Health system CEOs have no shortage of priorities heading into 2027. Medicaid funding reductions, affordability pressures, workforce needs, changing patient needs and new approaches to care delivery are all shaping their agendas. Across those priorities, leaders are balancing the fundamentals with what comes next. Or as one CEO put it: a world of “yes, and.”
“For us, that means we can’t simply work harder within the same model. We have to redesign it,” said Andrew Mueller, MD, CEO of Portland-based MaineHealth.
Becker’s asked health system CEOs what they are prioritizing heading into 2027 and why. In their responses, Dr. Mueller and the leaders of Meritus Health, Temple Health, Asante and Aspirus Health described priorities ranging from care redesign and genomics to physician recruitment and culture. Several said the harder work will be putting those plans into practice.
Patient affordability has become a growing pressure point for health systems, and Dr. Mueller said MaineHealth’s priority is transforming how it delivers care to make it more affordable while improving quality, access and the experience of patients and care teams. He pointed to an aging population that needs more care, new therapies and precision medicine that carry both promise and cost, and public and private resources that are increasingly constrained.
The system’s strategic plan focuses on redesigning care delivery so patients receive care in the right setting, better aligning the economic model with the outcomes it wants to achieve, using data and technology to build what he called greater system intelligence, and removing friction so care teams can spend more time with patients.
“The challenge in 2027 will be moving from strategy to execution,” Dr. Mueller said. “That requires making choices about where and how care is delivered, using technology thoughtfully, simplifying how our organization works and, importantly, engaging the people closest to the work in designing what comes next.”
He is not the only CEO focused on closing the gap between strategy and execution. Dr. Mueller said cost is only part of the equation.
“The goal isn’t simply to reduce expense,” he said. “It’s to build a model of care that is sustainable for the long term and allows us to continue improving the health of the communities we serve.”
For Temple Health and Asante, the 2027 agenda includes preparing for Medicaid funding reductions under HR 1. Temple is planning around an expected 45% reduction in supplemental Medicaid payments, while Asante expects a substantial reduction in Medicaid funding. Grandfathered Medicaid state-directed payments are scheduled to begin phasing down in 2028.
Abhi Rastogi, president and CEO of Philadelphia-based Temple Health, said the system’s response to an expected 45% reduction in supplemental Medicaid payments centers on two areas: continuing its strategic revenue growth by expanding access points and growing its workforce, and prioritizing operational innovation.
“A major part of these efforts is investing in automated workflows that make it easier for patients to get the care they need, and more efficient for our teams to deliver that care,” Mr. Rastogi said.
Tom Gessel, president and CEO of Medford, Ore.-based Asante, said 2027 will bring significant implementation of HR 1 and a substantial reduction in Medicaid funding.
“As a safety-net health system serving a predominately rural region of the state, we will need to operate efficiently, reducing administrative costs while prioritizing resources at the bedside,” he said.
Efficiency has come up often among health system leaders this year. Mr. Gessel described operating discipline as table stakes for responding to funding cuts and inflation, particularly in Oregon, which he said already over-regulates hospitals with unfunded mandates.
Asante also plans to improve access in areas of rising patient demand, including primary care, imaging and surgery, and to keep recruiting physicians and advanced practice providers. Mr. Gessel said the system had a record recruitment year in 2025 and is on the same track in 2026.
“This recruitment momentum needs to continue in 2027 across most specialties to meet the clinical needs of our region,” he said.
Mr. Gessel said “the voice of our physicians and clinicians will be invaluable to discern trade-offs in an increasingly resource-constrained operating environment.” Asante Medical Group, which has around 400 members, now has a physician CEO and a board made up predominantly of clinicians.
Some CEOs are adding to their agendas even as resources tighten. Maulik Joshi, DrPH, president and CEO of Hagerstown, Md.-based Meritus Health, said improving quality and reducing costs remain “job one.” In what he called “the world of ‘yes, and,'” Meritus is adding a major strategy in 2027 with the launch of the Meritus Personal Health Institute.
“We believe genomics at scale is going to become an increasingly important part of how healthcare is delivered and health will be impacted in a population,” Dr. Joshi said.
Genomics already plays a role in areas such as rare diseases, pediatrics and oncology, he said, but Meritus intends to apply it as a population health platform. The institute aims to provide genetic screening, advanced labs, select imaging, and physical and cognitive assessments to more than 10,000 people in the community, for both research and clinical intervention.
“The challenge will not simply be doing the testing. It will be building the clinical workflows, infrastructure, workforce and follow-up necessary to turn information into action,” Dr. Joshi said. “For us, 2027 is about beginning to demonstrate that precision health and genomics can be delivered at community scale and can ultimately improve both health outcomes and the value of care for a population of thousands of people.”
For Matt Heywood, president and CEO of Wausau, Wis.-based Aspirus Health, the 2027 priority is culture, which he called “the organizational strength that has carried Aspirus Health through every hard stretch.” Other CEOs have also leaned on culture to retain leaders.
“The forces impacting healthcare are intensifying. Reimbursement is tightening, regulation is expanding, and society is more negative and polarized,” Mr. Heywood said.
He said reinforcing a culture that anticipates those challenges will help team members see what is coming, adjust quickly, make hard calls and execute rigorously.
“We call that foresight, flexibility, fortitude and follow-through,” he said. “Those four capabilities are rooted in a strong culture, and they help us effectively advance our strategy and deliver positive impact for the benefit of the communities that depend on us.”
