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A Look Ahead: Navigating the Provider Landscape of 2035

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U.S. healthcare is entering a decisive decade. Surging costs, workforce shortages and accelerating innovation are redefining how care is delivered — and who delivers it.

By 2035, provider organizations will compete in a fundamentally reshaped market as payers, retailers and technology companies move aggressively into care delivery.

The systems that thrive will not simply adapt. They will master five critical areas that define healthcare leadership: care delivery transformation, AI, research and life sciences partnerships, specialty pharmacy and the supply chain.

At L.E.K., we help provider organizations turn this inflection point into strategic advantage.

1. Reimagine operations for financial and workforce resilience

The traditional care model is no longer sustainable. By 2035, high-performing systems will redesign operations around patient segmentation, integrated ambulatory networks, dynamic capacity planning and AI-enabled care teams — aligning capital, workforce and care delivery for long-term resilience.

  • Rethink how your system runs.

    • Invest proactively in areas where acceleration is already happening (e.g., ASCs, infusion centers, freestanding EDs).
    • Develop the organization’s integration muscle across systems, workflows and teams in existing ambulatory sites, and capture learnings.
    • Modernize patient segmentation to better define needs and journeys, and pilot new journey designs.
    • Build dynamic capacity planning and scheduling capabilities before adding more sites and care team models.
    • Pilot new care team designs and clinician support tools, especially those that emphasize APPs and reduce administrative burden.
    • Develop partnerships in clinician education to participate earlier in the pipeline and secure access to new clinicians.

2. Harness AI to drive smarter, more efficient healthcare

AI will define the performance gap between leaders and laggards. Embedded across clinical, financial and operational workflows, AI will drive productivity, unlock new value streams and create durable competitive advantage for organizations that scale it intentionally.

  • Make AI your advantage.

    • Build the organizational muscle to scale AI use cases (not just identify pilots).
    • Develop strong AI governance to protect patients, clinicians and the organization while enabling speed.
    • Identify and size the problems AI should solve, focusing attention on high-impact opportunities and avoiding distraction.
    • Learn from others already deploying AI and leverage lessons from peer organizations.
    • Push boundaries where there are clear opportunities for differentiation; don’t rely solely on a “fast follower” stance.

3. Transform care through research, data and life sciences partnerships

Research and innovation will no longer be optional. Providers that expand clinical trial participation, build scalable data assets and form strategic life sciences partnerships will accelerate access to breakthrough therapies — and capture new revenue and retention advantages.

  • Lead through research and data.

    • Catalog current research activities to understand scope, costs and value.
    • Conduct a gaps assessment to identify capability gaps and blockers to increased trial participation.
    • Define priority service lines and target manufacturers based on clinical needs and community/system value, then open discussions with those manufacturers.
    • Forge flexible partnerships to build out infrastructure (from point solutions to CRO partners) while preserving flexibility in a fast-changing space.

4. Drive specialty pharmacy and embed precision medicine at the point of care

As prescription drug spend approaches $2.5T, specialty pharmacy and genomics will reshape both margins and outcomes. Organizations that integrate pharmacy operations, optimize 340B strategy and activate precision medicine at the front line will win disproportionate value.

  • Capture the precision edge.

    • Prepare proactively for multiple 340B scenarios, with clear action plans for different potential program changes.
    • Embed genomics at the point of care to capture a disproportionate share of growth and build unique data assets.
    • Assess the drug pipeline to identify priority TAs and manufacturers for new relationships and programs.
    • Assess current specialty pharmacy operations (access, authorization timing, revenue, acquisition cost).
    • Chart a path to close gaps versus benchmarks and best practices, including potential partnerships.
    • Build out the delivery footprint, including ambulatory and home infusion (often via operating partners)

5. Establish the supply chain as a competitive advantage

Supply chain mastery will move from back-office function to strategic lever. AI-driven forecasting, integrated clinical-financial systems and resilient sourcing strategies will protect margins, reduce disruption and enable growth.

  • Turn supply chain into strength.

    • Assess the impact of tariffs and identify alternative sources to manage down supply costs if needed.
    • Assess current supply chain resiliency and identify opportunities to diversify supplier networks and improve sourcing agility.
    • Start work to integrate clinical and financial supply chain systems.
    • Identify, select and integrate AI-driven supply chain analytics to predict inventory needs, prevent stockouts and optimize procurement.

Part 1: Pressure is mounting, but will the cost curve bend?

U.S. healthcare spend could approach $8 trillion by 2035 — more than 20% of GDP.

While dozens of cost-reduction initiatives are in motion, structural barriers make significant spend reduction unlikely.

Continued growth will reshape competition, redistribute revenue and create new risks — and new opportunities — for providers.

Read more

Part 2: Traditional ‘Swim Lanes’ Are Breaking Down

Payers, retailers, tech companies and private equity are moving directly into care delivery.

By 2035, traditional boundaries between payer, provider and vendor will continue to erode, accelerating competition and partnership opportunities.

Providers that act decisively can turn disruption into strategic advantage.

Read more

Part 3: Five Areas That Will Define Provider Leadership in 2035

The health systems that thrive in 2035 will not simply adapt — they will master five interconnected capabilities.

From operational resilience and AI to research, specialty pharmacy and supply chain mastery, these areas will separate leaders from laggards.

The road to 2035 starts now.

Read more

Winners will invest where others hesitate

Healthcare leaders are under pressure to deliver results today while preparing for a fundamentally different future.

Subscribe to L.E.K.’s Healthcare Sector newsletter for clear, decision-relevant insight on the issues shaping performance now and the structural shifts that will define the next decade. And for organizations that want to move decisively, L.E.K.’s healthcare experts are working with leadership teams now to address immediate priorities and build durable advantage.

Subscribe for insight that informs action.

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