Health systems are heading into 2027 with less room for error than they’ve had in years. A merger might just have handed their leadership team a new set of hospitals to run. Their IT department can’t find the one person who could keep pace with AI on their own. Regulators are actively checking whether health data promises hold up. Another vendor breach just made headlines. And a Medicare subsidy that’s been propping up margins is about to disappear.
None of the five stories behind those pressures has anything to do with fax machines or document workflows on its face. But together, they explain exactly what health system buyers are going to prioritize this year.
1. Mergers are forcing hospitals to rethink who’s really in charge
Hospital consolidation isn’t new, but the way health systems are handling it right now is. Across nearly every major merger in motion this year, the same question keeps coming up: once a hospital becomes one piece of a much bigger system, how do you keep decisions from drifting too far away from the people it actually serves?
Northwell Health’s own history offers one example of how that question gets answered. Back in 2016, Northwell absorbed a group of hospitals in Westchester County and folded them into its existing, centralized structure. Northwell’s COO, Kevin Beiner, later told Becker’s Hospital Review that physicians and local staff had felt less connected to the system afterward, and described how easily a newly combined organization can start to feel distant to the communities it just joined. Beiner has said that experience informed how Northwell approached its much larger 2025 merger with Nuvance Health, which formed a $22.6 billion, 28-hospital system. This time, instead of one central structure running everything, the combined system operates as four semi-autonomous markets, each with its own president and clinical leadership, so decisions stay close to the people making them.
That same instinct is showing up across the industry. Jefferson Health and Lehigh Valley Health Network kept leaders from both organizations in place after their merger rather than consolidating under one. Sutter Health’s proposed combination with Allina Health lets Allina keep its own board and its own name. And in the pending Atrium Health and WakeMed merger, backed by a $2 billion investment in the community, WakeMed’s board keeps its authority even as the hospital gains access to a much larger system’s resources.
What this adds up to is a wave of brand-new leadership teams stepping into organizations that inherited technology decisions they never made themselves. A newly formed market inside a combined health system means a fresh set of decision-makers evaluating whether the fax, referral, and document workflows they inherited actually fit the organization they’re now part of, often across multiple EHRs and care settings that weren’t designed to work together. That’s exactly the kind of moment where automated, adaptable document workflows tend to get a second look.
2. There’s a job health systems can’t hire for, because it doesn’t really exist yet
Two hospital IT leaders, hundreds of miles apart, told Becker’s a strikingly similar story this week without knowing the other had said it.
At a small rural hospital in Gloversville, New York, CIO James Wellman is trying to roll out AI tools and running into a challenge that has nothing to do with the software itself. What he actually needs is someone who understands clinical workflows, data systems, and AI risk all at once, and he told Becker’s that finding someone with real depth across both the clinical and technical sides is rare. That kind of hire, he said, is hard to find and, once found, worth compensating well.
At Atlantic Health System, a much larger organization, chief digital and AI officer Sunil Dadlani described the same shortage from a different angle. For him, the hardest role to fill combines cybersecurity and AI governance, someone who can help keep clinical systems secure while also understanding the specific risks that come with running AI in a hospital setting. Dadlani said even a system Atlantic Health’s size competes with much larger technology companies for that kind of talent.
There’s a hopeful wrinkle here too: as tech companies have gone through layoffs this year, some of that talent has started moving toward hospitals instead of away from them. But that’s a helpful trend, not a guaranteed fix, especially for smaller systems. It’s a big part of why automation is showing up so often in these conversations: tools that can handle document intake, routing, and referral workflows on their own reduce how much a hospital needs that hard-to-find hybrid AI and integration specialist just to keep its document processes running.
3. The FTC’s lawsuit against a major telehealth company is a reminder of how closely health data practices are being watched
On July 29, the Federal Trade Commission filed suit against Hims & Hers, alleging the telehealth company shared users’ health information with advertising platforms like Meta and Snap despite telling customers their data would stay private. The complaint, joined by Utah and California, also alleges the company billed customers for prescriptions before a medical consultation took place and made it difficult for some customers to cancel a subscription.
Hims & Hers has pushed back firmly, saying the lawsuit disregards evidence it provided during a lengthy investigation and stating it intends to defend itself. Its stock dropped on the news, and the case is ongoing.
Regardless of how the case is ultimately resolved, it’s a useful reminder that regulators are actively reviewing how health data actually moves behind the scenes, not just what a privacy policy says. For any vendor handling protected health information, that raises the bar on what “compliant” needs to mean in practice: being able to show, specifically and concretely, how documents move, who can access them, and where consent and audit trails live. In a climate like this, that kind of transparency is a real differentiator rather than a compliance formality.
4. A billing vendor disclosed a breach affecting 1.2 million patients
A medical billing company called MCBS recently disclosed, in a filing with the HHS Office for Civil Rights, that a breach of its network last September exposed the personal and health information of 1.26 million people. The company confirmed which records were affected this May and shared a public notice in late June.
It wasn’t the only vendor breach disclosed around the same time. A separate revenue cycle vendor, Unlimited Technology Systems, also disclosed a breach tied to an October 2025 incident affecting several hundred thousand patients across multiple states, and has been notifying affected individuals and offering identity monitoring as part of its response.
These incidents are a reminder that every hospital relying on a third-party vendor for billing or document processing is also relying on that vendor’s security practices, whether or not that connection is top of mind day to day. Security posture, encryption, audit trails, and compliance certifications are becoming as central to a vendor evaluation as the workflow features themselves. Being able to point to a secure, well-documented chain of custody for every document that moves through a platform is turning from a nice-to-have into a baseline expectation buyers are asking about directly.
5. CMS is ending a subsidy that’s been keeping drug plan premiums in check
CMS announced this week that it’s ending a program that has helped stabilize Medicare Part D premiums since 2025. The agency says insurers now have enough experience with the newer benefit rules to price their own plans without it. According to the Government Accountability Office, the subsidy has been doing real work: without it, premiums for people who stayed in their existing plans would have nearly doubled. Starting in 2027, premiums are expected to rise, and the number of standalone drug plans on the market, already down from 464 to 360 over the past year, is likely to keep shrinking.
For hospitals, pharmacies, and payers already managing tight margins, this is one more reason cost efficiency is moving to the top of every conversation, including the ones about which vendors and tools get renewed. Messaging built around measurable efficiency, faster document turnaround, reduced manual processing, fewer dropped referrals, is likely to land better with buyers under margin pressure than a pitch built around abstract, long-horizon strategic value.
What it all adds up to
None of these five stories is about fax machines or document workflows on its face. But put them side by side and they describe the same buyer from five different directions: a health system rebuilding its leadership after a merger, one that can’t easily find or afford specialized integration staff, one operating in a climate where regulators are scrutinizing how health data is shared, one that’s read about vendor breaches and is asking harder questions about security, and one bracing for tighter margins as a federal subsidy winds down.
Every one of those pressures points toward the same kind of answer: automation that doesn’t require a large internal team to run, backed by real, demonstrable security practices, and priced around clear, near-term value rather than abstract strategic promises. That’s the environment healthcare document automation exists to solve for, and it’s the thinking behind how we build Documo.
