The Future of Tech Enabled Care in 2026: What It Means for Medicaid, HIEs, and Rural Health Transformation

The future of tech enabled care has never felt more real than it does heading into 2026. We are standing at a moment where statewide interoperability, Medicaid modernization, AI acceleration, and community level transformation are converging to reshape how data supports the people who need it most. The national focus on Rural Health Transformation (RHT) reinforces that progress will not be measured only by new tools, but by whether those tools work for the front lines.

As ASTP brings together federal leaders, innovators, and policy strategists to talk about the next wave of health care technology, it is clear that the opportunity ahead is not simply about digital tools. It is about building systems that can support resilient, sustainable models of care in both urban and rural communities. The conversations happening at ASTP about data liquidity, TEFCA readiness, AI in clinical workflows, and the nation’s interoperability strategy are directly tied to whether states and communities can deliver whole person care at scale.

1. Tech Enabled Care Will Rise or Fall on Interoperability

There is growing recognition that the most impressive innovation in the world cannot perform well if the underlying data is fragmented. A study from the National Academy of Medicine highlights that lack of interoperability remains a primary barrier to care coordination and clinical decision support within Medicaid and safety net settings.

For rural communities, this challenge is amplified. RHT initiatives across the country are working to improve access to primary care, behavioral health services, and community based supports. None of that succeeds without reliable, timely clinical and social data exchange. When a rural emergency department, EMS crew, behavioral health provider, and critical access hospital are all working from different versions of the truth, transformation becomes an aspiration rather than a reality.

The connection between tech enabled care and interoperability is no longer theoretical. It is foundational.

2. AI Will Speed Up Decisions, but Only High Quality Data Makes Them Useful

AI is moving quickly into the clinical space, and ASTP is giving it plenty of airtime. The promise is real. AI can support triage, reduce administrative burden, strengthen care pathways, and help clinicians spot patterns that would normally hide in plain sight. The catch is that none of this works without complete, reliable, high quality data.

Research continues to show that AI systems can misfire when the underlying data is incomplete or unrepresentative. A recent review highlights how gaps and bias in clinical data influence AI accuracy and can increase risks in real-world decision-making.

Additional analysis shows that even FDA cleared AI tools often lack transparency in performance reporting when datasets are inconsistent or incomplete. That creates a challenge for clinicians who rely on clear inputs to understand what an algorithm is doing and when it may fail.

For rural providers, these risks are not theoretical. A single missing data point can change the entire picture in a small clinic or critical access hospital. Rural Health Transformation programs are creating a testing ground for responsible AI adoption because they match technology investments with better data infrastructure. When an HIE can deliver clean, cross-sector information to the point of care, AI becomes safer, more reliable, and genuinely useful rather than experimental.

The future of AI will favor communities that fix the data foundation first. Rural communities included.

3. The Rise of Whole Person Data Will Reshape Medicaid and Community Care

Tech enabled care in 2026 is no longer defined by a single platform or shiny digital tool. The real progress comes from connecting clinical information, behavioral health histories, social care data, EMS records, community referrals, and care coordination notes into one coherent picture. This is the ecosystem Medicaid programs and community partners have been trying to build for years, and it is finally within reach.

Federal research illustrates why this matters. HHS ASPE highlights both the potential and the practical challenges behind community-level sharing of social determinants of health information.

National Quality Forum also points to the impact of linking clinical care with community resources. Their recommendations underscore the importance of digital pathways that help teams address social needs more effectively.

And to reinforce where the field is heading, NQF and partner organizations issued a joint statement encouraging broader digital exchange of SDOH assessments as a key step toward usable, interoperable whole person care.

These gains matter everywhere, but they matter most in rural regions where small provider networks often carry the full weight of community health. When a clinician in a frontier clinic can see housing instability, transportation barriers, crisis encounters, and care management notes right alongside clinical data, the quality of decisions changes immediately.

Rural Health Transformation efforts are proving that whole person data is not a luxury limited to large health systems. It is a necessity for communities that need every available insight to support better outcomes. The future of Medicaid and community care will belong to states that invest in interoperability, strengthen governance, and make cross-sector data usable in daily workflows. Rural communities are already showing what is possible when this foundation is in place.

4. Data Liquidity Will Become the New Competitive Advantage for States and HIEs

ASTP is spotlighting data liquidity for a reason. The nation is shifting from static data repositories to real time exchange models that follow the patient and make information available when decisions need to be made.

TEFCA implementation is accelerating this shift. The Sequoia Project notes that increased exchange volume, expanded use cases, and multi directional data flow are expected outcomes as more organizations onboard to QHINs through 2026. This creates both an opportunity and a pressure point for HIEs. Rural health systems often depend on their state HIE as the single reliable integration hub. If the data infrastructure cannot keep pace, rural communities feel the impact first.

Data liquidity is becoming a strategic asset. When data moves smoothly, providers deliver smoother care. For RHT, this isn’t just important. It is essential.

5. The Future Belongs to Systems That Can Scale Across Urban and Rural Realities

Tech enabled care can only be considered successful if it works for both urban hospitals and frontier clinics. RHT programs are proving that innovation does not have to be limited to metropolitan systems. Rural communities are designing creative ways to connect EMS, critical access hospitals, behavioral health providers, food programs, housing supports, and local nonprofits into a unified data ecosystem.

The lessons flowing out of RHT will help shape national strategy. They show that when technology is deployed with purpose, supported by local governance, and connected through strong interoperability infrastructure, even the smallest communities can take big leaps.

As ASTP explores the national roadmap for tech enabled care, the real story is not about new platforms or compliance milestones. It is about whether we can build systems that work for every community regardless of geography. Rural communities are not a footnote in this transformation. They are the proving ground.