The Healthcare Trilemma: How Agencies Are Balancing Cost, Quality & Access
- Agencies need to balance healthcare cost, quality and access amid already strained budgets
- Leaders are adopting various strategies to improve access and quality without driving up costs
- Join the 2026 Healthcare Summit’s panel on ‘the healthcare trilemma’ to hear how federal health leaders are balancing cost, quality and access
The federal health system faces a dilemma: how can agencies improve quality and access to care without causing skyrocketing costs? Agencies are increasingly caught between competing priorities, as rising operational expenses, evolving patient demands and outdated legacy infrastructure strain already limited funding. To address the challenge, federal health leaders are adopting new strategies to deliver sustainable, high-quality care.
The Potomac Officers Club’s 2026 Healthcare Summit on Dec. 3 is facilitating dialogue between government and industry on the challenges of balancing cost, quality and access. The event will host the Navigating the Healthcare Trilemma: Cost, Quality and Access to Care panel featuring Tim Borchert of Tria Federal, Dr. Gil Alterovitz of the Department of Health and Human Services’ Agency for Healthcare Research and Quality and other experts. Register here to join the conversation.
How Are Federal Health Agencies Navigating the Healthcare Trilemma?
1. Applying AI to Prevent Fraud
Federal health agencies have deployed artificial intelligence tools to safeguard public resources.
The Centers for Medicare & Medicaid Services has shifted its approach to curbing fraud, replacing the “pay and chase” strategy with the “caught and stopped” model, and AI is playing a part in the effort. The agency is testing the use of AI to analyze existing information and flag potentially high-risk applicants for closer monitoring without preventing them from entering CMS programs.
Kimberly Brandt, deputy administrator and chief operating officer at CMS, shared at an event in February that the pilot has already led to $2 billion in savings within less than a year of implementation, Nextgov/FCW reported.
“Within the first year [of using AI], to be able to get rid of 90 percent of some of these potentially bad actors, it’s a huge thing for us,” she stated.
The official added that CMS will expand the program’s implementation, which she said will generate more savings.
Brandt is expected to provide updates and future plans for CMS’ AI pilot during her keynote at the 2026 Healthcare Summit on Dec. 3. The health regulatory and policy expert may also talk about modernization efforts and industry partnerships as CMS requests a $1.48 trillion budget for fiscal 2027. Click here to secure your tickets!
2. Giving Clinicians AI Tools to Improve Care
Agencies are also utilizing AI to automate routine tasks, streamline clinical workflows and reduce cognitive strain on clinical staff.
At the Department of Veterans Affairs, healthcare providers are using Ambient Scribe, an AI-enabled tool that captures patient-provider interactions and generates notes in real time. The tool is intended to alleviate administrative burden by automating documentation, freeing providers to focus on delivering quality care during patient consultations.
Providers who are using the technology report that Ambient Scribe creates clear and comprehensive medical documentation, reduces after-hours charting, and improves coding and risk adjustment accuracy.
The VA noted that AI-generated documents are still reviewed and edited by clinicians before being uploaded to an electronic health record, or EHR.
3. Modernizing Health IT
Modernization continues to be a priority across federal health agencies to improve healthcare delivery and patient outcomes.
The VA is accelerating the rollout of the federal EHR and has reached its goal of deploying the systems at 13 hospitals in 2026. According to VA Deputy Secretary Paul Lawrence, the agency aims to implement its new federal EHR system at 26 medical facilities in 2027, with a target to complete rollout by 2031.
Meanwhile, CMS created the Office of Health Technology and Products in June to oversee the development of digital health tools, the implementation of AI and sharing of health data, Healthcare Drive reported.
4. Investing in Health Infrastructure
The government is making investments to improve access to quality care, especially in rural and underserved areas.
In December 2025, CMS announced that all 50 states will receive funding under the $50 billion Rural Health Transformation Program. Established under the Working Families Tax Cuts legislation, the program is intended to help states modernize rural facilities, strengthen the clinical workforce, promote innovative care models and bring health services within reach across the nation.
“More than 60 million Americans living in rural areas have the right to equal access to quality care,” stated HHS Secretary Robert F. Kennedy Jr. “This historic investment puts local hospitals, clinics and health workers in control of their communities’ healthcare.”
CMS said that states will receive an initial funding ranging from $147 million to $281 million in 2026. The program will provide $10 billion annually through 2030.
5. Changing Acquisition Strategies
In alignment with executive mandates, health agencies are making strategic shifts in how they procure goods and services.
HHS, for instance, has moved 5,000 contracts into a new shared-services organization, consolidating common purchases such as IT licenses and administrative support. The initiative, called the Procurement Alignment and Collaboration Task Force, or PACT, is intended to cut costs. The department said PACT builds on efforts that generated more than $16 billion in acquisition savings in 2025.
Who Are the Speakers on the Navigating the Healthcare Trilemma Panel?
Dr. Gil Alterovitz
Chief AI Officer, Chief Data Officer
Agency for Healthcare Research and Quality
Alterovitz has served as inaugural CAIO at three agencies: the National Institutes of Health, the VA and, currently, the AHRQ.
At AHRQ, where he also holds the role of CDO, he is overseeing efforts to develop AI for evidence, data and implementation, with the goal of improving patient health outcomes.
AHRQ recently launched the Super Intelligence for Healthcare Improvement Initiative, a $5.85 million challenge seeking to transform clinical evidence synthesis through advanced technologies. Submissions for Phase 1 of the challenge begin on Jan. 11.
Before joining AHRQ, he spent more than seven years at the VA. As the department’s inaugural CAIO, he spearheaded the development of its Trustworthy AI Framework. He also founded and led the agency’s National Artificial Intelligence Institute in 2019.
At the NIH, where he served as CAIO in 2025, he proposed a unified AI program and strategy, according to his LinkedIn.
Alterovitz is also an associate professor at Harvard Medical School and president of the Presidential Innovations Fellows Foundation.
Tim Borchert
CEO
Borchert is a healthcare executive with more than 25 years of industry experience. He has served as CEO of Tria Federal since 2023, leading the company’s expansion strategies. In September, under his leadership, Tria Federal secured a $120 million task order from the VA to support VHA’s community care operations.
He also served as chief executive of Federal Advisory Partners from 2017 until the firm, after acquiring Favor TechConsulting and Universal Consulting Services, rebranded as Tria Federal in 2023.
Prior to Federal Advisory Partners, he spent nearly 10 years at the nonprofit organization Altarum Institute.
The Navigating the Healthcare Trilemma: Cost, Quality and Access to Care panel at the 2026 Healthcare Summit on Dec. 3 will provide an opportunity for government and industry to communicate operational challenges that health agencies are facing and identify strategies and technologies that can improve the delivery of care to the public. Tickets are available here!
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