Vizient's 2026 Forecast: Outpatient Care Demand Is About to Grow 20%, and Employer Mental Health Networks Aren't Ready

Vizient’s 2026 Impact of Change forecast, built with the healthcare analytics firm Sg2, projects that outpatient care volume across the U.S. health system will grow 20% over the next decade, compared with 7% growth in inpatient discharges (BioSpace, June 30, 2026). Buried inside that same forecast is a sharper number for behavioral health specifically: pediatric behavioral health volumes are projected to climb 19% over the same ten years, nearly three times the 6% growth forecast for pediatric outpatient care overall (HFMA, June 30, 2026).

That forecast didn’t come from an advocacy group or a mental health nonprofit. It came from the analytics firm hospitals pay to plan capacity, the kind of report that decides where health systems build clinics for the next ten years. Employer benefits teams building 2026 plan designs are, in most cases, still working off last decade’s utilization numbers.

Quick answer: Vizient’s 2026 forecast projects outpatient care volume growing 20% over the next decade, with pediatric behavioral health volume specifically projected to grow 19%, a demand curve most employer mental health networks were never sized to absorb. The risk isn’t that employees will suddenly want more care. It’s that the network built to hold them was sized for a market that’s already changing shape.

What Vizient’s 2026 Outpatient Care Forecast Actually Projects

Vizient’s 2026 Impact of Change report projects outpatient care volume will grow 20% system-wide over the next ten years, while inpatient discharges grow just 7% (BioSpace, June 30, 2026). Care is moving out of hospital beds and into outpatient settings faster than the population is growing, and behavioral health is a named part of that shift.

Vizient produces this forecast annually with Sg2 for hospital and health system clients, the same clients who use it to decide where to build outpatient clinics or add behavioral health capacity over the coming decade. This is a capacity-planning document, not a wellness trend piece. It’s the kind of number hospital finance committees build ten-year budgets around, and it deserves the same weight from anyone building a benefits plan.

Why Is Pediatric Behavioral Health the Sharpest Number in the Report?

Pediatric behavioral health volumes are projected to grow 19% over the next decade, nearly triple the 6% growth forecast for pediatric outpatient care overall (HFMA, June 30, 2026). That gap between the behavioral health line and the general outpatient line is the real signal here.

We keep hearing “more care is moving outpatient” treated as one undifferentiated trend. It isn’t. Behavioral health volume is outpacing general outpatient growth by more than three to one in the pediatric population Vizient measured, which means whatever’s driving the overall shift, behavioral health is driving harder.

Most employer plans size behavioral health networks as a subset of general medical networks, using historical claims to set the roster. A forecast showing behavioral health volume outpacing general outpatient growth this sharply is a signal that historical sizing will undercount the next decade, not just miss this year’s open enrollment by a rounding error.

Employers Are Already Bracing for Higher 2026 Health Benefit Costs

Mercer’s 2026 National Survey of Employer-Sponsored Health Plans, covering more than 1,700 employers, found total health benefit cost per employee is projected to rise 6.5% in 2026, the highest increase since 2010 (Mercer, Sept. 2025). Without the cost-management changes employers are already making, that number would have hit 9%.

Employers are treating that as a pricing problem: higher premiums, tighter formularies, more cost-sharing passed to employees. What the Vizient forecast adds is a volume problem sitting underneath the pricing problem. A network priced for today’s utilization still has to absorb a decade of outpatient behavioral health growth arriving on top of it. Cost management that doesn’t account for rising volume is a plan for this year, not the next ten.

Is the Behavioral Health Workforce Growing Fast Enough to Match Rising Demand?

The clinicians who’d staff growing outpatient behavioral health demand are already short today, and federal projections say that gap widens, not closes, by 2038. HRSA’s 2025 workforce brief projects baseline national shortages of roughly 99,840 psychologists, 99,780 mental health counselors, 77,050 addiction counselors, and 36,780 adult psychiatrists by then (HRSA, 2025).

That’s the baseline scenario, not the worst one. HRSA’s elevated-need projection, which accounts for rising diagnosed need instead of holding it flat, pushes the psychiatrist shortfall alone to 86,430. Vizient’s forecast says demand for outpatient behavioral health is climbing. HRSA’s forecast says the workforce meant to meet it is shrinking relative to need over that same stretch. A benefits network is only as wide as the clinicians willing to take the plan, and that supply line was already strained before this decade’s demand curve showed up.

Why Doesn’t Offering an EAP Guarantee Mental Health Network Capacity?

Eighty-two percent of U.S. employers already offer an Employee Assistance Program (SHRM, 2024), but typical annual utilization sits at just 3.5% of eligible employees (SHRM). Low utilization today gets read as proof the benefit has room to spare. That’s a different question from whether the underlying network could actually absorb it if utilization moved.

This is a capacity question, not a design or awareness question, and it’s worth being precise about that difference. A network that looks adequate at 3.5% utilization can look very different at double or triple that rate, and Vizient’s forecast is a ten-year signal that utilization across outpatient behavioral health is headed up, not a claim that any single employer’s usage spikes overnight.

An EAP roster built once and left alone doesn’t expand on its own just because the benefit exists on paper. Capacity has to be planned for the population it will eventually serve, not just the smaller share calling this quarter.

What Should Employers Do Before This Demand Curve Gets Steeper?

None of this requires a crystal ball, just a willingness to treat behavioral health network adequacy as a capacity-planning exercise instead of a line item renewed on autopilot every open enrollment.

That starts with auditing the actual in-network roster for real appointment availability, not the names printed on a directory PDF. It means asking vendors how their clinician network is projected to grow against a demand curve like Vizient’s, not just this year’s claims data. And it means building in flexible, tech-enabled access points, like the AI-assisted intake and clinical support Mental Wealth Solutions builds into VibeCheck, that let a fixed number of clinicians serve more people well instead of assuming the roster will simply get bigger on its own.

The employers who treat this decade’s forecast as someone else’s problem will spend 2030 explaining to their workforce why the benefit they bought has no room left for them. The ones who start sizing for it now will just have a network that works.

FAQ

What does Vizient’s 2026 forecast say about outpatient mental health demand? Vizient’s 2026 Impact of Change forecast, built with Sg2, projects system-wide outpatient care volume will grow 20% over the next decade versus 7% inpatient growth, and that pediatric behavioral health volumes specifically will grow 19%, nearly triple the 6% rise projected for pediatric outpatient care overall (BusinessWire and HFMA, June 30, 2026).

Is this forecast about the psychiatrist shortage? No. This forecast is about outpatient care volume and network capacity, a different data source and question from workforce-supply projections. The workforce side is real too, HRSA projects a baseline shortfall of roughly 36,780 adult psychiatrists nationally by 2038, but that’s a separate dataset from Vizient’s volume forecast.

Why are employer health costs rising in 2026? Mercer’s 2026 survey of more than 1,700 employers found total health benefit cost per employee is projected to rise 6.5% in 2026, the highest increase since 2010, and would have been 9% without cost-management changes employers are already making. Vizient’s forecast suggests a volume increase sits underneath that cost increase.

If EAP utilization is only 3.5 percent, why does network capacity matter? Because low utilization today doesn’t prove a network has room to spare tomorrow. SHRM cites a 3.5% median EAP utilization rate, even though 82% of employers offer one, and a roster sized for that usage level can fall short fast if outpatient behavioral health demand grows the way Vizient projects.

What should employers actually do about this forecast? Treat behavioral health network adequacy as a capacity-planning exercise: audit real appointment availability rather than directory listings, ask vendors how their clinician network is projected to grow, and build in flexible, tech-enabled access points that let existing clinicians serve more people well.

Sources

1. Vizient, “Vizient Forecasts 20% Growth in Outpatient Care, 7% in Inpatient Care,” BioSpace (mirroring BusinessWire), June 30, 2026. https://www.biospace.com/press-releases/vizient-forecasts-20-growth-in-outpatient-care-7-in-inpatient-care
2. HFMA, “Vizient: Healthcare utilization shifts will reshape care delivery over the next decade,” June 30, 2026. https://www.hfma.org/fast-finance/vizient-healthcare-utilization-shifts-will-reshape-care-delivery-over-the-next-decade/
3. Mercer, “Employers are bracing for the highest health benefit cost increase in 15 years,” Sept. 4, 2025. https://www.mercer.com/en-us/about/newsroom/employers-are-bracing-for-the-highest-health-benefit-cost-increase-in-15-years/
4. HRSA, “State of the Behavioral Health Workforce, 2025.” https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/data-research/Behavioral-Health-Workforce-Brief-2025.pdf
5. SHRM, “Managing Employee Assistance Programs (EAPs),” 2024. https://www.shrm.org/topics-tools/tools/toolkits/managing-employee-assistance-programs-eaps
6. SHRM, “Solving the EAP Under-Use Puzzle.” https://www.shrm.org/topics-tools/news/benefits-compensation/solving-eap-use-puzzle

Disclaimer

This article is for educational and informational purposes only. It does not constitute medical, clinical, legal, or therapeutic advice, and reading it does not create a therapist-client relationship with Matthew Sexton, LCSW or Mental Wealth Solutions, Inc. Although the author is a licensed clinical social worker, the content in this article is not clinical assessment, diagnosis, or treatment.

Industry forecasts, employer health benefit costs, workforce shortage projections, and EAP utilization figures cited here reflect the sources and dates noted above and may change as new data is published. Nothing here is a substitute for confirming plan design, network adequacy, or benefits costs with your own broker, plan administrator, or qualified counsel. Every employer’s population, plan structure, and region differ, and what is described here may not match your organization’s situation.

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