As health systems plan for 2026, supply chain leaders say the next set of challenges will be less about acute shortages and more about structural pressures — from reimbursement declines and cost escalation to contract discipline, geopolitical instability and the practical limits of automation.
Here’s what hospital supply chain leaders across the country told Becker’s they’re monitoring most closely — and why.
Cost pressure and reimbursement headwinds
For many leaders, cost remains the dominant concern — particularly as reimbursement tightens and traditional savings levers lose effectiveness.
Eric Berger, system director of supply chain at Tewksbury, Mass.-based Covenant Health, said supply chain leaders need to closely monitor the downstream impact of reimbursement changes on their organizations’ revenue streams.
“Declining reimbursements will cause supply chain leaders to shift even more of their focus to cost-cutting activities,” Mr. Berger said. “Since we have already wrung out a lot of cost for products, the focus will need to be on purchased services expense and product utilization opportunities.”
James Dugger, director of materials management at Sonoma Valley Hospital in California, said the pressure is especially acute for small, rural hospitals.
“As a small, rural, standalone hospital, the main thing I believe like-hospitals should be watching out for is cost,” Mr. Dugger said. “Hospitals are limited in ways of obtaining reimbursement, and it’s important to connect with a large purchasing group to standardize purchases and reduce overall costs in order to survive and continue providing care to our communities.”
Larry Kennedy, executive director of campus operations and logistics at Pine Bluff, Ark.-based Jefferson Regional Medical Center, said factors such as tariff-related global volatility, political instability and natural disasters are expected to continue straining operational margins and supply chain resilience heading into 2026.
Contract compliance and utilization discipline
Several leaders emphasized that the issue is no longer just what hospitals are paying — but whether they are actually buying and using what they’ve negotiated.
Michael Alfaro, director of materials management at Community Memorial Healthcare in Ventura Calif., said contract compliance tied to a disciplined, systemwide formulary strategy will be critical.
“Without real-time visibility and clinician alignment, organizations risk leakage that erodes savings and undermines standardization,” Mr. Alfaro said. “The systems that win will pair strong compliance governance with ongoing clinician engagement around quality, outcomes and substitution pathways.”
Don Barton, chief technical officer and director of supply chain management at Major Health Partners in Shelbyville, Ind., echoed that concern, pointing to vendor price escalation and opaque pricing practices.
“Leaders need real-time visibility into contract terms, utilization and alternatives to ensure they are paying the right price for the right product,” Mr. Barton said. “Without disciplined oversight and standardization, incremental cost creep can quickly erode financial performance while offering little clinical value.”
Ongoing fragility, resilience and automation after COVID-19
While shortages have eased in many categories, some leaders cautioned that the supply chain remains more fragile than it appears — and that technology will play a growing role in how organizations respond.
Nicholas Sica, supply chain manager at Radnor, Pa.-based Main Line Health, said improvements since COVID-19 should not lead to complacency.
“Although there have been improvements in some areas, it’s crucial for us to remain vigilant and proactive in ensuring that our patients have access to the necessary resources,” Mr. Sica said. “The supply chain is still fractured in the aftermath of COVID-19.”
Thomas Shaffer, director of supply chain at SouthEast Alaska Regional Health Consortium in Sitka, Alaska, said AI will be critical as health systems navigate ongoing economic and operational pressures.
“Shifting an organization’s use of artificial intelligence from a buzzword to a competency will be the key to staying ahead of operational and financial pressures,” Mr. Shaffer said. He pointed to opportunities to automate rote tasks so staff can be reallocated to more complex initiatives.
Mr. Dugger also noted that AI is an area supply chain leaders should be watching, though he said adoption is likely to be slower in healthcare than in other industries.
What it adds up to for 2026
Taken together, leaders said the supply chain function is being pushed beyond its traditional operational role. Cost containment, contract discipline, reimbursement awareness and technology adoption are increasingly intertwined — and directly tied to organizational survival.
As one leader put it, the margin for error is narrowing, and supply chain decisions are no longer happening in the background.
