From AI to telehealth: 82 healthcare leaders discuss emerging trends

Becker's asked C-suite executives from hospitals and health systems across the U.S. to share the trends they're currently following. 

The 82 executives featured in this article are all speaking at the Becker's Healthcare 12th Annual CEO+CFO Roundtable on Nov. 11-14, 2024, at the Hyatt Regency in Chicago.

To learn more about this event, click here.

If you would like to join as a speaker or a reviewer, contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com. 

For more information on sponsorship opportunities, contact Jessica Cole at jcole@beckershealthcare.com.

As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.

Question: What trends are you following most closely in healthcare right now?

Richard J. Gray, MD. CEO of Mayo Clinic Arizona; Vice President of Mayo Clinic (Rochester, Minn.): The major trend I’m watching continues to be the impact of AI in healthcare. Nearly five years ago, Mayo Clinic created the first-of-its-kind distributed data network with protected and deidentified patient data in a federated system that allows AI solution developers to have the breadth and heterogeneity of data to create models that are valid, safe, and impactful. Mayo Clinic Platform has also developed EHR-agnostic deployment technology for models, allowing all participants in the platform to benefit from its solutions. 

With 46 million patient records from top health systems on four continents, the Platform is the most complete body of federated longitudinal clinical data in the world and is also a co-founder of the Coalition for Health AI to ensure the responsible use of AI in healthcare. Outside of AI, I’m also watching innovations in multi omics, theranostics, and immunoengineering.

David Lubarsky. MD. CEO and Vice Chancellor of Human Health Sciences at UC Davis Health (Sacramento, Calif.): We are watching the Supreme Court’s case about medical misinformation (Murthy v. Missouri), which is the medical equivalent of free speech and shouting ‘fire’ in a crowded theater. The outcome will be interesting for everyone who plays a role in health education. 

We’re also watching how things develop with GLP-1’s and their ability to disrupt future metabolic disease, potentially changing approaches to Type II diabetes and the treatment of its vascular impacts. And, like everyone else, we’re closing watching the escalating costs of care.  

Together with inflation, increasing labor costs, the aging tsunami, the lack of medical providers, and the unsustainable transfer tax that increases commercial prices to cover care provided below cost for government plans, balancing these pressures and finding ways to break even financially becomes more difficult each year.

Madeline Bell. President and CEO of Children’s Hospital of Philadelphia: I’ve been paying particularly close attention to cybersecurity because of the increasing threat of cyberattacks on hospitals and health systems. Labor shortages and labor inflation in healthcare are also top of mind for me. There are many positive trends that I’m excited about, too – including opportunities to use AI and other automation in healthcare and advances in cell and gene therapy, an area that is a major focus for us at CHOP.

Kevin Smith. CFO of SSM Health (St. Louis): We all know that healthcare is a dynamic industry, with new trends and ideas regularly cropping up. At SSM Health, we not only follow but also drive key trends that align with our mission and strategy for sustainability and growth.

Partnerships: SSM Health will continue diversifying its revenue base by creating an ecosystem of care; therefore, we will collaborate with like-minded partners to make healthcare accessible, equitable, and sustainable. More importantly, we partner with healthcare disruptors as collaborators, instead of competitors, and seek opportunistic investments in asset-light growth strategies.

Access: SSM Health continues to focus on providing frictionless access and throughput. We also focus on solutions, especially in the revenue cycle space, that reduce manual processes and provide intelligence into where we have the most opportunity. 

Expansion of AI: We are early in our journey of investigating automation through AI and large-scale analytics. Our goal is to use large structured and unstructured data sets for predictive analytics and better decision-making. This will lead to better automation, ultimately enhancing clinical outcomes and reducing costs.

Leong Koh, MD. President and CEO of Northwest Permanente (Portland, Ore.): At Kaiser Permanente Northwest, our patients are our north star, and our physicians are our foundation. So, a trend that is top-of-mind for me is how to balance the dual challenges of providing patient access to care with the physician and workforce shortages that are compounding post-pandemic burnout. To address these dual challenges, we’re working to ensure that our patients do as much at home as possible through the digital front door. We have many video visits, telehealth visits, and we leverage technology so patients may receive answers to their questions in the comfort of their own homes. We also use artificial intelligence to triage incoming messages and direct them to the most appropriate care team member. The goal is to balance the workload of physicians between administrative tasks and time spent with patients in the exam room.

Neil Meltzer, MPH, MHA. President and CEO of LifeBridge Health (Baltimore): Medicine and its application is rapidly moving from a model of patient treatment (some call it “sick care”) to a broader, more holistic vision of healthcare worthy of the moniker.  Here, governmental agencies, legislative bodies, non-profits, health systems and payers work together and are incented to address both the immediate need and the root cause.  Chronic issues like access to care, food insecurity, prenatal care and even gun violence, too big to be addressed alone, can be worked on collectively with real progress made.   We’ve all heard the refrain that we pay too much and get too little for our healthcare dollar; we’re making progress toward addressing social determinants of health but have the capability to move so much faster (a lesson from COVID-19).

Elizabeth Wako, MD. President and CEO of Swedish Health Services (Seattle): In our local Western Washington market, healthcare organizations, hospital systems, and medical groups are rapidly consolidating and affiliating. We are closely watching the evolution of our industry. Across healthcare broadly, another significant issue has come into sharp focus: sustainability. It’s really more than a trend, it’s an imperative. There’s a growing emphasis on sustainability in all aspects of healthcare, including reducing the carbon footprint of facilities, managing medical waste, and promoting environmentally friendly practices — and at Providence Swedish we are making great strides. We are extremely proud that Swedish Issaquah was the first of our hospital campuses to become carbon neutral in 2021, as we work toward making our hospitals carbon negative by 2030. Energy Star named Swedish Issaquah in the top 1 percent of hospitals in the U.S. for its energy score. We’re especially proud that each year we’re awarded numerous sustainability honors from Practice Greenhealth. That recognition of our work on such a vital issue means a lot to our caregivers across the entire Providence Swedish organization.   

Bill Pack. CFO of Conway (Ark.) Regional Health System: 

Value-Based Care:

• Focus on patient outcomes and quality of care rather than the volume of services provided.
• Implementing and optimizing VBC contracts to improve financial performance and patient satisfaction.

Workforce Management:

• Addressing staffing challenges, especially in clinical and specialized healthcare roles.
• Implementing strategies for staff retention, training, and employee engagement.

Artificial Intelligence:

• Leveraging AI for predictive analytics; primarily in finance and back-office functions
• Evaluating the cost-benefit of AI-driven tools and technologies in healthcare delivery and choosing the best products.

Cybersecurity:

• Protecting patient data and financial information from cyber threats.
• Investing in robust cybersecurity measures and ensuring compliance with data protection and new cybersecurity regulations that are coming.

Charles Emerman, MD. Chair of Emergency Medicine and Medical Director, Service Line at MetroHealth Medical Center (Cleveland): There is a continued uptick in patients with addiction problems and behavioral health needs that affects all services in the hospital. Addressing these complex patients will need to be part of the planning across the system

Lisa Carter. Southern Regional President of Ballad Health (Johnson City, Tenn.): As with most people in the industry, I'm closely monitoring all things AI, but my interest focuses primarily on how this could change the landscape or rural healthcare while furthering health equity. I am also interested in seeing how AI might close specific access gaps. In addition, I am looking at trends affecting the overall delivery models for care and how the next generation of healthcare consumers and workers will impact how we provide services.

Doug Pogue. President of BJC Medical Group (St. Louis): As a physician organization leader, I have been closely following the availability of tools to transform frontline caregiving. AI now has the potential to make material improvements in the provider experience, yet the pricing of these tools so far might erase any net gains they deliver. Providers who can complete documentation and message responses one hour earlier using the technology might have to see three additional patients per day to pay for the technology – thus erasing the hour they gained. We are committed to finding meaningful relief for our providers, and will be searching for impactful technologies at price points that clearly allow the provider to improve their work experience. 

Andrew Molosky. President and CEO of Chapters Health System (Temple Terrace, Fla.): Chapters Health is a firmly committed believer in the value of a highly engaged and employee-led workforce. With my number one concern always being the perpetual challenges of workforce attraction, development, and retention the inevitable intersection of increasingly advanced artificial intelligence tools is a trend I’m dialed in on. The razor's edge between empowerment and task relief of an already stressed workforce with perceptions of replacing the very human beings we build this service from is a delicate dance and one I constantly seek perspective on.

Sunil Dadlani. Executive Vice President and Chief Information and Digital Transformation Officer of Atlantic Health System (Morristown, N.J.): In 2024, healthcare is significantly influenced by generative AI and other advanced AI tools, leading to transformative trends. AI will enhance predictive analytics, enabling early diagnoses and personalized treatments, while Gen AI will accelerate drug development and disease modeling. Telemedicine and remote monitoring will expand with real-time AI-driven data analysis. Integrated digital health platforms and patient-centric apps will empower individuals to manage their health.

Mental health care will see advancements through AI-powered digital therapeutics. Sustainability in healthcare being promoted via AI-driven resource optimization.

Brian Peters. CEO of Michigan Health Hospital Association (Okemos): I have always been fascinated with the hospital consolidation trend, but now more than ever. In Michigan, we have gone from 230 hospitals in the 1980s, to 130 today. While virtually all of those 230 were independent, the vast majority today are part of multi-hospital systems, some with a multi-state footprint. Despite this consolidation into ever-larger systems of care, the reality is that most of our hospitals continue to work every day with insurance companies, pharmaceutical and medical device manufacturers, and other organizations that are national or international in scope, many of them large enough to rank in the Fortune 500 and all of them with comparatively deep resources. The bottom line is that there is likely to be even further integration and consolidation in the hospital field, and it has enormous implications for the future of healthcare delivery and financing.

Jim Heilsberg. CFO of Tri-State Memorial Hospital and Medical Campus (Clarkston, Wash.): Charity care, Mandatory OT changes in WA State, Nurse/Clinical Staffing laws in WA, Payer stall tactics, Agency staff reduction models, Productivity improvement tools, BOT solutions, AI solutions…the list goes on.

Susmita Pati, MD. Chief of Primary Care Pediatrics and Chief Medical Program Advisor, The Alan Alda Center for Communicating Science at Stony Brook University (N.Y.): I am following trends in workforce developments – including effective strategies to recruit and retain top talent, utilizing technology to reduce administrative burdens, and proven organizational strategies to address burnout. Of course, I always pay attention to financial trends and am currently following changes in private equity relationships with healthcare organizations as well as increasing payments for care coordination and management services. I am also following the ways that retail companies are evolving in offering healthcare services and/or making the decision to stop doing so.

Cliff Deveny, MD. President and CEO of Summa Health (Akron, Ohio): I am looking forward to wide adoption of ambient listening and automatic transcription for all caregivers (not only physicians). This will dramatically change the level of frustration all providers, nurses, respiratory therapists, etc., suffer daily. Imagine a world with fully transcribed notes with inputs from monitoring equipment, lab/imaging and relevant other findings from the patient medical archives ready for review and immediate AI assisted coding and submission for billing. This will provide more time for direct care and increased capacity of limited clinical resources while assuring more accurate claims submission, less denials and prompt pay.

Pooja Vyas, DO. Vice President and Chief Medical Officer of BJC Christian Hospital (St. Louis): Recent trends that we are closely following in healthcare include artificial intelligence as a means to support our workforce, telemedicine and remote patient monitoring. These are all seen as a tool to help patients improve their life by getting care they need in their environments and preventing unnecessary emergency room visits. We want patients to have access to care in areas they don’t and to bring healthcare closer to them.

Arshad K Rahim, MD. Chief Medical Officer and Senior Vice President of Population Health at Mount Sinai Health System (New York City): Some key trends in population health and across coordinated, longitudinal healthcare delivery is how we can do more with the same or even less leveraging technology assets such as AI, ML and NLP. I am very interested in identifying and understanding the impact of specific examples to achieve efficient scale in operations. Also, appropriate utilization strategies related to Part B and Part D drug spend is an increasing challenge in all shared savings and risk based arrangements.

Eric Beshires, MD. COO, Chief Medical Officer and Vice President of Medical Affairs at Baylor Scott & White Medical Center (Dallas): A rapidly expanding space in healthcare relating to post-acute care has been both interesting and dynamic. With an aging population who prefers care at home and hospital financial constraints looking to reduce length of stay, the hospital at home program is an innovative and logical pathway. More robust SNF availability along with payer support of home health would be complimentary but the freshest idea is home-based hospital care following the acute hospital stay as a component of that integrated network.

Adrian Moran, MD. Chief Medical Officer of Aurora St Luke's Medical Center (Milwaukee): In the rapidly changing world of healthcare so much is changing. Right now, I’m seeing how workforce needs are forcing us to redefine the way we deliver care. Artificial intelligence is front and center both for back office functions and clinical care delivery and I believe it will help reduce the administrative burden of our care team members. Minimal invasive approaches to procedures especially in the cardiovascular arena is exciting. Cellular therapy including mRNA therapies are modifying our approaches to hematologic and non-hematologic diseases. At a community level we are finally talking about health inequities and how best to deliver care to all of our communities.

Garrett A. South. Senior Leader of Patient Experience at Dignity Health, California Hospital Medical Center (Los Angeles): I am closely following consumer behavior trends, both within and outside of healthcare. By examining where people receive their content, what engages them, and how they interact with companies, I can identify key pain points and opportunities. We are seeing an increasing importance of the digital front door, the need for short video clips to push out content, and how technology solutions aid in streamlining operations.

This insight informs strategies to enhance patient and family experiences, as well as to boost engagement and satisfaction among healthcare staff. Understanding these dynamics helps drive innovative, effective, and fun approaches in our organization.

Kathy Healy-Collier. President and CEO of Mercy Anderson Hospital (Cincinnati): As leaders in healthcare, we understand that employee engagement is the cornerstone of exceptional patient experience. By fostering a culture where our team feels valued, empowered, and supported, we've witnessed firsthand the profound impact it has on our patients' care journeys. Our commitment to continuous improvement, as demonstrated through our remarkable successes in associate engagement and patient experience, exemplifies our dedication to delivering compassionate, high-quality care. I believe that by prioritizing employee engagement, we not only enhance the well-being of our team but also elevate the overall standard of care we provide to our community.

Rod W. Neill. COO of Bon Secours Mercy Health Medical Group (Cincinnati): Presently, I am spending a fair amount of time in the realm of AI as many others are in healthcare and other fields. We are actively instituting AI ambient clinical intelligence tools within our medical group for the purposes of accurately and efficiently documenting encounters between physician and patient. We are about two-months into a 100 provider pilot and the results have been extremely positive. 

Time spent with the EHR and time spent working outside normal hours have been reduced up to an hour per day for those using the tool consistently. The feedback from physicians and advanced practitioners have been glowing and we are expediting this to make it available to our larger medical group and exploring the utility in other clinical areas. If used properly, I think this can provide great relief to our overburdened clinicians.

Wayne Gillis. CEO of Great Falls (Mont.) Hospital: The changing workforce in acute care hospitals.

1. Current landscape and challenges

• Work-life balance demand: Increasing demand among providers for better work-life balance, leading to resistance against taking calls and extended hours.
• Provider shortage: Existing shortages, exacerbated by the pandemic, affecting all specialties.
• Hospitalist model impact: Potential shift towards a hospitalist model across specialties, which could triple the demand for specialists.

2. Impact on hospital operations

• 24/7 coverage: Difficulty in maintaining 24-hour coverage with fewer providers willing to take on-call duties.
• Budget constraints: Increased demand for specialists leading to higher operational costs, which current hospital budgets and reimbursement rates cannot support.
• Medical education: Insufficient number of medical students to meet the growing demand for specialists, resulting in a long-term supply issue.

3. Strategies for adaptation

• Innovative staffing solutions: Implementing flexible schedules, telemedicine options, and job-sharing to attract and retain providers.
• Leveraging technology: Using AI and other technologies to optimize workflows and reduce the burden on providers.
• Cross-training and upskilling: Training existing staff to handle a broader range of duties, reducing dependency on specialists.
• Collaborative models: Exploring collaborative care models where primary care physicians and nurse practitioners share responsibilities with specialists.

4. Advocacy and policy changes

• Increased funding for medical education: Advocating for more funding to increase the number of medical students and residency positions.
• Policy adjustments: Working with policymakers to adjust reimbursement models to better support the evolving workforce needs.
• Support for provider well-being: Developing programs focused on mental health and well-being to retain current providers and attract new ones.

5. Future Outlook

• Sustainable models: Identifying and implementing sustainable care models that balance provider work-life needs with patient care requirements.
• Continuous Improvement: Embracing continuous improvement strategies to enhance efficiency and provider satisfaction, drawing from the Toyota Production System principles.

Michael C. Backus. President and CEO of Oswego Health (N.Y.): Certainly, the rising cost of just about everything is a trend that everyone in healthcare is concerned about with reimbursement models that do not keep up with inflation. Putting in place “hospital at home” strategies, or scaling up home care services, as we have at Oswego Health, is certainly a component of finding less costly ways to deliver high-quality results. This does place more administrative burden on already truncated business models that aren’t necessarily robust. This requires strong business planning and analytical work to ensure the work is scalable. 

Coupled with inflationary costs of care, workforce recruitment, and participation are trends that I’m not sure healthcare has a solid handle on nationally. Caregivers are leveraging their work/life balance more than ever and given the heightened complexity of patients, especially in behavioral health, it’s a challenge to see how we build anything but more redundancy behind the staff that we have. That causes increased costs as well … if you can find, recruit, and onboard the clinician. It’s an incredibly competitive environment right now and that is why I’m proud of the work Oswego Health has done building pipelines to bring more students into clinical rotations. 

Healthcare needs more people willing to step up and care for their communities. Oswego Health is nearing a million dollars spent on training programs and for a sole community, independent hospital health system like us, that’s a big commitment. It is starting to pay off now that some of the eighth graders we started talking with years ago are graduating and entering either the workforce or clinical education. More commitment to those kinds of training programs and early educational incentives to build caregivers in the communities that need them has to be a trend that we all work toward in healthcare.

Terri Donovan. Interim CFO of MercyOne Iowa (Des Moines): I am closely watching our Medicare Advantage payer practices. As we negotiate rate increases, we are monitoring to ensure those are not offset by increases in denials and downgrades. In the last year, the hospital I currently support has seen their yield on traditional Medicare and Medicaid exceed that of our commercially managed populations. I remain hopeful that the current focus on the behaviors of these payers will lead to regulatory changes to ensure that the taxpayer funds intended to provide care for Medicare beneficiaries are actually being directed toward the provision of their care.  

Ronda Lehman. President of Mercy Health Lima (Ohio): There are so many exciting trends in healthcare currently! The following are a few trends that I follow most closely:

Artificial intelligence/technology: Who is using it? Is it effective? What is truly value added to the patient and caregiver experience.

Staffing models: What are some innovative approaches? How are other facilities redesigning the care team?

Service lines that are growing/shrinking – this generates both ideas, and also lets us know various threats in the healthcare industry.

All of this leads me to be focused on our primary question: how can we serve our community and our patients better?

Bill Munley. Administrator of Shriners Children’s Greenville (S.C.): Some obvious answers would be labor shortages, healthcare workplace violence, and the increase of uninsured/underinsured patient populations — which are all national issues. However, Shriners Children’s Greenville is more concerned with some other trends at the current time. First, we are saddened to see the multitude of health systems across the country eliminating services, laying off employees, or shutting down completely. We are also concerned about reimbursement challenges from the government and third party payers, especially changes in DSH payments. 

Furthermore, we are working closer with FQHCs, rural hospitals, critical access hospitals, and school nurses to treat the underserved pediatric populations that often fall through the cracks when seeking specialist care. Finally, we are working to build partnerships and affiliations with health systems and payers alike for things like CIN memberships, bundled payments, and other alternative payment models. We want the healthcare community to know that we can help by treating their sometimes complicated and costly pediatric orthopedic and neuromuscular cases, because we treat all patients who fall within our service spectrum regardless of ability to pay.

Sachin K. Gupta, MD. Chief Medical Officer of UNC Physicians Network (Durham, N.C.): It’s been exciting to see the rapid development in generative AI platforms for digital scribing. Clinician burnout continues to be such a critical issue for workforce wellness and when done right, Gen AI scribing can be a game changer. It has the potential to make positive impacts across both primary care and specialty care. I look forward to seeing what solutions they can deliver to our clinicians to help return joy to the clinic workday again.

Quanna Batiste, DNP, RN. Chief Nursing Officer of Ambulatory Care at UCLA Health (Los Angeles): The trends that I am closely following in healthcare include:

• Incorporation of artificial intelligence solutions into clinical documentation and as a tool to relieve clinician burnout.
• Clinical staffing challenge solutions including creative ways to increase flexibility in staffing models and the integration of upskilling to solve staffing challenges.
• Incorporation of virtual care delivery models into areas that were historically direct care models such as acute care and use of these modalities to increase access and improve health inequities.

Dane Wheeler. CFO of Adams Memorial Hospital (Decatur, Ind.): 340B. There are a number of court cases and proposed legislation with this program. It is the life blood of rural health systems. An adverse outcome could doom many rural health systems and the communities.

Stephanie Weatherly, DNP. Chief Clinical Officer of Psychiatric Medical Care (Brentwood, Tenn.): We follow several key behavioral health trends, including the integration of telehealth services, which has significantly expanded access to mental healthcare, and the growing emphasis on holistic and personalized treatment plans that consider the whole person rather than just their symptoms. Additionally, I monitor advancements in psychopharmacology and evidence-based therapeutic interventions, as well as trends in mental health policy and insurance coverage that impact service delivery. Keeping abreast of these trends ensures our organization remains at the forefront of effective and compassionate care.

Alan Fisher. CEO of Woodlawn Hospital (Rochester, Ind.): As a CEO of a critical access hospital, I am troubled by the trend of maternity unit closures among rural hospitals. Just in our geographic area, we have seen the closure of four maternity programs resulting in an maternity desert within a 50 mile radius. We have sought out legislative and financial assistance from our state to enhance our program and maintain this vital service; but have had no success. Our plan is not to quit fighting for maternity care as it is our strategic plan to continue to provide maternity care to our local community and surrounding counties. 

Debbie Lull. Chief Nursing Officer of Mackinac Straits Health System (St. Ignace, Mich.): The trends I am following most closely are impacts to critical access hospitals in rural settings such as access to care, workforce, technology, quality performance and fiscal resilience.

Access to care trends continue to demonstrate declining inpatient volumes and shifts to outpatient care, such as surgical procedures, which subsequently requires an astute eye on payers' coverage and impacts on the patient care and resources. In addition, patients needing behavioral health services continue to be held in emergency departments due to lack of inpatient behavioral health beds for adults and children. When a bed is found, it may be miles away from the patients' residence and family support. 

Workforce trends are showing successful international recruitment efforts and lowering of costs long-term versus agency staffing, particularly in the hospital lab environment.  I am also watching trends in the nursing workforce and various skillsets necessary for upcoming innovative care treatments. There is also much advocacy regarding nurse staffing ratio legislation and the nurse licensure compact efforts for Michigan. Preventing violence in the workplace is another legislative advocacy effort as all of our hospitals in the U.S. are experiencing rising aggression against all healthcare workers.

Technology trends regarding cybersecurity is top of mind, as well as any trends of AI technology and how to best prepare for that in the upcoming years.

Quality performance and fiscal resilience trends demonstrate increasing prior authorizations with necessary resources to accommodate. While many rural hospitals are closing, it is imperative that we advocate for oversight of this growing trend as well as legislation such as 340B that will continue to support the underserved areas. Likewise, associations that can assist critical access hospitals with lower fees for quality collaboratives continue to show trends of supporting evidence-based care in all geographic areas. Rural health equity is imperative.

Overall, a standardized approach to addressing healthcare costs cannot be met with the same resources in tertiary centers versus critical access and rural areas. Compartmentalizing barriers of the cost of doing business with specific solutions for myriad settings may result in a patient-centric method of lowering costs of services.

Muhammad Siddiqui. CIO of Reid Health (Richmond, Ind.): I am closely following several transformative trends in healthcare that are reshaping the industry. One of the most significant trends is the integration of artificial intelligence and machine learning into healthcare operations. AI and ML have the potential to improve patient outcomes, streamline clinical workflows, and enhance the overall patient experience.

Another critical trend is the increasing focus on data analytics. By leveraging vast amounts of patient data, we can gain valuable insights into population health trends, predict potential health risks, and develop personalized treatment plans. At Reid Health, we are investing in advanced analytics tools and building a robust data infrastructure to support data-driven decision-making and improve the quality of care we provide.

Furthermore, I am closely monitoring the evolving cybersecurity landscape in healthcare. As we continue to digitize patient records and adopt new technologies, ensuring the security and privacy of sensitive patient information is of utmost importance. We are continuously strengthening our cybersecurity measures and educating our staff to mitigate potential risks and protect our patients' data.

Amit Vashist, MD. Senior Vice President and Chief Clinical Officer of Ballad Health (Johnson City, Tenn.): Three trends I am looking at:

1. The recent shuttering/scaling back of health clinics by retailers like Walmart, Walgreens and CVS underscores the challenges and complexities of imparting a "2.0" version of primary healthcare that was promised not so long ago by these retailers. This also reinforces the role of the health systems in the communities serving as a bulwark when such healthcare experiments go under to make sure that patients are taken care of. These integrated systems combine various healthcare services under one umbrella, including primary care, specialty care, diagnostics, and pharmacy services. By streamlining communication and coordination between different departments, vertically integrated systems can provide more personalized and cohesive care to patients. This approach also facilitates continuity of care, allowing healthcare providers to better monitor patients' health over time and intervene proactively when needed. With a focus on holistic care delivery, health systems can achieve better patient outcomes and higher levels of patient satisfaction compared to fragmented care models like retail clinics.
2.  As the healthcare landscape increasingly pivots from "sick care" to "healthcare", focusing on meeting patients' care needs wherever and whenever necessary, ensuring consistent care delivery and fostering positive patient experiences will become paramount. With continued digitalization of healthcare and expansion of modalities like hospital-at-home, wearables, remote patient monitoring, tele visits etc., healthcare caregivers will continue to enable and empower patients to access care from the comfort of their homes. This trend will continue in the foreseeable future.
3. Hospitals, clinics and health systems are inundated with data, or in other words, we have too much noise and barely any signal emanating from that noise. The best healthcare delivery organizations will successfully harness the power of big data in providing actionable insights to their caregivers to help improve workflows, processes as well as outcomes of their patients, a true win-win for all. I believe that we will continue to see the blending of predictive and prescriptive analytics tools with generative AI, machine learning models etc. to help us towards creating and sustaining a learning and agile health system.

Jochen Reiser, MD. President, University of Texas Medical Branch; CEO of UTMB Health (Galveston, Texas): Well, I follow and participate in the discussion and developments around artificial intelligence. This is clearly with enormous potential, not only for diagnostics but also for operational use, ultimately creating more time for doctors and providers to do what they love to do which is to spend time with the patients. In my world, AI stands for actual and artificial intelligence. Clearly, a very exciting area that will influence many domains including patient journey and quality and safety of care. 

Another topic is the re-branding of the physician-scientist, a group I belong to myself. I believe physician-science is strong for discovery but equally useful in the C-suite where analytical mind and careful consideration for the approach are areas where physician-scientists can contribute. 

Finally, I follow and discuss ways of alternative revenue-streams for academic health centers and universities that include physician and nurse innovators and the creation of products that improve health. Very exciting topic!

Kenneth Sable, MD. Regional President of Southern Market at Hackensack Meridian Health (Edison, N.J.): One of the biggest trends we are following currently surrounds physician specialist availability. We are seeing continued challenges hiring or staffing physicians in key specialties, including anesthesiology, gastroenterology, urology, and radiology, to name a few.  There is also a concerning trend of physicians no longer wanting to take call at hospitals, and if they are willing to take call, the costs are exorbitant compared to just a few years ago.  

In addition, private equity, in addition to providing capital infusion, often provides acquired physicians with sophisticated analytics regarding where they are most (outpatient) vs. least (inpatient) profitable. And because payment to physicians, via both Medicare as well as commercial payers, has not kept up with inflation, more often than not they are requesting that hospitals make up the difference.

Vi-Anne Antrum. Senior Vice President and Chief Nursing Officer of Cone Health (Greensboro, N.C.): One trend I am following closely right now is the divide between organizations embracing value-based care versus those who are firmly committed to fee for service. I believe consumers and payers will demand value-based care and a variety of risk-based models. I worry about the potential negative impact to communities if we don’t fundamentally change the way we deliver care. The impact of Lifestyle Medicine, IOM Future of Nursing 2030, health equity, and other growing initiatives all lend themselves nicely to value-based care.

Another trend I am keeping an eye on is AI utilization in healthcare. There is enormous potential for AI and we are using it in a variety of ways at Cone Health. I am also cognizant of the need to mitigate bias and inaccuracies in the data ingested to any given platform. It highlights the need for broader research across populations and demographics of people than what exists today. I believe academic institutions and partners could help drive some of the research towards these aims that integrate health equity. Beyond that, AI has become the new “buzzword” and there are varying levels of credible offerings in the marketplace. The other big concern here is the price tag with or without proven value.

It has been fascinating to watch players enter the healthcare space and leave it after realizing the enormity of what it takes to provide healthcare in America. Whether looking at pharmacy chains or equity ventures, I think some companies have started to realize how challenging providing healthcare in a meaningful way that achieves great outcomes for patients and communities while allowing a business to remain profitable is. Healthcare organizations have started to become more selective about who and how they partner with others. I will continue to watch this trend!

Gian Varbaro, MD. Chief Medical Officer and Vice President, Ambulatory Services at Bergen New Bridge Medical Center (Paramus, N.J.): I think the most interesting trend is the movement of big outside companies, payers, and PBMs into and out of provider services. Seeing the challenges and successes they are having is very illustrative of the broader trends in healthcare. Additionally, watching how different systems have been negotiating with and/or leaving Medicare Advantage has also been a fascinating trend as it again shows the many challenges in the system. I am also interested in how healthcare is thinking about and starting to use AI. There is such a staffing and provider shortage that there would seem to be efficiencies that could be found (such as offloading documentation or other types of work to free the time of providers and other limited staff) but no one seems to have found much yet beyond minor uses.

Ebrahim Barkoudah, MD. System Chief and Regional Chief Medical Officer at Baystate Health (Springfield, Mass.): The current convergence of clinical, operational efficiency, and digital health is of utmost importance. One significant trend I am diligently monitoring involves the integration of digital health tools into clinical settings to transform service delivery and streamline operations. This integration aims to enhance patient outcomes, increase operational efficiency, and cater care experiences to individual requirements. 

Furthermore, the spotlight on digital transformation in healthcare is a trend that demands recognition. This strategic move towards embracing technology seeks to innovate healthcare delivery, enhance patient engagement, and realize cost efficiencies through advanced digital solutions and platforms.

Another impactful trend shaping the industry is the consumerization of healthcare. This trend prioritizes improving accessibility and convenience for underserved populations by emphasizing user-friendly digital health solutions and remote care options to effectively meet diverse patient needs. Moreover, the growing momentum behind incorporating digital health tools to boost clinical performance and operational efficiency is gaining traction. These tools are crafted to improve care quality, streamline workflows, and promote seamless communication among healthcare teams, leading to optimized service delivery and enriched patient care experiences.

Examples of these trends include:

• Integration of digital health tools for personalized care experiences
• Emphasis on digital transformation to optimize healthcare delivery
• Consumerization of healthcare for enhanced accessibility and convenience
• Utilization of digital tools to enhance clinical performance and operational efficiency

These trends collectively signify a progressive shift towards a more effective, patient-centered healthcare environment propelled by innovation, technology, and a dedication to enhancing healthcare outcomes.

Raji Kumar. CEO and Managing Partner of Crescent Regional Hospital (Lancaster, Texas) and Hill Regional Hospital (Hillsboro, Texas): The trend that I am fascinated by, following closely, and investing in, currently, is the integration of advanced technology to enhance patient care and accessibility. One of the most exciting developments is becoming the first hospital in North America to use holographic technology to transform TeleHealth. Recently, we've partnered with Holoconnects to introduce their cutting-edge Holobox, a groundbreaking solution that creates a more immersive and personal connection between patients and doctors.

This innovative technology allows us to provide a more elevated version of telehealth, which is crucial for building trust and rapport between healthcare providers and patients. By using holograms, we are bridging the gap that often exists in traditional telehealth, making virtual consultations feel as personal as face-to-face meetings. This is particularly important for connecting top-tier doctors located in other parts of the Dallas/Ft. Worth Metroplex with local patients, who are predominately black and hispanic, who have historically and systemically received second and third-tier healthcare.

At Crescent Regional Hospital, our mission is to ensure that every patient receives the highest quality care, regardless of their background or circumstances. By leveraging holographic technology, we are not only enhancing the quality of interactions but also ensuring that all patients have access to the best medical expertise available. This approach aligns with our commitment to innovation and equity in healthcare, setting a new standard for patient care in our community.

Claudia Eisenmann. President of Texas Health Harris Methodist Hospital (Fort Worth): There are three trends that I am closely following right now. They include innovation, especially in the area of AI, vertical integration, and strategies for disease prevention, particularly at the grass roots level. For too many years, healthcare organizations have functioned as reactive systems with limited focus on disease prevention. The changing healthcare landscape is shifting in such a way as it relates to physician and clinician shortages that this reactive approach needs to shift as well. AI, integration, and population health are vital tools that can and should be leveraged as we design the health and wellness models of the future.

Rene Suntay. CFO of Meadville (Pa.) Medical Center: I am closely following the discussions regarding the “nurse staffing requirements." This is a very serious topic because it can and will impact the delivery of care for all health operations. Additionally, it will have a tremendous impact on the cost of providing care, of which we are already struggling with reimbursements and severely under compensated by all payors.

Ashley Arey. Vice President of Care Access at UNC Health (Chapel Hill, N.C.): I’m interested in how we’re leveraging technology to support care pathways and different modes of care that are best suited for our patients. Improvements in care pathways support timely access to care, and lead to better patient outcomes, surfacing options for care that may not have been fully leveraged via traditional paths. In terms of modes of care/how we engage with patients, virtual care is a wonderful option when it matches patient needs, saving both time and expense, so I’m hoping to see more widespread integration and hardwiring support for it.

I am also very excited about how we can use AI to simplify the information burden for our care teams, and especially how process simplification can lead to shorter turnaround times for referrals and appointment scheduling in the ambulatory setting. We’ve come a long way from tall stacks of referrals on desks!

Jeff  Edge. CEO of MS Gulf Coast Division at Ochsner Health (New Orleans): One priority continues to be access to care with technology and efficiency as a driver. Locally and as a system we’ve continued a focus on home health, virtual care, and improved Primary Care access. Looking to the future of healthcare, we’re piloting programs with our providers such as ambient listening AI.

Abha Agrawal, MD. President and CEO of Lawrence (Mass.) General Hospital: 1. Workforce challenges including availability, costs, well-being, burnout and motivation.

2. Healthcare finances - inequity in safety net reimbursements at multiple levels. Shift toward alternative payment models.

3. Optimal utilization of emerging technologies including AI.

4. Shifting the site of care from acute care to ambulatory setting to home.

Allan Klapper, MD. President of Wexford Hospital, Allegheny Health Network (Pittsburgh): At AHN Wexford, we have been focused on opportunities to reduce redundancies and waste in healthcare, while at the same time increasing value through improved quality and safety metrics, provider engagement, patient experience, and health equity. These strategies will involve improving preventative and team-based care models, decentralized and patient centric approaches, innovative primary care strategies, more robust value-based and risk models, along with more robust data collection and analysis. In addition, newer and emerging technologies including AI will play an ever-increasing role in helping to bridge gaps and accelerate solutions.

Alexa Kimball, MD. President and CEO of Harvard Medical Faculty Physicians, Beth Israel Deaconess Medical Center (Boston): A critical healthcare trend worth our immediate attention is the looming - and existing - physician shortage. Exacerbated by an aging population, a limited number of U.S. medical school graduates, and pervasive physician burnout, addressing the challenge will require more than merely recruiting doctors. Comprehensive reforms to reduce medical school debt, streamline training, and ensure fair physician compensation are essential. Through collaborative efforts, we can reshape the future of healthcare, creating a resilient and fulfilled physician workforce capable of meeting our ever-growing patient care needs.

Mark G. Moseley, MD. President of USF Tampa General Physicians; Executive Vice President of Tampa (Fla.) General Hospital: While I think the “easy” answer to this question is the technological explosion of artificial intelligence applications, I believe the more interesting observation is on the impact on the human workforce. Post-COVID, we all experienced the “great resignation” in healthcare as many workers left healthcare for other service industries. What we have been dealing with ever since is insufficient skilled labor to backfill those vacancies. As such, many organizations such as ours are pivoting to pipeline programs (partnering with educational institutions) and building our own training programs to help “upskill” our workforce. 

At the same, as we have realized we may not ever be fully staffed to the degree we were pre-COVID, we now must augment our existing workforce with technology that extends their capabilities. This is a two-part challenge. First, we need to deploy technology thoughtfully with sound blocking and tackling, which is expensive in both time and capital. Second, we must train our workforce to use these new technologies to aid them in their daily responsibilities in a manner that does not diminish the ethos of why many of us went into healthcare (the interactions with patients and members of the healthcare team). While this can be difficult, it is also an exciting chance to innovate and to challenge the status quo. How can we implement technology that truly aids our workforce in aiding our physicians, providers, staff and patients? That’s an interesting and complex challenge that requires thoughtful leadership.

Peter Banko. President and CEO of Baystate Health (Springfield, Mass.): In Western Massachusetts, we are particularly tracking trends in workforce, consumer-driven access, value-based care, and the impact of private equity. In a brand-new role in a new community, I am hyper-focused on getting it right rather than the temptation to be right. I am spending the summer listening to patients, the community, caregivers, physicians, leaders, and governance. Asking far more questions than making statements.  Is there anything that’s working particularly well? What is not working well? Where do we need to be in the 6 months, year, and five years? Where do you need my help?

Chani Cordero. CIO of Brooke Army Medical Center (Houston, Texas): With everything being AI, one trend in healthcare that I find especially fascinating is the advancement of AI-enabled diagnostic imaging interpretation. Right now, this technology is just being used to triage radiology images, but the diagnosis is still solely on the radiologist. However, if there is one area that generative AI has potential is within radiology as it can consume large data. 

Adam Smith. Executive Vice President and Chief Ambulatory Care Officer of Tampa (Fla.) General Hospital: At Tampa General Hospital (TGH), partnerships have been key to our growth and success over the past five years. We have been able to expand our footprint from 17 locations, centralized mainly in the Tampa Bay area, to six hospitals and over 150 locations across the state of Florida to provide accessible care to the communities that we serve. 

As we look at the access to healthcare and service providers in the market, there are three trends that we are watching. A few years ago, we saw several companies entering the market focused on low-acuity services, like Walmart and Walgreens, which are now exiting the market. We are seeing several health systems expanding their reach, sometimes into new states, and consolidating service providers to gain market share. The final trend that we are following related to access is the seemingly growing dissatisfaction among once-independent physicians and providers. Several years ago, the industry saw a movement for groups to consolidate with national entities, many with investors backing the expansion. We are starting to see that there is a movement back to providers seeing the value in alignment with larger organizations, including health systems that provide a balance of local autonomy and decision-making with financial backing and security.

Adam Breslow, MD. President and CEO of Children’s Primary Care Medical Group (San Diego): As a pediatrician leading a primary care medical group, I follow trends that are of a different slant than most: the declining birth rate among women, the fallout of Medicaid unwinding of continuous enrollment with the effect on children, increasing teen mental health crisis, declining interest in pediatrics among today’s medical students and burnout for primary care pediatricians. If we ever want to decrease the cost of healthcare in this country, we need to get serious about prevention. That all starts with the great work of primary care pediatricians.

Edward S. Kim, MD, MBA. Vice Physician-in-Chief of City of Hope (Duarte, Calif.); Physician-in-Chief of City of Hope Orange County: As one the largest cancer research and treatment organizations in the United States, City of Hope is focused on bringing our advanced cancer care and research to more people across the United States. One immediate need is removing barriers and exclusions to clinical trials that currently limit the participation of 95 percent of people with cancer, especially underserved populations. Digitization and decentralization — where all or some of the trial-related activities occur outside traditional trial sites — as well as the role of AI to create efficiencies and open up more access – are part of the solution; I’m deeply involved in this work and closing following these trends. Cancer prevention and early detection is another area of focus. We are seeing a deeply concerning global and national rise in adult early-onset cancer. We must identify the reasons behind this trend, educate people, advance prevention and early diagnosis and develop more effective treatments.

William Morice, MD, PhD. President and CEO of Mayo Clinic Laboratories/Mayo Collaborative Services (Rochester, Minn.): I first heard about the advent of large language models at a Becker’s event no more than two years ago, where this was described as one of the most transformative events in the history of computing. That certainly seems to have held true, and the rate at which these tools are being improved is staggering. What I am closely following now is their introduction into healthcare, both in terms of speed of adoption and impact. These technologies hold promise for revolutionizing healthcare from the perspectives of operations and patient care, with the potential to increase access while also improving quality. 

In response there’s been a proliferation of companies in this space, I think at the most recent Becker’s conference this Spring I was told there were over 200 such companies now in the market. But what will the barriers be to success?  These tools will need to be embedded in our processes, introduced in a way that is not disruptive to workflows, we must ensure the training of staff who will use these tools, so they are applied properly. So, I am anticipating some disconnect between the promise and the reality in these early days, with some hard lessons to be learned. But I am watching closely as I do believe these tools will ultimately enhance patient care and alleviate many of the problems we face including staff burnout and accessibility.

Theresa Martinez, DNP, RN. Vice President of Patient Care Services and Chief Nursing Officer at La Rabida Children’s Hospital (Chicago): Regularly I watch turnover rates for nursing and other healthcare disciplines. In addition, I pay close attention to projections of the nursing shortage anticipated in the upcoming years. 

Aside from staffing, I follow social determinants of health and how they impact overall health and healthcare disparities.

Theresa Dawson, DNP, MSN, RN. Chief Nursing Officer of Oaklawn Hospital (Marshall, Mich.): The trend that I am watching currently as the CNO is related to mandated nursing ratios. As a small community hospital in Michigan, I have been very fortunate to be supported by my CEO to keep our nursing: patient ratios at a safe (lower) level. This of course costs the organization more in salaries but will result in benefits of retaining nurses. If nurses feel they cannot safely care for their patients, they will not stay.

Unfortunately, many organizations have not been as committed to lower ratios due to attempts at expense reduction. This has resulted in groups gaining support with their legislators to push for mandatory staffing levels. The downside to this legislation is that if passed, those same organizations will have to close units or services in order to meet the mandate. This will result in lack of access and care to our communities.

Nurses are most of the salary expense in hospitals budgets, with retention being of grave importance. Each time you must “on-board” a new nurse, the expense is greater yet. Keeping staffing ratios safe thereby retaining nurses really is a cost savings in the long run. This practice will also reduce the chances of being forced to staff according to someone outside of the organization.

Brendan Carr, MD. CEO of Mount Sinai Health System (New York City): The healthcare trends I am closely following are the regulatory and payment issues around delivering care in the home. This delivery model has been shown to reduce costs, improve outcomes and enhance the patient care experience, and we must evolve policies and payment models to support these efforts. 

Niobis Queiro. Interim Chief Strategy Officer of Nashville (Tenn.) General Hospital: There are several areas of focus that need to be followed and solved for in this current healthcare environment.  I am greatly focused on the sustainability of academic medical centers by truly finding technologies, processes and collaborations between the clinical community and the financial administration in order to achieve long-term success.  Costs are increasing, operating margins are decreasing and talent force shortages impact care access.

It is impressive to see how organizations are being creative to skill-up their talent force, expanding the roles and use of mid-levels to fill some of the provider gaps.

The use of technology has become the expectation for all task oriented work in the revenue cycle. Finally we are working on LLM data driven solutions for coding, CDi, prior-authorization and denial management.  We are learning from other industries to get our business to the next level.

Last but not least I am tracking the changes in value based models and CMS innovation projects. We need to be keen in being agile as we live one foot in the fee-for-service canoe and one foot in the value based care canoe.

Sophia Holder. Executive Vice President and CFO of Children’s Hospital of Philadelphia: CHOP’s mission to provide exceptional patient care, to conduct groundbreaking research, and to foster academic excellence necessitates a keen awareness of the broader healthcare landscape. I am closely following several trends. The integration of advanced technologies such as artificial intelligence, telemedicine, and electronic health records continues to reshape healthcare delivery. At CHOP, we are investing in digital health strategies to enhance patient care, improve operational efficiency, and leverage data and analytics for informed decision-making. 

This also includes strengthening our cybersecurity measures to protect patient information. Balancing the need for investments in cutting-edge medical treatments, like cell and gene therapy, with financial sustainability is paramount. At CHOP, we are employing a few strategies, including supply chain optimization and revenue cycle management improvements, as well as exploring alternative revenue streams and partnerships to diversify our financial base. 

As an academic medical center, research is a cornerstone of our institution. We are actively seeking and securing funding opportunities to support our research initiatives, fostering innovation that translates into advanced clinical practices. Collaboration with academic partners, industry stakeholders, and government entities is essential to sustaining our research endeavors.

Robert Baxter. President of Mercy Health Toledo (Ohio): The three biggest trends that I am following right now include:

• The attacks on healthcare providers by special interest groups and in the media.  Regardless of the motivation behind this activity, it has never been more important to have open communications with our elected officials, employers and communities. 
• Impact of technology. While this is a broad area, areas of particular interest include cybersecurity, not just in our own organizations, but including the cyber security of those whom we rely for services. The promise and the peril of AI, including the real opportunity to reduce burnout, administrative burden, and waste.  Finally, advances in life sciences in terms of bringing new and better drugs to market sooner as well as gene editing as a way to improve the lives of millions.
• The continuing evolution of risk-based contracting.  It’s been said people overestimate the impact of change in the short run and underestimate it in the long run.  I believe value-based care and the changing care and payment models fall in this category.  While this has been on health systems radar for many years, the pace of change is accelerating and will play out in ways that we still don’t fully understand.

David Krajewski. Executive Vice President and CFO of LifeBridge Health (Baltimore): Each of our systems, and healthcare more generally, is dealing with really significant change. The expectations of consumers resemble those of Amazon, and threats to what has been a traditional hospital-centric model continue to proliferate.  From different points of view, there are three trends – often working in unison – that we’re working to adapt into our strategies:

1. The migration of hospital services outside the four walls of the hospital: 

Consumers value convenience more than ever and are rewarding those who deliver. Our investment and M&A strategy continues to further develop a “continuum of care” which puts a variety of access points and services in front of the consumer, in-person or virtually. Care served outside the acute care setting of a hospital is often more convenient for the patient and more efficient providing value while also being less expensive and more profitable for the system to deliver.

2. The impact of AI on improving customer service and reducing the cost of healthcare: 

The cost of care in the United States is simply too expensive and too inefficient.  Length-of-stay is too long and the burden of clinical documentation and rev-cycle denials only compound these issues.  AI offers the potential to – accurately – highly compress some of these activities while simultaneously easing the burden on care teams and back-office staff.  Overall, we’re still a ways off from realizing significant benefit but early signs show real promise.

3. Consumerism:  

A catch-all phrase to be sure, but a significant trend, nonetheless.  In its most basic form, it means orienting medical care tono doubt it’s a trend that’s here to stay and one wh a service to be consumed as other services are day-in and day-out. Many will argue with the basic premise “is this a good thing?” but there is ich we’ll need to adapt to – or others will.  Healthcare needs to learn to “compete” for every healthcare dollar by delivering better care and better experience at a better price that the consumer perceives as having value.

Philip Quick. Vice President of Access Operations at Rush University Medical Center (Chicago): We are closely following digital integration into healthcare, particularly looking at new ways to provide access to care. Consumers deserve rapid access paired with the highest quality care. RUSH recently launched same day/next day virtual specialty consults as part of our broader digital strategy to meet the needs of consumers; continuing our commitment to provide access to care when, where and how patients want to receive it.

Ashwani Bhatia, MD. CEO of BayCare Clinic (Green Bay, Wis.): The healthcare landscape is experiencing many rapidly evolving trends. The top trends I am actively following include:

• AI and technological advancements to bolster cybersecurity
  • Rise of ransomware attacks on healthcare systems 
  • Use of AI and machine learning to detect and respond to cyber threats
  • Use of biometric Identification 
• Focus on financial performance of medical groups with recent failures and focus on operating profits 
  • Expansion of ambulatory surgery center services
  • Increased formation of ASC joint ventures
• Rising challenges with payor contracting dynamics
  • Increased reimbursement for ASCs indicating push from payers towards outpatient surgeries where possible 
  • Pushback on Medicare Advantage contracts

Kelly Champney. Network Vice President of UVMHN Managed Care Contracting at The University of Vermont Health (Burlington): The current focus in healthcare from my perspective is in three main areas: barriers to care, system sustainability, and data utilization in financial negotiations. Barriers include increased prior authorizations directly limiting patient access, systemic issues for our marginalized population impacting transportation and the ability to get to appointments during business hours.  Sustainability is challenged by rising payer denial rates alongside escalating labor and supply costs, affecting revenue and investment capacity. Lastly, while payers leverage data in negotiations, hospitals must also use social and regional data to the same degree supporting negotiations and justifiable rates.

Daniel Grigg. CEO of Wallowa County Health Care District (Enterprise, Ore.): The trends we are following most closely include: 1) OB payment for small rural hospitals, 2) use of AI for revenue cycle improvement and provider documentation and 3) staffing.

All hospitals take on significant fixed costs to have OB services available 24/7. Small hospitals with fewer annual births cannot generate enough revenue to cover those fixed costs. Most do their best to subsidize the service and others are choosing to discontinue OB. There are discussions both in our state and at the federal level to provide an OB standby payment or higher OB reimbursement for small hospitals.

AI is a rapidly evolving phenomenon. We believe the most immediate benefit of AI is to help hospitals improve the revenue cycle process and to decrease the documentation burden on our providers. Monitoring that progress and knowing when those tools are mature enough and affordable are key.

Being able to recruit and retain competent, well-trained staff is the life blood of all of our organizations. It is especially challenging in small remote areas. We are learning all we can from the success of others and taking steps to ensure long term success.

Laurin Cathey. Senior Vice President and Chief Human Resources Officer of Children's Minnesota (Minneapolis): First, there is the cost of our labor as a percentage of our overall revenue. This provides valuable insights into our scheduling efficiency and the optimal utilization of support and casual staff to empower our nurses in their professional roles.

Second, we are actively tackling burnout among our clinical staff. We've invested in enhancing mental well-being at work to support our caregivers. Additionally, by embracing technological advancements and fostering a culture of continuous improvement, we aim to streamline operations, allowing our staff to focus more on patient care and less on cumbersome or redundant processes.

Third, our employees remain our most valuable asset, a principle unchanged as we prepare for the future workforce. Alongside enhancing our talent acquisition efforts, we are committed to reskilling and upskilling our current staff. This approach not only mitigates future staffing challenges but also harnesses the wealth of experience accumulated in their respective roles. Furthermore, we are exploring the strategic use of AI and automation to improve human capabilities. Leveraging these tools effectively promotes innovation which enhances staff experience and patient outcomes.

Ronald Place. President and CEO of Avera McKennan Hospital and University Health Center (Sioux Falls, S.D.): At Avera McKennan Hospital & University Health Center, we continue to monitor hospital-at-home care models, as well as the authorization of this by CMS and other payers. There is a shift happening where more and more people desire care at home, and we believe that this trend will continue. Further, we’re seeing markedly lower readmission rates and higher patient satisfaction rates from this model. While not for every patient, we’re seeing more and more patients looking for this alternative care delivery. Staying ahead is important as we strive to meet patients where they are at in their care journey.

Christopher O'Connor. CEO of Yale New Haven (Conn.) Health: Technology is evolving at a pace we’ve never seen before, and artificial intelligence is leading that trend. As a result, we are reimagining everything we do with an eye to financial stability and looking at new technologies that can help us drive increased operational efficiencies and improve care. Yale New Haven Health is deploying novel AI note-taking tools to reduce the cognitive burden for clinicians, utilizing AI on our inpatient units in tools that help flag clinical deterioration and improve our response, and automating many business processes, such as prior authorization.   

Genea Wilson, MHA. CEO of East Bay Ambulatory Market at Sutter Health (Sacramento, Calif.): I am closely following two trends in healthcare, the first is artificial intelligence and machine learning to provide diagnostics, personalized medicine, predictive analytics, and operational efficiency improvements. The second trend that I am following is value-based care which encourages healthcare organizations to transition from fee-for-service models to value based care models that prioritize patient outcomes and quality of care. 

Winnie Adams, RN, BSN, MSN. Chief Nursing Officer of Astria Sunnyside Hospital, Astria Health (Sunnyside, Wash.): Contract nurse staffing, nursing shortage and the influx of novice nurses have been my primary focus. This focus results in keeping a pulse on the organization's financial bottom line. At Astria Sunnyside Hospital we further developed a partnership with our local nursing programs which enables us to hire nurse techs that fit with our organization's mission, vision and values. We provide nurse techs with an individualized orientation program throughout their nursing journey. 

Elham Yousef, MD. Vice President and Chief Medical Office of Bayshore Medical Center, Hackensack Meridian Health (Edison, N.J.): It’s increasingly challenging to keep up with healthcare trends, but the ones I follow up closely are focused on operational stability, workforce, payer, employer, technology and equity: 

• Healthcare Sustainability: Financial and operational trends around, labor shortage, utilization optimization, elimination of variation and creation of consistent service across the organization. Also trends focused on enhancement of digital operation particularly virtual visits and at home care, quality outcomes, competition in patient experience, market growth drivers and opportunities, strategic alliance and partnerships as well as joint ventures as a revenue stream. Environmental sustainability trends focused on improving energy efficiency and reducing the environmental impact of healthcare operation. 
• Care coordination and care delivery integration models trends, including in person, virtual or remote monitoring at all healthcare settings and across continuum of care. 
• Data sharing and data interoperability trends that focus on supporting clinical workflow and enhancing care coordination. 
• Generative AI , predictive analytics trends as well as trends in automation. 
• Healthcare equity; organizational equity strategies, key initiatives, action plans, barriers, community based interventions, expansion of mental health access and services and mental health integration into primary care. 
• Value-based; patient centered outcomes, payment models, cost reduction, financial transparency, regulatory updates as well as trends in connecting payers, physicians/providers and patients to manage care delivery to meet patients needs and improve satisfaction. 
• Healthcare access, telehealth and teletherapy expansion and virtual visits tends.
• Advanced therapeutics and personalized medicine trends like genomics and precision medicine

Nick Barcellona. Chief Financial Officer of WVU Medicine (Morgantown, W.Va.): We are paying particular attention to Total Rewards expense, including the cost of benefits. The cost of medical care continues to increase, and to support our workforce, we want to ensure employees and their covered family members have access to affordable, high-quality care. One area that continues to increase is prescription drug expenses. When comparing employer costs incurred during the first quarter of 2024 to the first quarter of 2023, we see an increase of approximately 61 percent. That increase is driven by our growth, but also by increased utilization of pharmaceuticals and the rising cost of pharmacy therapeutics. That is why we are focused on managing these expenses effectively to support our organization, our employees, and their covered family members, while also staying true to our mission to improve the health trajectory of those we serve within West Virginia and beyond.

Mark Klyczek. President and CEO of Virginia Health Services (Newport News): Value-based care and top line revenue growth are the top two trends that are following. In the post-acute space there are multiple value based care opportunities emerging, especially in the state of Virginia. Virginia has prioritized value based care in skilled nursing facilities, which is the best way to reward high performing organizations and incentivize organizations to improve. There are millions of dollars available in value based purchasing, the REACH ACO, and other initiatives such as Institutional Special Needs Plans (ISNPs) where we are able to accept risk and obtain payment for quality measures. These types of programs are vital to grow our top line revenue as expense increases remain sticky and do not show any signs of improving in the short term. Our strategy of top line revenue growth has significantly mitigated the expense increases and when our expense reduction strategies take hold, our top line revenue will already be growing and healthy.

Swannie Jett, DrPH, MSc, MHA. CEO of Park DuValle Community Health Center Inc. (Louisville, Ky.): Current trends I’m monitoring are value based reimbursement, the changing landscape of insurance and how AI is impacting operations. AI in billing and operations hasn’t been fully explored and potentially will lend to challenges in healthcare.

Peter Paige, MD, MBA. Chief Clinical Officer of UVA Health (Charlottesville, Va.): Many of the trends that I am watching right now in healthcare are centered on AI, especially in the perioperative and clinical documentation spaces. As Chief Clinical Officer for UVA Health, I am responsible for investing in products to address logistical challenges we face as a large academic medical system – from tools that improve schedule optimization, realize staffing efficiencies, and develop stronger staffing plans to those that generate more actionable scorecards to evaluate the quality of patient care and improve provider and staff satisfaction. 

I am also watching AI in the clinical documentation improvement space. Opportunities abound for AI-enabled products that enhance the quality of our documentation, provide more timely feedback for patient care, and more accurately represent inpatient acuity. At their core, these tools can reduce both administrative and staffing burdens in hospital care, important factors to address staff burnout and move us forward as a best place to work, while also improving our ability to provide high-quality patient care.

Valerie Mattison Brown. Chief Strategy Officer of Veterans Health Administration (Washington, D.C.): The VA is committed to ensuring that we see as many veterans for their healthcare needs in our direct care system as possible and when not possible partner with our community partners including the DoD, academic affiliates and local hospitals in the respective markets to provide a seamless integrated care delivery approach. To assist us with navigating between VA direct care and support from our community partners we are following the current trends related to artificial intelligence and how its use can, in an ethical manner, support providers from the administrative aspects of providing care such as note taking on patient charts and perhaps scheduling.  In addition, we are looking at how indirectly artificial intelligence can support the administrative aspects associated with hiring, training and other aspects of non-direct patient care. 

Similarly, VA is exploring further employing the use of telemedicine for urgent and emergency care delivery to ensure that Veteran patients are seen thereby enhancing their access to care.  In addition, telemedicine will support that Veteran needs are addressed at the appropriate level of care.  We all managed using this modality during the pandemic and found that there were benefits to continue utilizing this care model which helps the Veteran patient obtain access to the care needed while at the same time helping the VA serve more efficiently.

Caring for patients in an environment that is safe both mentally and physically is key to meeting the demands of our Veteran patients as well as our workforce.  Ensuring that facilities are 21st Century ready facilities is important to the VA.  Specifically, we are studying trends related to facility standardization that will help focus VA on providing the right care at the right time in the right place in a designed facility that meets the Veteran needs. 

Rebecca Napier. Vice President of Finance and Administration at The University of New Mexico Health Sciences Center (Albuquerque, N.M.): In the healthcare sector, I’m closely following trends related to healthcare workforce expansion. Several key developments are shaping this area:

1. Addressing Shortages: With an aging population and increased demand for services, there’s a critical need to address shortages in healthcare professionals, especially in nursing and primary care.

2. Telehealth Integration: The integration of telehealth is transforming how healthcare is delivered, requiring a workforce adept in digital health technologies and remote patient management.

3. Educational Pathways: Innovative educational programs and accelerated pathways are being developed to quickly and effectively train new healthcare professionals. This includes expanded roles for nurse practitioners and physician assistants.

4. Workforce Well-being: There’s a growing emphasis on the mental health and well-being of healthcare workers, recognizing the need for supportive environments to prevent burnout and ensure sustainable careers.

These trends are critical as they address both immediate and long-term needs in the healthcare system, ensuring that we can meet the growing demand for services and improve patient outcomes.

Olusegun A. Ishmael, MD, MBA. Chief Operating Officer and President of Hospital Division at MetroHealth (Cleveland): The trends I am most closely following in healthcare are:

• Healthcare Technology:

In healthcare, leveraging technology is going to be crucial for improving patient outcomes, easing caregiver workloads, and optimizing our revenue cycle. Artificial intelligence stands out as a key technology that will have significant impacts in these areas. We will be leveraging AI to analyze data, identify high risk patients, processing claims and creating medical records. However, the concern I have is that these technological advancements are rapidly outpacing human evolution. So, we must create guidelines for these rapidly advancing technologies. 

• Workforce Shortages in an aging population

The workforce shortage that we are facing across many industries is impacting healthcare operations significantly. Add in an aging population, this further poses an added workforce challenge. As more individuals retire and get older, the demand for caregivers increases, emphasizing the need for proactive solutions in workforce management.

• Payment Structure

Having worked in the insurance industry, I have seen firsthand how the administrative burden of working with insurers. Issues such as the prior authorization process, claims denials, and delayed claim payment contribute to this burden. It's noteworthy that administrative costs account for 31% of healthcare expenditures.

Additionally, with the aging population, we can expect to see a rise in government-related payments, particularly Medicare and Medicare Advantage. This trend underscores the importance of addressing these administrative barriers to ensure efficient and effective healthcare delivery for all individuals.

• The Increasing Costs to Deliver Care

Cost of delivering healthcare continue to rise, according to a AHA article there has been a 17.5% increase in overall hospital expenses between 2019 and 2022. Labor expenses per patient increased by 24.7% and non-labor expenses increased by 16.6% per patient. This sheds light on the financial strain healthcare delivery systems face.

• Industry Integration, both Vertical and Horizontal

The industry is witnessing rapid integrations, both vertically and horizontally, through hospital mergers, insurer acquisitions, and technology company takeovers. This shifting landscape is reshaping business models and competitive dynamics, driving industry evolution.

Jason Lineen. Chief Strategy Officer of UVA Health (Charlottesville, Va.): As UVA Health expands, a key trend I’m watching is how other growing organizations successfully scale a common high-performance culture and develop emerging leaders that are champions of the culture we strive towards. I personally take inspiration from other industries, especially large retailers who expand from a single store to thousands of locations worldwide while maintaining a commitment to culture, product excellence, employee satisfaction and a consistent customer experience. To that end, we launched the UVA Health Leadership Institute last year and have already invested in the development of nearly 100 rising leaders throughout the organization.

Secondly, I closely follow innovative strategic partnerships and alliances forming across the country between academic and non-academic community health systems. At UVA Health, we are committed to our mission of “Transforming Health and Inspiring Hope for all Virginians and Beyond.” Our creative partnerships with hospitals and health systems statewide are powerful force multipliers to enhance access to care, expand cutting-edge clinical trials, enable greater care coordination, and positively impact population health.  

Finally, I’m perpetually trendspotting innovations to expand access to care and enhance the experience of care for patients. Our industry is confronting two daunting macro-trends: (1) rising demand for services driven by an aging generation, and (2) national shortages in many clinical disciplines. An “all hands on deck” approach to innovation is required, from piloting new models of care delivery (e.g., team based care, group visits) to telemedicine and other technology/AI-enabled solutions. As an industry, we need to be much more nimble as we pilot and test potential solutions, “fail fast” and end projects that don’t demonstrate results, and rapidly scale and replicate innovations that achieve the desired results.