026?
Jonathan: Yeah. 2026, I think, is going to be a really interesting year. I think it’s going to be sort of a landmark year for some consolidations, which I think is just a part of the overall ecosystem in which we survive. So, I am going to be excited to see what happens with some of the provider community and how they’re going to continue to integrate along the care continuum. So, I know that rural hospitals in particular, they’ve been struggling lately.
So, I will be interested to see which either for-profits or even some not-for-profits that want to enter into that space and really bring their expertise into some of the underserved communities. So, I’m excited to see what’s going to happen with the rural community and how care is going to get delivered there. Certainly excited about what we’re going to see with AI. I think that that’s just going to be and continue to be sort of exponential growth in terms of how providers utilize it, how channel partners use it and what they do with it to really help implement either their solutions or be a value-add.
So, I am very excited to continue down the path of automation and really doing more with less, because candidly, I think that there is a lot of work to be done. And so the better we can leverage technology and computers, the more it frees up our industry experts to really think about those solutions and craft those solutions in new and different ways that hopefully can really bring some substantive change and the overall cost of care down.
Kelly: All right. So, let’s go ahead and move on to challenges. So, what are your thoughts on some of the challenges that we might have for 2026?
Jonathan: Yeah, I think 2026 is going to be a challenge for the hospital community, just Americans in general. And I would say it really comes down to three things, funding, funding, and funding. I think that the– and maybe I should have said it one word, but overemphasize it three different times because I do think that it’s the most important thing going forward. From a personal standpoint, I think the average American is really going to have a difficult time next year. The ACA premium hikes are ready to get underway. The tax credits will expire for the ACA. They’re going to expire at the end of 2025, which is going to be a major driver of change. I think there’s going to be a number– there’s been estimates of as up to five million people could become uninsured in 2026.
The average premiums are going to go up 100%. That creates a lot of anxiety around how folks are going to not only pay for healthcare, but survive in general. I mean, I think there’s going to be a couple of tough decisions to be made from that regard. So hopefully the government can come through and really save that program because that has really helped not only the average American, but it has also helped the hospital community just in terms of providing funding for people who otherwise don’t necessarily have it.
Obviously for the folks that do have insurance, I think the average cost is predicted to go up about 7% in 2026. So overall costs are going to go up, which, again, could have a trickle-down effect down to the hospitals. As some folks come off insurance, uncompensated care can rise. The federal funding cuts have already started underway. The One Big Beautiful Bill has already imposed a number of cuts. It’s estimated to be about $911 billion over 10 years to Medicaid, which obviously can lead to service reductions, maybe even service eliminations in certain areas. We talked a little bit about rural hospitals and how they might be affected.
But even for your average inner-city hospital, a lot of those hospitals rely on the uncompensated care pool and payments from Medicaid. And so, I do think that that’s going to put a lot of strain on hospitals. So, in short, again, funding, funding, funding, I think that’s going to be the word for 2026. And hopefully our government can really figure this one out because I do think that it’s going to put a lot of strain, from your average American all the way up through your integrated health delivery networks across the country.
Kelly: Yeah, no, I love that, the funding, funding, funding, just because it is so important. So, thank you for sharing that with us. So, what advice or thoughts do you have for us as we move into 2026?
Jonathan: I would continue to advise anyone who’s in the healthcare community to get involved. And that could take a number of different ways and shapes and sizes for folks that are interested in different things. And so, at the beginning of the show, I talked a little bit about my involvement with HFMA and how that has been certainly rewarding to me personally. I think that there are a lot of resources out there.
I think there’s a lot of need out there for people to get involved, regardless of wherever you are in your career, whether you’re a new careerist or looking to make a career change mid-cycle. Or even towards the end of careers, I know that some people either want to go part-time or just lend their expertise in different ways from a consultative standpoint. I think we’re at an interesting time because the level of expertise that we have throughout the healthcare community still continues to be high, but we do have a cliff that we’re heading towards from a resource, from an expertise standpoint, as those retirements continue to loom.
So, I would say to the extent that you can get involved in different things and continue to build your network, continue to build your skill set. We talked a lot about AI during this episode. The interesting thing about AI, I think, is that it has brought technology to the masses in ways that it never really has before. So, I myself am not trained in computer science and computer programming and the various languages that our team write their code in.
However, with a little bit of information and a lot of help from the various AI tools out there, there’s things that even I can do from a technology standpoint. And so, utilizing one’s resources to the fullest extent I really think can only pay dividends in the future as– whether you’re a young careerist or mid-career, really thinking about that level of engagement, “How do I build my network?” and continue to be a value-add to the industry.
Kelly: Definitely. Definitely some great advice and thoughts for us, Jonathan, as we move into 2026. We just thank you so much for joining us, for sharing your thoughts and insights on 2025 and 2026. I know we have another amazing year ahead of us, so thank you so much for joining us.
Jonathan: Thank you, Kelly. Have a wonderful end of the year, have a great and wonderful holidays to you and all of our listeners out there, and I look forward to a wonderful 2026 together.
Kelly: Yes, and thank you all for joining us for this episode of the Hospital Finance Podcast. Until next time.
[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.com/podcasts. The Hospital Finance Podcast is a production of BESLER | SMART ABOUT REVENUE, TENACIOUS ABOUT RESULTS.
If you have a topic that you’d like us to discuss on the Hospital Finance podcast or if you’d like to be a guest, drop us a line at update@besler.com.
