The year 2025 marked a turning point for care management. 

It did not introduce entirely new challenges but it made existing structural weaknesses impossible to ignore. Across healthcare organizations, persistent issues such as delayed post-discharge follow-ups, fragmented workflows, limited visibility into patient status, and reactive intervention models continued to undermine outcomes. 

Research has long shown that failures during transitions of care significantly increase the risk of avoidable readmissions, patient harm, and dissatisfaction (Agency for Healthcare Research and Quality – AHRQ). What changed in 2025 was the industry’s response: a growing recognition that these problems are systemic, not operational missteps. 

As healthcare moves into 2026, care management is evolving accordingly. The focus is shifting from deploying more programs to designing care systems that are timely, connected, proactive, and accountable. 

The trends below reflect how the lessons of 2025 are shaping the next phase of care management. 

Trend 1: Care Management Will Shift from Programs to Continuous Care Journeys 

In 2026, care management will increasingly move away from isolated program structures such as CCM, RPM, or TCM operating independently toward longitudinal care journeys that span settings and time. 

Research shows that continuity of care across transitions is strongly associated with improved outcomes and reduced hospital utilization (AHRQ; The Commonwealth Fund). When care is experienced as episodic, patients are more likely to fall through gaps between programs. 

What this means in practice: 

• Care will be organized around the patient’s journey, not billing categories 

• Teams will prioritize continuity over enrollment volume 

• Success metrics will increasingly reflect sustained engagement and follow-through 

Trend 2: Real-Time Care Orchestration Will Become a Core Expectation 

One of the clearest lessons of 2025 was that delayed care often results from delayed awareness. In 2026, static task lists and retrospective reporting will give way to real-time care orchestration. 

CMS data continues to show that timely follow-up after discharge is a key driver of reduced readmissions. Yet many care teams still rely on manual notifications and disconnected systems. 

In 2026, organizations will expect: 

• Immediate visibility into discharge and transition events 

• Time-bound, prioritized actions tied to patient risk 

• Systems that support action in the moment—not days later 

Trend 3: Proactive Risk Identification Will Move Earlier in the Care Timeline 

Proactive care management proved its value in 2025, but in 2026 it will begin before discharge, not after. 

Studies published in the Journal of Medical Internet Research show that early risk identification and proactive outreach significantly improve outcomes for patients with chronic conditions and transitional care needs. 

Emerging practices include: 

• Risk stratification during inpatient stays 

• Pre-discharge planning linked directly to post-discharge workflows 

• Early activation of care management resources 

This shift reflects a broader move away from crisis response toward anticipatory care models. 

Trend 4: Visibility Will Evolve From Reporting to Decision Enablement 

In 2025, visibility gaps were repeatedly linked to missed follow-ups and unclear ownership. In 2026, visibility will no longer be about dashboards alone; it will be about decision enablement. 

HIMSS has identified lack of unified visibility as a major barrier to effective care coordination and operational efficiency. 

What visibility will mean in 2026: 

• Clear understanding of patient status across teams 

• Real-time insight into pending actions and timelines 

• Shared accountability based on a single source of truth 

Trend 5: AI Will Move From Insight Generation to Operational Support 

Artificial intelligence in care management has historically focused on analytics and reporting. In 2026, AI will become operationally embedded in daily workflows. 

McKinsey reports that healthcare organizations derive the most value from AI when it reduces cognitive load and supports frontline decision-making rather than adding complexity. 

Expected use cases include: 

• Suggested next-best actions 

• Automated prioritization of outreach 

• Context-aware alerts that reduce noise 

Importantly, AI will increasingly be positioned as an assistant to care teams, not a replacement for clinical judgment. 

Trend 6: Accountability Will Become Patient-Centric 

Another key evolution in 2026 will be a shift from role-based accountability to patient-centric ownership. 

Research indicates that unclear responsibility during care transitions is a major contributor to care gaps and missed follow-ups (AHRQ). Assigning ownership at the patient level improves execution consistency. 

In practice, this means: 

• Clear ownership across the patient journey 

• Defined handoffs between teams 

• Reduced ambiguity during transitions of care 

Trend 7: Interoperability Will Be Judged by Workflow Impact 

By 2026, interoperability will no longer be evaluated by technical capability alone. It will be judged by whether it meaningfully improves care workflows. 

The Office of the National Coordinator for Health IT (ONC) and HIMSS have emphasized that data exchange must translate into actionable insight to improve care coordination. 

Successful interoperability will: 

• Reduce manual reconciliation 

• Enable seamless coordination across vendors 

• Support timely, informed decision-making 

Trend 8: Technology Adoption Will Become Outcome-Driven 

Tool overload and administrative burden remained persistent challenges in 2025. In 2026, care management technology will increasingly be evaluated based on outcomes and usability, not feature volume. 

Healthcare leaders are prioritizing solutions that: 

• Simplify workflows 

• Reduce documentation burden 

• Improve staff adoption and efficiency 

This marks a shift toward intentional, value-driven technology selection. 

Trend 9: Human-Centered Automation Will Define Scalable Care 

Automation expanded significantly in 2025, but with growing recognition that scale must not come at the cost of trust or quality. 

Evidence shows that automation supporting routine tasks while preserving human oversight improves efficiency and care consistency. 

In 2026, automation will increasingly focus on: 

• Reminders and follow-up tracking 

• Documentation support 

• Guardrails that preserve clinical judgment 

Trend 10: Care Management Will Be Recognized as a Strategic Capability 

By 2026, care management will be viewed less as a compliance requirement and more as a strategic lever for quality, sustainability, and patient experience. 

The Commonwealth Fund and CMS have highlighted the role of care coordination in advancing value-based care and population health outcomes. 

Organizations that internalize the lessons of 2025 will be better positioned to: 

• Deliver consistent, proactive care 

• Reduce preventable utilization 

• Build patient trust and loyalty 

  
  

How Clinicus Is Aligned with Care Management Trends in 2026 

• Enabling timely intervention during transitions of care 

  Clinicus supports real-time care coordination during hospital discharge and post-acute transitions. This addresses delayed follow-ups caused by limited visibility, a key driver of preventable readmissions. 

• Supporting proactive care management workflows 

  The platform enables early risk identification and structured outreach. This aligns with research showing proactive care management improves outcomes for chronic care and transitional care populations. 

• Reducing care fragmentation across programs and settings 

  Clinicus connects CCM, RPM, and transitional care workflows into a unified care journey. This supports continuity of care and aligns with industry guidance on reducing siloed care coordination. 

• Prioritizing workflow efficiency and reduced administrative burden 

  Clinicus focuses on simplifying care management workflows and lowering cognitive load. This reflects healthcare operations research highlighting administrative burden as a major barrier to care team efficiency. 

• Applying automation with clinical oversight 

  Automation supports routine care management tasks such as alerts, reminders, and follow-up tracking while preserving human decision-making. This approach is supported by evidence on safe and effective care automation. 

• Improving care visibility and patient-level accountability 

  Clinicus provides centralized visibility into patient status, pending actions, and timelines. Research links this level of care visibility to improved accountability and consistent execution across transitions of care. 

2026 Builds on the Clarity of 2025 

If 2025 was the year the care management industry confronted its structural gaps, 2026 will be the year those gaps are intentionally designed out. 

The future of care management will not be defined by how many programs are deployed, but by how effectively care is connected across time, teams, and settings. Timely action, unified visibility, proactive workflows, and thoughtful technology design will form the foundation of the next era. 

The organizations that act on these trends will be best positioned to deliver care that is not only scalable but truly responsive to real-world needs.