What will shape the business side of health care in 2026? We’re starting to see familiar pain points—claims denials, shrinking margins, and staffing shortages—collide with rapidly evolving technology. To kick off our trend-watching for the year ahead, we’re sharing three predictions from Dean Margolis, CEO and co-founder of Red Sky Health, focused on how revenue cycle technology and AI-driven automation could reshape the financial backbone of care delivery. While these insights span health care broadly, the implications are especially relevant for dental practices navigating reimbursement pressures, staffing constraints, and the growing need for smarter, more predictable revenue systems.
1. Claims management will make way for claims remediation
Every health-care executive knows that the business of health care is as complex as the care itself. Hospitals and medical practices rely on revenue cycle processes that translate clinical activity into financial reimbursement—a process that is supposed to be systematic, standardized, and precise. Regardless of the cause, claims denials represent a serious and often underestimated threat to revenue. Although a significant number of claims are denied on the first pass, only a portion are eventually recovered. Claims management is hard, but it is not enough, as more than 50% of claims are never resubmitted.
In 2026, claims remediation will become paramount as health-care leaders realize they can no longer afford to view billing as a back-office function. In the new year, providers will look to technology to establish a remediation approach and create a comprehensive process for addressing and correcting systemic problems. Leveraging artificial intelligence and machine learning, they will automatically address denied, underpaid, or noncompliant medical claims to recover lost revenue, prevent future denials, and improve the overall efficiency and compliance of the billing process.
2. Revenue integrity will become a c-level imperative
The US health-care system is entering a period of major transformation thanks to rising costs, shrinking margins, and growing pressure for transparency. Billing teams are often understaffed and overburdened, and they continue to triage their work by focusing on first-pass claims that are faster, cleaner, and more predictable. Denials, on the other hand, are complex, time-consuming, and uncertain, leaving enormous amounts of money on the table.
In 2026, revenue integrity will determine which organizations thrive and which struggle to survive. Those who master billing accuracy will not only safeguard their margins but also gain the ability to make decisions based on reliable, actionable data. In the coming year, billing accuracy will no longer be viewed as just a financial goal, but as a leadership responsibility, and organizations will demand visibility into their denial performance metrics to understand the full extent of their revenue loss. They will also realize that fixing the billing problem is about restoring trust and predictability to the business of care. When providers have confidence in their revenue, they can reinvest in people, technology, and patient services. In the coming year, expect providers to invest in intelligent automation and AI-driven denial solutions that learn from historical claim outcomes, predict risk patterns, flag errors, and automatically resubmit previously denied claims.
3. Software-as-a-service makes way for outcome-as-software for health-care providers
For 20 years, software-as-a-service (SaaS) has been the preferred delivery option for most organizations looking to purchase software. In the coming year, health-care providers and hospitals will adopt outcome-as-software (OaS), where technology is the enabler of the service and the vendor's success is directly tied to the client’s outcome.
With lower connectivity costs, ease of data sharing, and more powerful AI, OaS will usher in a new paradigm that is changing not only the technology vendor-client relationship but also the revenue cycle. Because OaS relies on a simple and powerful mindset, the technology will deliver a specific, measurable service or outcome and become an operational nervous system whose value lies in the expert service delivery it facilitates. The right OaS solutions will deliver validated AI and machine learning, and actionable insights that drive revenue recovery and efficiency gains for providers struggling to recover lost revenue. Most importantly, licenses and installation will no longer be the focus, but rather the tools by which the service is delivered, allowing healthcare providers to focus on what really matters—delivering exceptional care for patients.
For dental leaders, the takeaway is clear: the financial side of practice ownership is becoming more technology-driven, more data-dependent, and more strategic than ever. Whether you’re evaluating new tools, rethinking workflows, or simply trying to reduce administrative friction, the trends outlined here point to a future where revenue integrity becomes a competitive advantage—not just a back-office task. As always, we’ll continue tracking the business and technology shifts that matter most to dental practices and sharing what we learn along the way.
Editor's note: This article originally appeared in The Bottom Line with Dental Economics, the newsletter that will elevate your inbox with practical and innovative practice management and clinical content from experts across the field. Subscribe here.
