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Pulse check: 5 key findings for the decade ahead that demand action — now

Sg2’s Impact of Change® Forecast predicts modest spikes in inpatient and ED utilization, double-digit growth in outpatient and home-based post-acute care, and profound potential impacts of pharmaceutical innovation.
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Pulse check: 5 key findings for the decade ahead that demand action — now

If the 2025 Impact of Change® Forecast by Sg2, a Vizient company, makes one thing clear, it’s this: Demand is rising fast, and the old ways of delivering care won’t cut it.

Look for inpatient spikes and outpatient surges, consumerism to drive more convenient care access, and pharmaceutical innovation to take a front seat across several specialties.

What do all these shifts have in common?

More complex patients. Increased capacity pressure. Bigger stakes.

This forecast doesn’t just anticipate the future — it tells you where to act now. Whether you're leading strategy, planning capacity or rethinking workforce models, this is your blueprint.

Note: Analysis excludes 0-17 age group. Eco & consum = economy and consumerism; innov & tech = innovation and technology; pop = population; SoC = System of CARE. Sources: Impact of Change®, 2025; HCUP National Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP) 2021. Agency for Healthcare Research and Quality, Rockville, MD; Claritas Pop-Facts®, 2025; Sg2 Analysis, 2025.

The forecast: A 5% increase in adult inpatient (IP) utilization is anticipated over the next 10 years. The rapidly growing 65+ population will drive inpatient demand and is expected to account for more than half of all admissions by 2035. Of note, cardiovascular valve procedures are anticipated to grow by 106% in the 65+ group by 2035.

Why it matters: Patients are living longer and presenting with multiple chronic conditions. This means the current constraints faced by hospitals won’t abate any time soon, particularly without a strategy that maximizes workforce, technology and appropriate sites of care. Hospitals will need to pursue system-wide redesigns and coordinated throughput strategies to manage demand without sacrificing quality.

Where to start?

Your top three action items:

  • Upskill community hospitals and non-tertiary care centers to manage more complex cardiovascular and comorbid patients, relieving pressure from tertiary and quaternary facilities. To alleviate employee constraints, augment your human workforce with predictive analytics and AI to work smarter, not harder, and to minimize disruptions due to lack of access.
  • Go to market with specific strategies that target the 65+ cohort. Design and implement age-specific cardiovascular care models (e.g., valve clinics, care coordinators, prehab/rehab programs) that support early detection, preoperative optimization and postoperative recovery for seniors.
  • Invest in outpatient access, to manage chronic conditions before they escalate.

Learn how AI can help you maximize your workforce, especially for administrative tasks. The key to reaping the biggest benefits: Take small steps.

Note: Analysis excludes 0-17 age group. Sources: Impact of Change®, 2025; HCUP National Inpatient Sample (NIS). Healthcare Cost and Utilization Project (HCUP) 2021. Agency for Healthcare Research and Quality, Rockville, MD; Proprietary Sg2 All-Payer Claims Data Set, 2023; The following 2023 CMS Limited Data Sets (LDS): Carrier, Denominator, Home Health Agency, Hospice, Outpatient, Skilled Nursing Facility; Claritas Pop-Facts®, 2025; Sg2 Analysis, 2025.

The forecast: The IoC projects that by 2035, increasing GLP-1 utilization and proper disease management could soften IP growth for type 2 diabetes to 8%. Expanded GLP-1 adoption has the potential to transform care delivery models as clinical indications expand beyond diabetes and obesity. Ambulatory access must scale to improve access to chronic disease management that will soften acute patient exacerbations over time.

Why it matters: As noted above, chronic conditions are a major contributor to IP utilization, with type 2 diabetes costing hospitals roughly $96.2 billion per year, according to the National Institutes of Health. The Winter 2025 Vizient Spend Management Outlook found that 1 in 8 American adults report using GLP-1 medications, resulting in huge financial, clinical and operational impacts. However, GLP-1s are not the last medication to dramatically impact care delivery, and anticipating the impacts of new classes of specialty pharmaceuticals will require a savvy pharmacy strategy in the years ahead.

How can you prepare for the next GLP-1 — and reap the financial, clinical and operational rewards?

Your top three action items:

  • Expand access to E&M visits in outpatient settings to support consistent GLP-1 therapy management across multiple clinical areas such as primary care, endocrinology, cardiology, nephrology and hepatology. The forecast projects a 26% growth in E&M visits for type 2 diabetics alone, which illustrates the necessity of managing patients effectively and reducing acute-care demand. Without investment in outpatient care, hospitals won’t see the intended softening of inpatient utilization.
  • Evaluate and establish your pharmacy System of CARE to prepare for new innovations such as bispecifics, biologics and gene therapies. Build comprehensive administrative teams including finance, legal and regulatory experts, clinical leaders and patient representatives to ensure consistent access.
  • Build programs around managing patient conditions holistically, not just clinical service delivery, to differentiate and support a complex patient population.

Can one drug change the hospital industry? GLP-1s seem poised to significantly advance decades of population health management.

Note: Analysis excludes 0-17 age group. Eco & consum = economy and consumerism; innov & tech = innovation and technology; pop = population; SoC = System of CARE. Sources: Impact of Change®, 2025; Proprietary Sg2 All-Payer Claims Data Set, 2023; The following 2023 CMS Limited Data Sets (LDS): Carrier, Denominator, Home Health Agency, Hospice, Outpatient, Skilled Nursing Facility; Claritas Pop-Facts®, 2025; Sg2 Analysis, 2025.

The forecast: Adult outpatient (OP) care is on a steep upward trajectory, with volumes projected to grow by 18% through 2035.

Why it matters: The customer — the patient — is king. While OP growth is partly due to technological and procedural advances, it largely reflects patient expectations for convenient care outside the hospital, as well as better affordability. This means health systems must expand outpatient capacity and develop scalable, team-based care models that extend access and continuity, especially for medically complex populations. Also important to note: Outpatient surgical volumes are projected to grow 20% over the next 10 years as procedures increasingly shift from hospital outpatient departments to ambulatory surgery centers (ASCs) and physician offices.

Are you ready?

Your top three action items:

  • Implement or scale telehealth, virtual nursing and remote monitoring programs to support continuous care delivery — especially for high-risk populations like seniors and chronic disease patients.
  • Strengthen handoffs and coordination between inpatient, outpatient and post-acute settings using technology, partnerships and care navigation tools.
  • Harness minimally invasive surgery (MIS) as an innovation driver in healthcare delivery transformation. MIS can reduce acuity, enhance recovery and shift care to lower-cost outpatient settings (which also frees up inpatient ORs for emergency cases).

Learn more about developing the right ASC strategy for your organization in our ASC Insights Report.

Note: ED forecast defined as urgent and emergent visits. Analysis excludes 0-17 age group. Sources: Impact of Change®, 2025; Proprietary Sg2 All-Payer Claims Data Set, 2023; The following 2023 CMS Limited Data Sets (LDS): Carrier, Denominator, Home Health Agency, Hospice, Outpatient, Skilled Nursing Facility; Claritas Pop-Facts®, 2025; Sg2 Analysis, 2025.

The forecast: Emergency Department (ED) volumes are projected to grow 5% over the decade, driven by care access barriers and rising clinical acuity.

Why it matters: The ED is a significant pain point for hospitals, which now face a “dual bottleneck”: Critically ill patients wait too long for inpatient beds, while low-acuity patients who often lack access to primary or urgent care flood the ED for conditions that could be addressed elsewhere. According to the Centers for Disease Control, Americans made approximately 139.8 million visits to the ED in 2024 — equating to 42.7 visits per 100 people. That volume trajectory is clearly unsustainable.

So, how do you stem the flow?

Your top three action items:

  • To curb the acute-care demand for behavioral health services, invest in initiatives such as Partial Hospitalization Programs, Intensive Outpatient Programs, behavioral health urgent care, EmPATH units and dedicated behavioral EDs.
  • Use technology — including AI and predictive analytics — to forecast ED surges, align staffing and physical space to meet demand, fast-track low-acuity patients (ESI levels 4–5), reduce door-to-doc time and improve decision-making via tools like point-of-care testing.
  • Start discharge planning at admission by engaging caregivers early to align expectations and prepare for post-discharge care; using multidisciplinary rounds to track daily progress and discharge readiness; and structuring discharge workflows so they’re proactive, not reactive.

From AI-driven predictive analytics to dynamic triage and parallel processing, check out four proven strategies to reduce ED overcrowding.

Note: Analysis excludes 0-17 age group. 0% indicates the forecast is flat (less than ±1%). Home Health is defined as procedures home nurse visits and home visits other. Sources: Impact of Change®, 2025; Proprietary Sg2 All-Payer Claims Data Set, 2023; The following 2023 CMS Limited Data Sets (LDS): Carrier, Denominator, Home Health Agency, Hospice, Outpatient, Skilled Nursing Facility; Claritas Pop-Facts®, 2025; Sg2 Analysis, 2025.

The forecast: Post-acute care will grow 31%, emerging as a scalable, system-aligned solution to reduce inpatient stays and support aging patients in lower-cost settings.

Why it matters: Health systems should consider how to effectively scale programs and access, including partnership opportunities with other community players. Home care programs must be integrated with broader care redesign efforts and supported by robust operational and reimbursement infrastructures.

How scalable is your home health strategy?

Your top three action items:

  • Improve care handoffs from hospital to post-acute settings through standardized discharge protocols, dedicated care coordinators or transition teams, and real-time data sharing between acute and post-acute providers.
  • Scale care-at-home programs and virtual nursing to extend post-acute services beyond traditional facility-based settings. For instance, one health system collaborates with Geek Squad to deliver and set up remote monitoring devices in patients’ homes, and they also integrate virtual nurses into daily clinical routines. The results: Reduced nurse workloads, decreased readmissions and early cost avoidance.
  • Post-acute care orchestration requires strong ecosystem coordination. Establish or deepen relationships with high-performing post-acute providers and align on shared quality metrics, technology platforms, capacity planning and patient flow optimization.

Learn about tactics for transitioning high-risk patients that can improve capacity and create cost savings.

Sg2 Impact of Change® Forecast methodology

The Sg2 Impact of Change® Forecast marries data science and deep subject matter expertise. Based on tens of thousands of hours of analysis by 30 Vizient SMEs, the forecast projects healthcare demand across service lines and sites of care for over 27,000 unique disease and procedure combinations and analyzes six core impact factors that influence future demand. Here is a summary of each factor and its implications:

  1. Population: Evaluates how changes in population size and demographics (e.g., age and gender) affect healthcare service use, based on demographic forecasts.
    Key forecast story: Growth in the 65+ population is projected, driving demand across service lines and sites of care, including inpatient, ED and E&M services.
  2. Epidemiology: Assesses how changes in disease prevalence, health behaviors, environmental exposures, and social determinants influence healthcare utilization.
    Key forecast story: Rising mental health and chronic conditions are driving increased demand for related services.
  3. Economy and consumerism: Captures the influence of both macroeconomic trends and individual consumer behaviors on healthcare demand and utilization, including care deferral and price sensitivity.
    Key forecast story: Coverage loss and rising costs increase care deferral, especially in behavioral health, pain and chronic care.
  4. Policy: Focuses on the impact of federal health policies and insurance coverage shifts, including payment models and benefit designs, on service utilization patterns.
    Key forecast story: CMS models and payor pressures influence care demand and site of care shifts.
  5. Innovation and technology: Considers the influence of new medical technologies and digital tools on the site of care, treatment models and healthcare delivery.
    Key forecast story: AI, pharmaceutical innovation, and minimally invasive technology are shifting care delivery and enabling proactive management.
  6. Systems of CARE: Reflects how integrated care models and operational efficiencies — such as better coordination and site-of-care transitions — alter utilization and improve outcomes.
    Key forecast story: Focus is shifting to continuous, patient-centered care across inpatient, post-acute and virtual settings.
Access the Sg2 2025 Impact of Change® Forecast and listen to a Sg2 Perspectives podcast episode where Tori Richie and Danni Park unpack the major themes that shaped this year’s forecast spanning population shifts, policy uncertainties, breakthrough innovations and evolving care models.
Author
RichieVictoria.jpg (Original)
Vizient Senior Consulting Director, Intelligence
As a senior director on the Sg2 Intelligence team, Tori Richie leads Sg2’s proprietary Impact of Change® forecasting product, which projects 10-year patient demand across inpatient and outpatient services. She focuses her research on macro-level trends impacting future health care utilization trends and works closely with Sg2’s team of service... Learn more