What to Expect in U.S. Healthcare in 2026 and Beyond
McKinsey projects that US healthcare profits will stay under pressure through 2027 before recovering in 2028–29. Industry EBITDA as a share of national health expenditures fell from 11.2% in 2019 to 8.9% in 2024 and is projected to reach 8.7% in 2027. Overall EBITDA is projected to grow about 5% a year in 2024–27 and 10% a year in 2027–29, with payers and providers absorbing most of the decline. Provider EBITDA is expected to dip about 2% in 2027 versus 2025 before recovering. Among provider segments, ASC margins are projected to slip from 24.1% to 23.5% by 2029, urgent care margins to edge up from 15.2% to 15.5%, and office-based physician margins to rise from 5.7% to 6.1%.
The forecast gives multi-site operators a planning baseline: a tight 2026–27, then recovery driven by pricing, cost actions and portfolio moves such as M&A and divestitures. High-margin ambulatory segments like ASCs and urgent care stay attractive, while primary care margins could drop one to two points in 2025–27, which matters for capital and deal timing.
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When does McKinsey expect healthcare profits to recover?
McKinsey expects payers and providers to face near-term pressure through 2027, with recovery in 2028–29 driven by pricing and cost actions and by portfolio moves such as M&A and divestitures.
How are ASC and urgent care margins expected to change?
McKinsey projects ASC margins to slip from 24.1% in 2024 to 23.5% in 2029, while urgent care margins are projected to rise slightly, from 15.2% to 15.5%.
Which healthcare segment is growing fastest in McKinsey’s outlook?
Health services and technology. Its EBITDA pools are projected to grow about 9% a year from 2024 to 2029 and exceed $110 billion by 2029, driven by gen AI adoption, outsourcing and consolidation.