Global health outcomes are improving by several important measures. According to the World Health Organization, about 1.75 billion more people were healthier at the end of 2025 than they were in 2018, thanks to reduced tobacco use, improved air quality, and better access to clean water and sanitation.
But this overall progress obscures a growing problem: A widening K-shaped gap when it comes to healthcare access and outcomes.
While the tide is rising for all, wealthier people are enjoying more of the benefits. Higher-income populations are gaining access to preventive care, health technology and personalized services, while lower-income populations face mounting barriers to affordability and consistent treatment, according to a report by the Oliver Wyman Forum that surveyed nearly 300,000 people globally over the past five years.
The percentage of people in high-income households who reported regularly seeing a doctor rose to 65% in 2025 from 59% in 2022. Among lower-income households, that figure remained flat at 55%. Similar gaps emerged in access to digital health tools and regular exercise.
At a time when populations are aging, the burden of chronic disease is increasing, and providers face mounting financial pressure, governments are being forced to make up for these widening gaps in health outcomes.
Although delivery and payment systems differ by country, providers everywhere can offer better, more cost-effective care by tailoring their services to the markets they want to serve, investing in affordable preventative care and deploying innovative tools, including artificial intelligence.
Why better healthcare starts by understanding every patient
Many providers, payers and policymakers still build strategies around the “average” patient. That’s the wrong approach in today’s environment.
Instead, providers need to tailor services for different patient groups. For higher-income populations, that may include precision medicine, proactive health management and high-touch longevity services. For lower-income populations, success depends on scalable, lower-cost models that expand access to primary and preventive care. Simple interventions can have a significant impact. For instance, a text messaging program deployed in low- and middle-income countries boosted prenatal care for pregnant mothers by 174%, according to a study in the journal Reproductive Health.
At the same time, policymakers should accelerate efforts to pay for outcomes instead of volume. Efforts to scale value-based care vary by region, but better alignment between primary care providers, specialists, patients and payers has the potential to reduce costs and improve health outcomes.
In the United States, for instance, low-income Medicare beneficiaries enrolled in value-based care programs experienced roughly a 24% drop in both hospital admissions and avoidable emergency room visits compared with those in traditional Medicare. And in India, value-based care models at a network of 24 hospitals helped reduce the cost of cardiac surgery to less than $2,000 per procedure, roughly one-third the cost at many comparable hospitals.
Success should be measured by the ability to reduce the practical barriers consumers face when accessing care and lowering costs, not by the ability to maximize volume or pretending the health and wealth gap does not exist.
Expand preventive care with smarter diagnostics and technology
Health systems should also bolster preventive strategies to serve patients at both ends of the K-shape market. Investment in early screening and targeted intervention can help address disease before costs escalate and outcomes worsen.
In-vitro diagnostics — tests that can be done at home or in a clinic performed on body samples, like swabs of mucus from the nose or throat — are a prime example. Combined with algorithmic decision support, these can significantly streamline clinical workflows, especially in environments with limited access to advanced imaging. While in-vitro diagnostics are still limited in low- and middle-income countries, digital preventative care strategies can help industry players serve people in these areas where preventable diseases like malaria and tuberculosis account for eight of the top 10 causes of death.
For providers, these technologies can improve operational efficiency. AI-assisted imaging and diagnostics may help clinicians process higher patient volumes, accelerate diagnosis and intervene earlier in disease progression.
Technology alone, however, will not close the healthcare divide. Organizations must combine innovation with delivery models designed around the realities of the populations they serve.
Use AI and human judgment to meet changing patient needs
Consumer expectations around healthcare are changing, regardless of a person’s salary. High-income consumers are becoming increasingly proactive, using digital tools to monitor health, optimize wellness and seek personalized guidance. Lower-income consumers often search for more affordable and accessible ways to navigate healthcare systems and manage everyday health concerns.
Artificial intelligence can help both groups accomplish those goals. More than half of consumers say they use AI for everyday healthcare questions, according to the Oliver Wyman research. And more than a third use it for urgent health needs.
Patients are more informed and digitally engaged but are also searching for trusted guidance and assistance in navigating an increasingly complex healthcare ecosystem. Serving those patients will require new care models that combine scalable digital tools with clear clinical oversight and human judgment.
The healthcare divide will widen further unless systems become more deliberate about whom they are designing for. Acting with urgency now will help organizations better control costs, expand access, and bolster public trust.