What‘s the Deal With Utilization? Mostly Stable But Mix Matters...

Research evidence excerpt

What‘s the Deal With Utilization? Mostly Stable But Mix Matters...

USA | Medical Supplies & Devices EquityJulyResearch21, 2026

What's the Deal With Utilization? Mostly Stable

But Mix Matters...

Following HCA's pre including weaker surgeries and payor mix headwinds,

investors have debated whether utilizaiton is slowing in MedTech (MT). JNJ's

2Q print was solid and it noted no ACA impact, expecting MT growth to

accelerate in 2H26. ABT also brushed off utilizaiton fears, citing strong and

stable trends, but ISRG did note some tempering of US procedure growth, which

they, in part, attributed to ACA-related deferrals (e.g. in hernia).

In our view, medtech utilization should remain mostly stable and unimpacted by changes to ACA/

Medicaid coverage, though we could see some deferrals on the margin. Overall, MT is geared

to Medicare age patients/coverage and includes mostly necessary, high-acuity procedures that

cannot be deferred, or if they can, not for too long. JNJ and ABT's quarters were strong proof

points supporting this view, somewhat offset by comments from ISRG.

Recall ISRG's DV procedure growth slowed in the US to ~12% vs. 14% in 1Q and 15% last year

due to deferrals and law of large #s. ISRG noted moderation in growth vs. recent trends and

expectations at the start of the year, mostly in procedures that can be deferred. Its customers

cited changes in coverage and premiums potentially impacting when patients seek care. ISRG

believes these patients will ultimately progress to treatment.

Speaking with ISRG, inguinal hernia and chole (gallbladder) are two benign procedures, a subset

of which could be deferred. So we asked ourselves is 'how long can you defer a hernia or gallbladder