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The next era of healthcare delivery: HealthCare360

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A new model of care is emerging in the US. One that is technology-powered and human-elevated. Enabled by agentic AI, it can deliver more personalized, seamless care and continuous health engagement, while preserving the trusted human relationships at the heart of healthcare.

This new system of care creates an opportunity to extend the patient-caregiver relationship beyond episodic interactions to a 24/7, 365 relationship in which the patient feels empowered, supported, and educated in their health and care journey. And it has the potential to provide high-quality care at scale to reach even the most vulnerable and underserved populations.

We are calling this new system of care HealthCare360.

The Forces Shaping What’s Next

By 2035, 1 in 5 Americans will be age 65+. This demand is poised to break the economics of US healthcare delivery, creating extraordinary pressure to change. This older adult population will drive nearly all of the expected rise in utilization over the next decade, given older populations have greater care needs. This increase will place a larger burden on already stressed caregivers and potentially crowd out elective cases as physical capacity becomes more constrained.

As the proportion of younger adults (age 18–65) to older adults (age 65+) drops to an all-time low of 2.7:1, the traditional cross-subsidization framework for financing US healthcare will break.

This shift will place a significant burden on health system financials and the broader US economy. We project that the median health system will lose 11.1 percentage points (ppt) in operating margin with no action; and even with remediations (such as gaining share, negotiating better rates, and cutting costs), financial sustainability will be challenging for many.

For the broader economy, employers and households will need to dedicate a disproportionate share of wages to healthcare. As Medicare spending is expected to double in the next decade, nearly 25% of general federal income tax revenue will go toward funding Medicare, leaving less funds available to support other social needs.
Agentic AI-driven clinical innovations are changing where, when, and how care is delivered and accelerating clinical discoveries, with the potential for extending clinical care and support at scale.

For example, AI scribes are widely adopted today, enabling a return to a more human-centered patient-clinician interaction. In some cases, agentic AI care managers, coordinators, and schedulers are also supporting patients in their care journeys across symptom management, care plan support, care navigation, and scheduling.

Also, in some instances, AI-driven clinical discoveries are enabling faster screening and diagnosis of diseases, driving advances in personalized clinical treatments, and facilitating more precise clinical trial matching.

Working together, these innovations have the potential to create a new system of care in the US that delivers more accessible, equitable, high-quality care—at scale.
Growth capital, hyperscalers, and incumbent health-tech companies are pouring large amounts of capital into healthcare delivery transformation. These well-capitalized companies are pushing for the rapid adoption of technology-driven clinical innovations and funding the cost of change by taking on the burden and risk of running parallel processes and integration into workflows.

Early evidence shows that AI adoption among physicians is high: 80% report using AI in a professional context.¹ Consumers are also adopting healthcare AI tools, although at lower rates: approximately 30% of adults are using AI for healthcare questions. Promisingly, AI use appears to be uniform across demographic groups and across insurance status: 28% of insured individuals and 31% of uninsured individuals have used AI for physical health advice.²

A New Model for Care Delivery

The newly emerging model of care will create a more frictionless experience that’s better for individuals, clinicians, and the organizations that deliver care. HealthCare360 will manage health and care continuously, at scale and lower cost, with the human at the center.

It embodies five key features:

1. Always-on, personalized health engagement: Continuous proactive support is available anytime. This support is personalized to individual preferences and clinical/health needs based on the plan of care and comprehensive, longitudinal clinical/health data (also known as the “quantified self”).

2. Intelligent orchestration and navigation: The health system provides smart sequencing, matching, and fulfillment of care with the most clinically appropriate modality, site, and provider, incorporating patient preferences and requirements.

3. Integrated care anywhere: Flexible, convenient, and affordable care site options (including home, remote, and asynchronous). Physical locations are not the default, and transitions are seamless.

4. Human-agentic care teams: AI-enhanced care teams enable personalized high-quality interactions, reducing administrative and coordination burden, and elevating clinical quality with more timely data and predictions.

5. Evolved healthcare financing models: Pluralistic financing models and incentive structures reward health management and outcomes over volume.

What remains true is that healthcare is about human connection. Trust and empathy are essential. In creating a better system of care, organizations must harness technology and AI-powered innovation to enhance, not replace, the clinician and care team as they bring their expertise and experience to care for individuals at their most vulnerable moments.

While health tech companies are part of shaping what is next, established healthcare organizations such as health systems will be pivotal architects of this new, better future.

This new model of care must be designed to enhance:

Equitable access. Supportive capabilities, such as care team agents and new capacity, need to be designed and distributed equitably to effectively serve and engage all populations.
Tech-enabled workflows. Clinicians must be involved in designing how technology, including AI agents, will be incorporated into their daily workflows and how it will enhance support for their patients.
Responsible use of AI. Augmentation and automation in any form needs to be managed and continuously monitored, with governance in place to manage drift when it occurs.
Affordability. Patients today often end up in more expensive sites of care due to access challenges. This new model of care will need to direct patients to the appropriate, lower-cost mode or site of care while also lowering the cost of care delivery.
Quality. Human-agentic workforces cannot compromise quality. Vigilant monitoring of quality, safety, outcomes, and experience data must continue to be at the center of the new clinical operating model.

Emerging Questions for Healthcare Leaders

In this rapidly changing environment, the emerging strategic questions that healthcare organizations must grapple with include:

How will we define “care”—who and/or what delivers care, where, and how? Considerations include the role of agentic AI, care at home, virtual, and asynchronous care.
What is the new consumer/patient lifecycle, and what will it take to “win” the patient relationship at each stage and over time? Considerations include the shift from referral-dependence to self-navigation, and managing the plurality of relationships individuals will have with clinicians/organizations.
How will the business model need to evolve? Considerations include how to structure and capture value generated through care innovations; how to align system incentives, individual incentives, and performance measurements; and how to account for AI-driven activities for cost and reimbursement.
How will roles across the healthcare value chain shift? Considerations include the anticipated roles of health systems, health plans, consumers/patients, employers, health tech companies, and the government.
How do we ensure a responsible path to augmentation and automation that enhances quality, equitable access, and the safety net? Considerations include establishing ethical AI standards and managing risk of exacerbating disparities.

Given how quickly technology-driven clinical innovations are evolving and taking hold, time is of the essence. The next decade will not be a linear extension of the past. The pressure to change, the means to change, and the pace of adoption are all accelerating. Healthcare organizations that act, learn, and scale quickly will be better positioned to differentiate and compete.

NEXT: Explore the three forces shaping the new era of healthcare

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