- Sundar Subramanian, CEO, Zyter|TruCare
As we head into 2026, the question for healthcare organizations concerning AI is no longer whether AI tools work, but whether they can be operated coherently at scale with tangible ROI and improved outcomes, as AI continues to penetrate clinical and administrative workflows. While early AI point solutions have delivered some benefits, simply automating a broken task or process can’t deliver the cost savings and efficiencies that well-orchestrated AI can.
Looking ahead, the next phase of healthcare process solutions must and will focus on reimagining broken processes, then orchestrating AI agents in concert with human staff and responsible oversight to truly transform outcomes and not just automate tasks.
Below are areas where I expect today’s care delivery and administration models to improve as healthcare organizations scale the use of AI:
1. Telehealth Becomes the Front Door to Rural Care, Powered by AI Agents, Not Video Visits
In 2026, telehealth stops being the fallback option for rural communities and becomes the front door to the health system. The shift is not about more video visits. It is about AI-orchestrated hybrid care that continuously manages a rural patient before, during, and after the encounter.
The breakthrough will come from integrating remote monitoring, automated triage agents, and virtual care teams into a seamless experience that closes care gaps and keeps clinicians informed in real time. With new CMS rural health flexibilities and a wave of omnichannel tools, telehealth finally becomes a viable operating model, not an emergency substitute.
The winners in rural health will be the systems that treat telehealth not as a channel, but as an operating system for continuous care.
2. 2026 Is the Year Health Plans Move From “Black-Box AI” to “Glass-Box Decisions” and Pull Ahead of Providers
Providers jumped out early on AI with single-use-case tools such as ambient listening, medical documentation automation, and point-of-care assistants. Those were important proofs of concept, but they were primarily clinical micro-automations.
2026 is the year health plans pull ahead, with population-level, system-level AI that spans claims, prior authorization, care management, risk adjustment, and quality workflows.
That acceleration will also force a major transparency shift. Members, regulators, and providers will expect glass-box AI, with clear explanations of how care decisions are made, what data informed them, and where humans intervene. Plans will increasingly need to produce explainability reports for key decisions, especially in prior authorization and complex claims.
Transparent AI becomes the new compliance standard and the new competitive differentiator.
The health plans that succeed will be the ones that move from automation to accountability.
3. Explainable AI Becomes a Clinical Imperative, Shifting Care From Recommendations to Reasoned Workflows
The most important clinical AI breakthrough in 2026 will not be accuracy. It will be explainability built directly into daily workflows.
AI systems will not only generate alerts or recommendations. They will display confidence levels, the evidence behind each output, and how their reasoning aligns with established clinical pathways.
When AI behaves less like a calculator and more like a collaborator, learning from physician feedback and adapting in real time, override rates decline and confidence increases.
This shift transforms AI from a second opinion into a true member of the care team.
In 2026, understanding the AI will matter as much as the result it produces. That is how we move toward truly collaborative, intelligent medicine.
4. 2026 Marks the Beginning of the End of Healthcare Point Solutions
After years of fragmentation, 2026 will be the year healthcare leaders begin consolidating dozens of point solutions into unified agentic platforms, systems that orchestrate entire workflows rather than automate isolated tasks.
Instead of buying tools, health systems and plans will buy outcomes.
Agentic platforms will oversee complex processes end to end, closing gaps in care, coordinating benefits, completing prior authorization packets, reconciling claims, and guiding clinicians through multi-step pathways.
The era of point solutions is ending.
The era of outcome platforms begins.
What the Next Phase of Healthcare Will Demand
The signals emerging across telehealth, AI adoption, and platform consolidation point toward healthcare environments that must function continuously rather than episodically. Care delivery models are becoming more distributed. Decision logic is increasingly embedded in software. Operational dependencies across clinical, financial, and administrative systems are tightening.
As these conditions take hold, technology choices become structural. Architectures must support real-time data exchange, coordinated workflows, and decision support that can be understood, governed, and audited. AI systems will need to operate within clearly defined clinical and administrative pathways. Platforms will need to coordinate actions across functions rather than optimize isolated tasks.
As 2026 approaches, organizations will be distinguished by how well their technology environments support consistent execution across populations and programs, and by how clearly decisions made by those systems can be explained to clinicians, members, and regulators.
At Zyter|TruCare, we work with health plans and providers to help operationalize these capabilities across care management, utilization management, and population health.
Contact us to learn how your organization can prepare for what comes next.
