Academy Insights | 2026 Service Line Disruptor Response
In today's market, the greatest strategic risk is not choosing the wrong strategy—it’s waiting too long to choose any strategy at all. delaying the choice. Power in healthcare often shifts quietly. By the time you see volume or margin drop, the real leverage has already moved somewhere else. Health systems that are clear—service line by service line—about what they want to protect, influence, or walk away from keep far more control than those that react after the fact.
That’s why THMA's Strategy Catalyst team has released a new tool designed to help assess where service line control is eroding before volume or margin moves—and to guide strategic decision-making. Use it to regularly stress-test each priority service line, identify blind spots early, and align leadership attention and capital to where leverage is shifting.
Why it matters: Patients aren’t choosing services the way they used to. Instead, their path is increasingly shaped upstream-- by benefits design, referral defaults, networks, and intermediaries. So even if you “own” the care delivery, someone else may be deciding who gets to you. As payers, payviders, and distributors gain more control, health systems that don’t have leverage in those channels may feel like they’re winning locally—but they’re actually losing influence in the system overall.
Key questions for 2026:
Where do we need ownership vs. influence? Which specific access or referral decisions that drive our volume are now controlled by entities we do not contract with, own, or meaningfully influence?
Which service lines must be defended vs. selectively exited? Some service lines quietly become structurally weaker long before the numbers show it. If you wait for margins to drop, your options are already limited.
Which assets should we be ready to re-acquire? Market corrections and PE exits create short windows to reacquire assets that restore access or influence.
What are we intentionally ignoring? Doing nothing without saying so is riskier than making a conscious choice. Have we clearly decided, service line by service line, how we’ll respond to disruption?
360 Takeaway: In 2026, maintaining leverage means explicitly articulating service line strategy, not assuming things will hold. Strategic advantage is preserved by proactively deciding in advance how each service line fits into your strategy, rather than responding reactively. The winners won’t be the fastest reactors; they’ll be the ones who set their position before the ground shifts.