In 2026, U.S. health systems are expected to keep moving away from a heavy reliance on traditional inpatient hospital care and instead focus on new growth opportunities across outpatient and non-acute settings. For healthcare organizations looking to hire international nurses, these changes are more than just market trends they directly impact workforce planning, staffing needs, and long-term immigration strategies.
At VisaMadeEZ, an immigration law firm that specializes in helping healthcare organizations hire international nurses, we closely monitor these shifts so our clients can align their recruitment and visa strategies with the evolving healthcare landscape.
Health Systems Are Looking Beyond the Hospital Bed
Industry analysis released in January 2026 indicates that health systems will continue to “look beyond traditional inpatient services for new growth opportunities.” Rather than expanding only through large acute-care hospitals, many organizations are now:
- Investing in non-acute services
- Forming capability-based partnerships
- Building outpatient and ambulatory care networks
This ongoing transition means growing demand for nursing staff across a wider range of care settings including ambulatory surgery centers, diagnostic laboratories, home health, and specialty clinics. For international nurses and the health systems that sponsor them, this opens new pathways and new roles beyond the traditional hospital floor.
Non-Acute and Capability-Based Partnerships Are on the Rise
Health systems are increasingly pursuing partnerships that extend their capabilities and geographic reach without necessarily building or buying full-service hospitals. Two recent examples highlight this direction:
1. Ascension and AmSurg (Ambulatory Surgery Centers)
- St. Louis–based Ascension announced in June 2025 that it had entered into an agreement to acquire ambulatory surgery center (ASC) operator AmSurg.
- AmSurg operates more than 250 facilities across 34 states, significantly expanding access points for outpatient surgical and procedural care.
- For workforce planning, this kind of expansion means greater demand for perioperative nurses, endoscopy nurses, and other specialized outpatient nursing roles many of which can be filled by internationally trained nurses through strategic immigration planning.
2. Corewell Health and Quest – Diagnostic Lab of Michigan
- Grand Rapids, Michigan–based Corewell Health announced a laboratory joint venture with Quest Diagnostics in September 2025, which was finalized in January 2026.
- The partnership created Diagnostic Lab of Michigan, a capability-based collaboration that centralizes and enhances lab services.
- As health systems deepen their lab and diagnostic capabilities, they often require nurses and allied professionals with experience in phlebotomy, specimen collection, outpatient diagnostics, and care coordination.
These collaborations underscore a broader trend: health systems are building networks of services that extend well beyond the hospital. For international nurse recruitment, that means a wider array of potential job placements and visa sponsorship opportunities in non-acute settings.
Divestitures: Scale Alone Is No Longer Enough
Another key trend for 2026 is the continued divestiture of non-core assets by large and national health systems, particularly:
- For-profit hospital operators
- Catholic and faith-based systems
According to the analysis, these organizations increasingly recognize that simply being large is no longer a sufficient growth or margin strategy, especially when they lack strong market or regional scale. As a result, they’re focusing on:
- Core markets and service lines
- Strategic partnerships instead of owning everything outright
- Reducing or exiting operations in non-core regions
In 2025, 45.6% of healthcare transactions involved a divestiture, a significant share of deals. Notably:
- For-profit systems were the seller in 11 deals
- They were the acquirer in only one
This pattern signals mounting financial pressure on certain hospitals and illustrates that many for‑profit entities are shifting investments into other healthcare subsectors or, in some cases, leaving hospital operations altogether.
For healthcare organizations and their HR teams, this has direct implications for staffing and immigration strategy:
- Facilities in financially weaker markets may face instability, mergers, or ownership changes.
- Organizations may need to adjust where and how they sponsor international nurses.
- VisaMadeEZ often advises clients to factor potential divestiture or restructuring risk into long‑term immigration planning, especially for multi-year sponsorships.
Financial Distress and Transaction Trends: Impact on Workforce Planning
The report also predicts that a high percentage of healthcare transactions will continue to involve financially distressed organizations. This reflects the ongoing financial challenges facing hospitals across the country from rising labor costs to reimbursement pressures.
For international nurse recruitment, this environment requires careful planning:
- Employers must ensure they can maintain sponsorship obligations even during mergers or restructuring.
- International nurses need clarity around job security, location, and long‑term immigration pathways.
- Legal support becomes critical when ownership changes affect corporate entities, worksite locations, or employment terms all of which can impact immigration filings.
VisaMadeEZ regularly works with healthcare organizations undergoing M&A activity, helping them navigate how transactions interact with visa categories such as the EB-3 immigrant visa for nurses, H-1B (where applicable), and other employment-based immigration options.
Policy Uncertainty: ACA Subsidies and the One Big Beautiful Bill Act
Strategic planning and capital decisions in 2026 are also being shaped by policy uncertainty, particularly around:
1. Extension of Enhanced ACA Subsidies
- Enhanced subsidies under the Affordable Care Act expired at the end of 2025.
- Uncertainty over whether these enhanced subsidies will be fully extended or modified is influencing how systems plan for future revenue, patient mix, and payer coverage.
2. Anticipated Effects of the One Big Beautiful Bill Act (Starting 2027)
- The expected implementation of the One Big Beautiful Bill Act in 2027 is causing hospitals and health systems to be cautious in deploying capital and committing to long‑term investments.
- Many organizations are reassessing service lines, facility expansions, and workforce strategies in light of these upcoming changes.
When health systems are more cautious with capital, they often:
- Delay new builds but expand capacity in existing sites
- Rely more heavily on flexible staffing models
- Turn to predictable and reliable recruitment pipelines such as international nursing to stabilize their workforce
As an immigration law firm focused on healthcare, VisaMadeEZ helps organizations build multi-year international nurse pipelines that align with these financial and regulatory realities.
States May Take a More Flexible Approach to Healthcare Transactions
There are signs that some states may adopt a more conciliatory or flexible stance toward healthcare transactions, particularly in situations where hospital closures are a real risk due to financial distress.
This potential shift could mean:
- Faster approvals of mergers or acquisitions intended to keep essential hospitals open
- More support for partnerships that preserve access to care in rural or underserved communities
- Greater emphasis on stabilizing local healthcare systems instead of allowing closures
From a staffing and immigration standpoint, keeping hospitals open even under new ownership can protect jobs and maintain visa sponsorship opportunities for international nurses. However, these transactions can also trigger complex legal and regulatory questions, making it crucial to have experienced immigration counsel involved early in the process.
What This Means for International Nurse Recruitment in 2026
For healthcare organizations:
- Demand for nurses is shifting, not shrinking. As services move further into non-acute and outpatient care, there will be growing need for nurses in ambulatory surgery centers, diagnostic centers, and community-based settings.
- Strategic partnerships and divestitures require careful immigration planning. Ownership changes, restructurings, and service-line shifts can all affect visa petitions, prevailing wages, and worksite compliance.
- Policy uncertainty makes long-term planning harder but not impossible. With the right legal guidance, organizations can still build stable, long-term international recruitment programs that support both inpatient and non-acute growth.
For international nurses and foreign-trained healthcare professionals:
- Opportunities are expanding beyond traditional hospital roles, including outpatient surgery, diagnostics, chronic care management, and integrated care networks.
- Choosing an employer with a clear, stable strategy and experienced immigration counsel is more important than ever.
How VisaMadeEZ Supports Healthcare Organizations in This Environment
VisaMadeEZ is an immigration law firm dedicated to helping healthcare organizations hire and retain international nurses. In light of the current trends in 2026, we:
- Advise health systems on building sustainable international nurse recruitment programs aligned with their growth strategies in inpatient and non-acute care.
- Provide end-to-end immigration support, including EB-3 immigrant visas for nurses, consular processing, adjustment of status, and related employment-based immigration solutions.
- Help organizations undergoing mergers, acquisitions, or divestitures understand and manage the impact on existing and future international nurse sponsorships.
- Coordinate closely with HR, legal, and executive teams to ensure that immigration strategies support broader operational and financial goals.
If your health system is expanding ambulatory services, forming new partnerships, or navigating financial and regulatory uncertainty while still facing critical staffing shortages, international nurse recruitment can be a powerful, long-term solution.
To discuss how these 2026 market trends intersect with your recruitment goals and how to structure a compliant, efficient international nurse hiring program contact VisaMadeEZ for a consultation.
