There is something quietly overwhelming about trying to keep up with the American healthcare system. The rules change, the costs climb, and the policies shift faster than most people can track. Whether you are managing a chronic condition, shopping for insurance, or just trying to understand your options, the system can feel like a maze designed specifically to confuse you.
The good news? There are smarter ways to move through it. Below are seven practical, evidence-based tips that can help you take better control of your healthcare in 2026, backed by the latest data and the trends actively reshaping how care is delivered and paid for. Let’s dive in.
Tip 1: Understand Just How Much Healthcare Really Costs – and Budget Accordingly
Most Americans know healthcare is expensive. Few realize how expensive it has actually become. Healthcare spending in the US reached $5.3 trillion and increased 7.2 percent in 2024, fueled by increased demand for healthcare across the board. To put that in perspective, that is a number so large it barely feels real – like trying to count stars.
On a per capita basis, total health spending has increased from $353 per year in 1970 to $15,474 per year in 2024. That is not a typo. Nearly $15,500 per person, per year. Health spending as a percent of GDP reached 18.0% in 2024, an uptick from 17.7% in 2023 as health spending grew faster than GDP.
What does this mean for you practically? It means building a healthcare budget is not optional anymore – it is essential. Track your premiums, deductibles, and likely out-of-pocket costs for the year. Having a rough annual estimate gives you the power to plan, rather than simply react in a panic when a large medical bill arrives.
Tip 2: Embrace Telehealth – It Is Here to Stay, and It Could Save You Time and Money
Let’s be real: not every medical concern requires a trip to the doctor’s office. Telehealth stepped in during the pandemic and never fully stepped back out. Approximately 54% of Americans have participated in at least one telehealth visit, with nearly 38% of these visits pertaining to medical or mental health needs. That is a remarkable shift from where things stood just a few years ago.
Physicians and health care systems across the country have embraced a blend of in-person and virtual care, creating hybrid workflows that can adapt to evolving patient needs, and as the U.S. confronts an aging and growing population and an intensifying physician shortage, the adaptability telehealth can provide could prove more critical than ever.
Think of telehealth like the express lane at a grocery store. Not every situation calls for it, but when it fits, the efficiency is hard to argue with. Research shows that 67% of patients find telehealth visits as good as or better than in-person visits, citing ease of use and cost-effectiveness. If you have not tried it for routine care, it may be worth exploring with your provider.
Tip 3: Know Your Insurance Coverage Inside and Out
Honestly, most people only open their insurance documents when something goes wrong – and by then, it can be too late to avoid a nasty surprise. Insurance coverage levels in the US have remained relatively strong in recent years, but they are shifting. The insured share of the population peaked in 2023 at 92.5%, but still remained strong in 2024 at 91.8%.
However, coverage does not mean affordability. Eligibility redetermination that began in late 2023 and 2024 led to a 7.9 million decline in Medicaid enrollment between the two years, with private health insurance rising by 4.9 million but uninsured numbers growing by 2.8 million. Millions of people lost coverage they may not have even known was at risk.
Review your plan annually, especially during open enrollment. Understand what your deductible is, which providers are in-network, and what your out-of-pocket maximum looks like. A plan that costs less in premiums can end up costing far more if you need significant care during the year. The cheapest plan is rarely the most affordable plan in the long run.
Tip 4: Take the Physician Shortage Seriously and Plan Ahead for Access to Care
Here is something that does not get enough attention: the US is heading toward a serious, structural physician shortage. This is not a future problem – it is already affecting wait times and access to care in many parts of the country. In March 2024, the AAMC revised their prediction, now estimating a physician shortage of up to 86,000 by 2036.
The American Medical Association estimates that in the next five years, 35% of the physician workforce will reach retirement. The AMA’s 2024 report further points out that physicians who are currently 65 years or older make up 20% of the clinical physician workforce, while those aged 55-64 comprise 22%. That’s nearly 44% of the physician workforce either already retiring or nearing retirement, resulting in a devastating hit to physician supply.
In 2024, more than half of primary care physicians reported feeling burnout, which only compounds the problem further. The practical takeaway? Don’t wait until you need urgent care to establish a relationship with a primary care provider. Find one now, schedule regular visits, and don’t take that relationship for granted. Office visits to primary care clinicians are projected to increase from 773,606 in 2020 to 893,098 in 2040, meaning competition for appointments will only intensify.
Tip 5: Get Familiar With the Medicare Drug Price Negotiation Program If You Are a Beneficiary
If you or a family member relies on Medicare for prescription drug coverage, this is one of the most significant policy shifts in decades. The Inflation Reduction Act, signed into law by President Biden in 2022, for the first time authorized the federal government to negotiate the prices that Medicare pays for selected prescription medications. For a very long time, Medicare was literally forbidden from doing this.
Although the negotiated prices won’t be effective until 2026, on August 15, 2024, Medicare announced the prices for the first 10 drugs as outlined in a Negotiated Prices Fact Sheet released by the Centers for Medicare and Medicaid Services. The negotiated prices range from 38% to 79% discounts off the 30-day supply list prices. CMS commented that if the new prices had been in effect the prior year, Medicare would have saved an estimated $6 billion, or approximately 22%, across the 10 selected drugs.
A second round is already in motion. On January 17, 2025, CMS announced the list of 15 Part D drugs selected for the second round of price negotiation, which includes the popular diabetes and obesity drugs Ozempic and Wegovy, along with other drugs used to treat asthma and chronic obstructive pulmonary disease, type 2 diabetes, and different types of cancer. If any of your medications are on these lists, it is worth talking to your plan provider about how these changes apply to you directly.
Tip 6: Use Digital Health Tools Actively – Patient Portals Are More Powerful Than You Think
Think of your patient portal like a dashboard for your health. Most people glance at it once in a while, but very few actually use it to its full potential. In 2026, digital tools have become a central part of how care is coordinated, monitored, and communicated. Telemedicine is increasingly integrated into electronic health record (EHR) workflows and hybrid care models, shifting away from being viewed as a standalone service.
Artificial intelligence may minimize the effects of workforce shortages by streamlining administrative burdens and enhancing efficiency, enabling providers to focus more time on direct patient care. Physician use of AI nearly doubled from 2023 to 2024, with more than 66% of physicians using AI. What this means for you as a patient is that the information and tools available through digital platforms are becoming faster, smarter, and more personalized.
Log into your portal regularly. Check your test results, review your medication list, and send messages to your care team instead of waiting on hold. Telehealth solutions are pivotal in managing chronic conditions like diabetes and heart disease – remote monitoring, connected devices, and tailored care plans empower patients to maintain health from home while reducing hospital visits. Engaging with these tools is no longer optional if you want to stay ahead of your own health.
Tip 7: Understand the Mental Health Access Gap – and Advocate for What You Are Entitled To
Mental health care has historically been one of the most under-resourced, underfunded, and stigmatized areas in US healthcare. That is changing, slowly, but the gaps are still enormous. Between July and December 2024, mental health conditions accounted for 66-67% of telehealth claim lines, solidifying it as the most persistent and in-demand telehealth service. The demand is clearly there – the supply side still struggles to keep up.
A total of 122 million people live in a mental health Health Professional Shortage Area (HPSA), and the maldistribution of the health care workforce results in severe shortages in rural communities. That is roughly one in three Americans living somewhere with inadequate mental health provider access. It is a stunning number that rarely makes headlines.
Telehealth is revolutionizing mental healthcare by improving accessibility and reducing stigma, with virtual therapy sessions, AI-driven mental health assessments, and 24/7 crisis support platforms now integral to addressing the rising demand for psychological well-being services. Know your insurance policy’s mental health parity rights – federal law requires that mental health benefits be comparable to physical health benefits. If you are being denied care or facing unequal cost-sharing, you have legal grounds to appeal.
Conclusion: Navigate With Knowledge, Not Just Hope
The American healthcare system in 2026 is genuinely complex. There is no getting around that. Costs are rising, providers are stretched thin, and policy changes are arriving faster than most people can absorb them. Still, knowledge is real leverage in this system – and most people are leaving a lot of it on the table.
The seven tips covered here are not magic fixes. They are practical moves rooted in verifiable data and emerging trends: understanding your true costs, leveraging telehealth, knowing your coverage, securing a primary care relationship early, watching prescription drug reforms, using digital tools actively, and advocating for mental health access. Each one of these is something you can act on today.
The healthcare landscape will keep evolving. The people who fare best in it won’t just be the luckiest or the wealthiest – they’ll be the ones who showed up informed. What step will you take first?
