Elizabeth Watson: In 2026, health care providers are not just asking for more innovation, they’re asking for more proof. Proof of efficiency. Proof of ROI. Proof that your solution helps them survive real financial pressure. And the companies that can make that case clearly will grow in this constrained environment. Welcome, I’m Elizabeth Watson, principal at the Alexander Group. I am one of the leaders of our healthcare practice, and I’m here with Alison Smith to discuss the findings from our recent provider research. Together, we’ll explore how organizations like yours can refine your go-to-market strategy to better meet customer needs, and set yourself up for a successful year ahead. But first, Alison, please tell us a little bit more about yourself.
Alison Smith: Thanks, Elizabeth. I’m Alison Smith, I’m a director at Alexander Group, and my expertise lies within healthcare commercial strategy and marketing.
Elizabeth Watson: Well, thanks so much for joining me today. And I’ll jump into some of our findings and then really curious to hear what you’re seeing out in the marketplace. So healthcare providers are entering 2026 under unprecedented pressure reimbursements. Declining expenses are rising, capital budgets are tightening, and yet expectations for performance, quality and access continue to rise. To understand how providers are responding, the Alexandra Group surveyed hospital executives and physicians across the U.S. to uncover their top priorities and what they now expect from their medtech and digital health providers. So what we found is a very clear reset on this buying behavior. Providers are no longer investing in technology for potential, but they’re investing in solutions that deliver measurable impact.
Elizabeth Watson: So let’s start with their number one priority for 2026 – operational efficiency. Providers are under pressure to do more with less. Overall, reimbursement is projected to decline while total expenses continue to increase, improving administrative efficiency, protecting margins and increasing patient volumes now sit at the top of our providers agendas. So, Alison, what are some of the things, given this current environment that you’re advising your clients to do in order to meet this challenge?
Alison Smith: This is a great question, and I think we’ll see some of these themes really tie through the rest of the discussion here, but what we’re seeing across the board is that we really can’t encourage our clients to rely on features, right? Features alone, they’re not sufficient. And providers really want a better understanding of how our clients solutions are improving things like their throughput, the burden on their labor in their teens, their ability to realize revenue. And so we’re advising clients to be much more focused on their broader value propositions and messaging. And so within that, the critical thing is to tell a very compelling efficiency story. Knowing that efficiency is the top priority, but that also has to be backed by concrete evidence. And so that’s another one that we’re really noticing as we’re continuing to do these surveys, is that the story only matters to the extent that the evidence is defensible and believable. So as part of this, we also are encouraging clients to build out their metrics capabilities. Oftentimes this looks like economic calculators, but it needs to be incorporated in CRM processes so that as contract renewal period approaches, there’s this ability to really demonstrate definitive results that are tied to an individual client.
Elizabeth Watson: Thank you. It’s funny, I was just speaking with one of our large medtech clients earlier this week, and they mentioned starting to build that calculator for their commercial force to help drive some of the value proposition and things that you were just mentioning. The other kind of top priority is really around capital budgets. They’re telling the same story. So year over year trends show this slowdown in capital investment driven by market and regulatory uncertainty. So when providers do invest, spending is funneled towards IT labor and essential infrastructure. So Alison how does this translate to our clients.
Alison Smith: Yes. And so what we see here is that some of the things that used to be differentiators. So ability to have flexible pricing, bundled contracting, even the way you tell your ROI story, they used to differentiate you, but now they are really table stakes. And so I’ll give an example from a recent client who’s a leading medtech company. And so Alexander Group, we conducted some deep customer research. And the intent of that was to develop a better understanding of where their customers are prioritizing their investment, how they’re spending and how they’re actually making the purchase decision because those trade offs have changed. Once we had a better understanding of the adaptations to purchasing behaviors, we then went and built a new strategy that includes a revised targeting model, a much more competitive and detailed value story, and then some upgrades to make their contracting and pricing models more sophisticated. And I think the key thing to remember here is that this shrinking CapEx does not mean that spending stops altogether. What it means is that our clients need to have a deep understanding of the circumstances under which CapEx investments are still occurring. So it’s reduced. But if we understand where the money is being spent, adjust the market model so that you’re more competitive within that new scope. That is where we see client success.
Elizabeth Watson: Yeah. It’s funny, when we were doing one of our interviews for the provider research, the chief medical officer for one of the large health systems was talking about how financially constrained they are. But then in the next sentence, he was talking about buying a really expensive robot. So, while there are constraints, spending is still happening. So appreciate that layered on top of these challenges is the expected impact of the one big beautiful bill act. 75% of providers expect OBBBA to decrease net patient revenue. Many expect declines on top of 10% or more. So, standalone community hospitals and academic medical centers anticipate the biggest hit. And in response, providers are adjusting reimbursement strategies, revising payer mix and investing in automation to protect those margins. So, Alison, what does this mean for medtech and digital health organizations?
Alison Smith: Yeah, as we think about the impact of one big beautiful bill act for medtech, digital health organizations. I think the biggest takeaway is that product innovation on its own is no longer going to be enough. And again, this ties back to even the last question, but it’s really about how do you defend and prove the total value that your product and that your organization can bring to these, to these customers? And that could look like ROI. It could look like driving efficiency, improving patient outcomes, education and clinical support. But really it is the total value and how you prove it. And so one thing as well as we think about how to be sort of more partner of choice within this restricted environment is pricing and contracting structures. So how do you understand and incorporate the appropriate degree of flexibility? How do you make sure that you have a deep knowledge of your customers price elasticity? And one thing that we advise clients to do in this case is to not overcompensate. So there is some restrictions and some additional barriers, but oftentimes a strong value story can help support and maintain pricing and help protect margins. The one other thing I really want to call out here is that for clients who have customers specifically with rural community hospitals, it’s so important to include Rural Health Transformation Fund eligibility, as well as award status within the targeting models. If there’s a large enough impact, it actually is really beneficial to develop a specific partnership strategy for that customer segment.
Elizabeth Watson: Great. And the other thing I’m hearing too, especially as we think about some of that legislation, is it may impact geographies a little bit differently as well. And so thinking about as we put together a targeting strategy, what that looks like in Georgia versus a California where the Medicaid makeup might look a little bit different. So really appreciate that insight there as well. So providers are also raising the bar for vendor engagement 57% of providers cite inadequate reimbursement knowledge as a major gap among medical device representatives. Providers are expecting reps to be clinically credible, technologically savvy, and capable of navigating some of that reimbursement complexity. So what have you seen some of your clients do to address this talent profile gap?
Alison Smith: This has really strong ramifications actually for talent, including hiring, training, enablement. And as we think about it, I guess some of the ways that we’ve seen clients address this, right? So if we think about larger clients or clients with a larger and more sophisticated sales organization, one of the most effective ways is to transition your generalist rep into more of a specialist QB. And so what they need then is this level of training and resources so that they can answer first and second line questions. So that’s that sort of competitive selling objection handling, and that should be able to cover clinical evidence products, technology, some guidance on reimbursement at a high level as well as things like pricing. But from there, that’s where the QB element jumps in. And so there is this skill set that is practiced and developed and trained, where then that seller can go through that first and second line questioning, and then seamlessly transition the discussion to a specialist. So reimbursement specialists, clinical specialist, key account managers, but that transition to the specialist without losing momentum and without damaging credibility is what’s important. It’s all about the customer’s perception of your selling organization as experts across the board. You don’t need each individual to be that expert, but unless you can fall asleep, transition, that credibility tends to get lost.
Elizabeth Watson: Yeah. And I know as we’ve been having some of these conversations with a lot of our clients, people are also cautious of having their salesperson be reimbursement experts. And actually from a compliance and legal perspective, they don’t want to do that. And so having that transition to an expert where the client is comfortable and making that seamless, I think is, is really great advice for our medtech and digital health organizations.
Alison Smith: Yes. And I’ll just add really quickly to that. So exactly on that note, it’s the training, but then the guardrails on exactly where, when and how that handoff needs to take place that protects that entire infrastructure.
Elizabeth Watson: Great point. One of our last big topics is of course, AI. So AI adoption is accelerating rapidly, and 72% of organizations expect to adopt AI for clinical decision making within the next 24 months. But here is the shift. Ai is no longer viewed as this experimental spend. I think everybody’s now aligned to the fact that this spend is going to happen. So it’s now kind of an efficiency investment. So of 75% of providers would consider paying a premium for AI, but only if ROI is clear in the near term. So cost and unclear ROI remain the biggest barriers of adoption to AI. So what do you see from our clients who are winning in this space?
Alison Smith: Oh, I love this question so much. And if we think back to the first question, you noted, Elizabeth, some data about how operational efficiency is. I think one of the number one priorities for hospital executives 2026. And so the clients that we have, Alexander Group’s clients who have been most successful delivering their AI products have a deep understanding of that operational efficiency as a driver. And that AI solutions are a direct driver of that efficiency. And so they have this ability to combine real world data and have a deep understanding of operational obstacles that their customers experience on the daily. And then they position their AI products as efficiency engines. They pair that with tangible, quantifiable ROI impact data and then improved outcomes, demonstrably improved outcomes. And so wrapping all of that together, leveraging AI as efficiency, meeting the customer’s greatest needs and helping them overcome the greatest obstacle and then supporting it with evidence. Both outcomes, evidence as well as ROI is really important. And then the last thing I also want to note, and we saw this as we did some of our interviews across the leadership and executives at hospitals, is that hospital executives tend to have a very low degree of belief in their organization’s ability to actually implement AI solutions, and that’s a major barrier to adoption. So our clients that do a good job in delivering on ease of use and product integration, but also offer robust user training. Those clients tend to outperform their competitors.
Elizabeth Watson: Yeah, a great point and certainly here that one of the things that struck me was they have all of this noise from all these different companies around AI and how they can help drive or how great their AI products going to be for the hospital. And so how do we cut through that noise with all those things that you just mentioned is really important. So we’ve talked about a lot of different factors today budget constraints, vendor preferences and AI technology spend and adoption. So what is all of this mean for our clients broader go to market strategy.
Alison Smith: So I’ll break this down across a few different points here. But I think the most important one is the value propositions and messaging. So how are you leveraging value propositions to incorporate the value drivers, right. The efficiency margin improvement patient outcomes. And so medical tech, digital health companies that really understand our customer specific value drivers and then can tell a value story that encompasses all of them in a defensible way, will do really well. The second one is that sales models need to change. So you mentioned that the expectations on what a seller can deliver, whether it’s reimbursement, whether it’s technical support, whether it’s a deep understanding of the clinical elements of the product and the procedure space, it’s really important that sales training adapts to this and that the sales models also understand the differences in the local geographical pressures, as well as rural versus urban sites of care, hospital, ASC, things like that. Right. So site of care is really important. Geography is really important and clinical expertise and training among your sales teams are critical. Then the last thing is the messaging that comes across that story needs to be the same across every single messaging channel, whether that’s your sellers, whether that’s digital, whether that’s conferences, but that ROI, clinical impact and economic value really need to stand strong throughout the breadth of messaging.
Elizabeth Watson: Well, here’s the bottom line. In 2026, providers will reward partners who understand their financial reality and help them operate more efficiently. Medtech leaders to align those commercial models, all based on really the overview that you just provided. So those things like talent strategies and then messaging to providers and all of those components will help our clients outperform the market. If you want to understand how these provider priorities impact your commercial strategy, talent model, or go-to-market execution, we’d love to continue the conversation. Alison, want to tell them where to find us?
Alison Smith: Absolutely. So please visit Alexandergroup.com and reach out so that you can connect with our healthcare practice. We’d love to go more in depth with you. Thank you for joining us and we really look forward to helping you win in 2026 and beyond.
Elizabeth Watson: Thank you.
