Episode Overview

Podcast: Becker’s Healthcare Podcast
Episode Title: 12 Healthcare Trends & Issues We Are Following (1-12-26)
Host: Scott Becker
Release Date: January 12, 2026

Scott Becker hosts a solo episode outlining 12 major trends and pressing issues shaping the healthcare landscape in the U.S. in early 2026. Focusing on provider supply, payer dominance, financial strains, investment patterns, inequality in access, and the growing roles of technology, Becker delivers a rapid-fire, data-rich rundown designed for healthcare professionals, policy watchers, and leaders seeking a pulse check on the industry’s evolving challenges and dynamics.

Key Discussion Points & Insights

1. Supply & Demand Imbalance ([00:35])

• There are approximately 1.1 million doctors in the U.S., with 900,000 to 1 million actively practicing for 345 million people.
• The provider-to-population ratio “is getting worse,” intensifying the challenge of accessing primary and specialty care.
• “Triple aim” (cost, quality, access) is under pressure: costs rise, quality diminishes, and access is more difficult.
• Notably: “You have to know somebody to get into the right person. An incredible challenge.” – Scott Becker [01:31]

2. Payer Power Over Providers ([01:41])

• Four major payers rank among the 20 largest U.S. companies by revenue (UnitedHealthcare, CVS/Aetna, Cigna, Elevance).
• Payer consolidation “makes it very hard for small and mid-sized providers to negotiate.”
• Reimbursement lags behind rising costs for providers.

3. Scope & Scale of Healthcare Facilities ([02:32])

• U.S. has about 6,100 hospitals (5,100 acute care), 6,500 Medicare-certified surgery centers, up to 12,000 surgery centers total, and over 14,000 urgent care centers.
• Ongoing consolidation leads to clear distinctions between “haves” and “have-nots” among both providers and patients.

4. Private Equity in Healthcare ([03:15])

• Strong, though declining, private equity (PE) investment, particularly in practice management.
• 7–8% of physicians are employed by PE-sponsored firms.
• Results vary widely: “With private equity, it’s not monolithic. It’s really the good, the bad, and the ugly in terms of results.” – Scott Becker [03:49]

5. Winners & Losers Among Providers ([04:14])

• About 60% of health systems currently have positive margins; 40% do not.
• Disparities by specialty: low-reimbursement fields are “getting crushed,” while high-demand, well-reimbursed specialties “doing very well.”

6. Multi-Tiered Healthcare & Rising Inequity ([05:00])

• Increasing segmentation: from top-tier concierge care across more specialties to commercial plan patients struggling to access services.
• “There’s an upper 1%, an upper 10%... concierge used to be relegated to primary care. Now you’re seeing it across increasing ranges of specialties.” – Scott Becker [05:33]
• Government now funds about half of all healthcare.

7. Margin Pressures on Health Systems ([06:08])

• 40% of health systems are struggling for survival and considering consolidation (“finding a dance partner”).

8. Urban vs. Rural Growth ([06:33])

• Services are growing in “midsize and larger metro areas,” while rural areas face stagnating or declining access and growth.

9. Reliance on Government Funding ([07:10])

• “The healthcare system is half or more government funded,” and ongoing federal spending is crucial for system viability.

10. Margin and Reimbursement Squeeze ([07:30])

• “Margin issues remain very critical for all kinds of healthcare providers. Reimbursement is quite slow to grow and staff and other costs keep rising.” – Scott Becker [07:34]

11. Strategic Investments by Health Systems ([07:55])

• Hospitals are investing in high-revenue specialties: oncology, orthopedics, cardiovascular, and technology.
• “You’re seeing more developments in oncology centers, orthopedic centers and cardiovascular specialty centers… and in technology.” – Scott Becker

12. Advancing Technology & AI ([08:30])

• “Technology has cascading use cases” beyond administration into clinical and diagnostic arenas.
• AI and tech are essential, but won’t replace the need for more nurses and doctors: “We’re going to need both technology and an increased labor force of nurses and doctors to really provide health care…”
• Significant improvements in pharmaceuticals, but diseases like pancreatic/brain cancer remain tough.
• “We should have most favored nation pricing. We’re not paying more than they’re paying in other countries for the same drugs.” – Scott Becker [09:41]

Notable Quotes & Memorable Moments

• “You have to know somebody to get into the right person. An incredible challenge.” – Scott Becker [01:31]
• “With private equity, it’s not monolithic. It’s really the good, the bad and the ugly in terms of results, in terms of what’s happening.” – Scott Becker [03:49]
• “There’s an upper 1%, an upper 10%, that [has] special access, special quality, and concierge used to be sort of relegated to primary care. Now you’re seeing it across increasing ranges of specialties.” – Scott Becker [05:33]
• “Margin issues remain very critical for all kinds of healthcare providers. Reimbursement is quite slow to grow and staff and other costs keep rising.” – Scott Becker [07:34]
• “We should have most favored nation pricing. We’re not paying more than they’re paying in other countries for the same drugs.” – Scott Becker [09:41]

Important Segment Timestamps

• Supply and Demand Crisis: [00:35–01:38]
• Payer Consolidation and Power: [01:41–02:20]
• Scale of Providers & Consolidation: [02:32–03:13]
• Private Equity’s Role: [03:15–03:54]
• Haves/Have-Nots Among Providers: [04:14–05:50]
• Tiered Patient Experience: [05:00–06:08]
• Margin Stresses: [07:10–08:00]
• Technological Advances & Labor Needs: [08:30–10:16]
• Drug Pricing & Research: [09:41–10:10]

Overall Tone

Scott Becker delivers his analysis with urgency and frankness, expressing concern over deepening inequities, squeezed provider margins, payer dominance, and rural vulnerability, while cautiously optimistic about technology’s and pharmaceuticals’ potential. Becker’s tone is pragmatic, data-oriented, and directed at a policy and industry-savvy audience.

Conclusion

Scott Becker’s summary of healthcare in 2026 highlights a sector grappling with resource scarcity, increasing stratification, and unsustainable financial dynamics. He calls out the urgent need for structural reforms—particularly in provider supply, payer-provider relations, and access equity—while recognizing the critical role of technology, research, and strategic investment in shaping the future.

Feedback welcomed: Scott Becker asks listeners for responses and offers a $100 Amazon gift card to the first listener to provide substantive comments (contact: 773-766-5322). [00:06]