Session Overview:
Entering 2026, established disruptors are evolving their playbook—shifting control upstream through referral pathways, benefit design, drug channels, and capital reallocation. While payviders, private equity, and distributors remain deeply embedded in the healthcare ecosystem, their strategies vary across service lines, creating differentiated risks and decision points for health systems.
In this Strategy Catalyst webinar, health system strategy leaders shared their interpretations of these shifts. Through a series of deliberately provocative claims, the discussion surfaced where leaders see emerging threats, where views diverge, and where service-line strategy may require different choices in 2026. The session examined how disruptor impact varies by service line and introduces practical frameworks to help leaders determine when to partner, compete, acquire—or deliberately stand down.
Key Takeaways
Influence is shifting upstream—and distributors are capturing structural leverage: Competitive advantage is increasingly exercised through benefit design, referral pathways, and drug channels. Distributors like Cencora are moving beyond supply roles to acquire stakes in specialty networks (e.g., OneOncology)—creating durable leverage independent of covered lives. Referral-dense and buy-and-bill service lines face disproportionate exposure to both payvider steerage and distributor control—often before volume or margin erosion becomes visible.
PE exits are opening brief acquisition windows and reshaping service-line control: As private equity shifts capital away from care delivery, health systems face a short opportunity to strategically reacquire or re-anchor critical service-line assets. The risk is less about ownership structure and more about whether systems are positioned as a desirable return destination for physicians.
Smart service-line strategy in 2026 considers where to intentionally retain or cede control: Because influence can shift without asset ownership, the core decision by service line is no longer growth versus defense, but what must be controlled (access, referrals, channels), what can be shared, and what can be intentionally let go—using a tailored posture by service line rather than a single enterprise stance.