Hospital and health system CEOs are leading organizations through growth and adaptation to meet the demands of an evolving healthcare landscape. Amid these efforts, 13 healthcare executives shared their thoughts on healthcare strategy with Becker's, addressing topics ranging from financial challenges to partnerships with community organizations and other healthcare institutions.
Below is a sampling of insights obtained from CEOs throughout the past year, representing systems with national footprints and critical access hospitals serving local communities.
Financial challenges
1. Multiple CEOs cited inflationary pressures and rising operational costs as significant challenges for 2025, mirroring trends from 2024. These include increasing costs of medical supplies and pharmaceuticals, as well as costs associated with telehealth services.
2. Rising staffing costs remain a challenge, particularly for rural hospitals. Holly McCormack, DNP, RN, CEO of Cottage Hospital, a 35-bed independent, nonprofit critical access hospital in Woodsville, N.H., told Becker's her organization is preparing to address this by starting internal travel contracts with per diem staff.
"Employing our own staff in these per diem contracts helps us to know and be familiar with the people who will be working for us, maintain a level of quality and still meet the demands of the workforce," Dr. McCormack said.
3. CEOs also pointed to stagnant reimbursements as a pressing concern.
"The denials are getting more and more acute and significant, to the point where we have almost 11% of our expected reimbursement lost to denials, and I think that's going to continue to be a big issue for us," Ketul Patel, CEO of Tacoma, Wash.-based Virginia Mason Franciscan Health, told Becker's. "We believe we're very strong partners to our payers, and we are very transparent with them about some of the issues, but we need to see that level of partnership the other way."
Capital investments
1. Multiple CEOs emphasized investing in technology to improve care. For example, Denver Health acquired a Da Vinci robot to assist in surgery and invested in ambient listening to allow physicians to have more face-to-face time with patients. And the University of Alabama at Birmingham Health System is allocating $380 million to transition to an Epic EHR system.
2. Leaders also highlighted infrastructure projects, including improvements to facilities, as mentioned by the CEOs of Denver Health and Cottage Hospital. The Ohio State University Wexner Medical Center in Columbus is building a new 1.9 million-square-foot hospital tower and a 200,000-square-foot ambulatory site, both of which are set to open in 2026, CEO John Warner, MD, told Becker's.
3. At least one CEO mentioned focusing capital investments and operating costs toward patient care. To accomplish this, Falls Church, Va.-based Inova Health has intentionally "closed our accelerator, closed our investment arm, dropped our drug discovery program — a number of these other things that were 'revenue diversification,'" President and CEO Stephen Jones, MD, said.
Mergers and acquisitions
1. Some CEOs are focusing on their organization's existing facilities rather than pursuing large-scale transactions. As Dr. Jones of Inova Health put it, "We are not big fans of the concept that big is automatically better."
2. Others, including UAB Health, are focused on integrating newly acquired facilities. UAB Health acquired Ascension St. Vincent's Health System on Nov. 1, adding five hospitals and 19 ambulatory locations. CEO Dawn Bulgarella said the acquisition meets the system's need for additional beds, operating rooms and emergency departments while aligning operationally and culturally.
3. Maryland's reimbursement model adds complexity to M&A strategies, said Theodore DeWeese, MD, CEO of Baltimore-based Johns Hopkins Medicine. However, the system is exploring opportunities to expand its missions and bring care closer to home "through a portfolio of new builds and partnership — working with like-minded organizations and clinicians who share our passion for quality health care and our culture of collaboration," Dr. DeWeese said.
Outpatient and ambulatory care
1. CEOs are prioritizing care access through outpatient expansion. For instance, Fairfield, Calif.-based NorthBay Health is investing more than $250 million over the next five years in its ambulatory strategy, including the construction of neighborhood clinics, President and CEO Mark Behl told Becker's.
2. Denver Health, a safety-net health system led by Donna Lynne, DrPH, is poised to receive a financial boost after Denver voters approved Ballot Issue 2Q. The measure increases the city's sales tax rate by 0.34%, generating up to $70 million annually to support Denver Health's mission. Dr. Lynne told Becker's that with the Ballot Issue 2Q money, the health system will add to primary care, pediatric care and dental care. She noted this may mean expanding existing clinics or adding clinics over the next two years.
3. Minneapolis-based Children's Minnesota has more than a dozen ambulatory locations — primary, specialty, rehab and ambulatory surgery — throughout the 11-county Twin Cities area. CEO Marc Gorelick, MD, told Becker's as the organization continues to grow its market share, it is largely focused on "better using the ambulatory footprint we already have to increase access, while also pursuing additional opportunities to partner with other health systems in the community to expand our reach."
Employee retention
1. CEOs highlighted the importance of creating a supportive workplace culture. Many told Becker's their organizations strive to be a place where employees want to stay.
"We are working to bring the joy back to medicine by creating a culture where everyone can thrive, whether it's by easing the administrative burden that clinicians face or offering greater flexibility for front-line workers," Dr. DeWeese of Johns Hopkins said.
2. Some organizations have invested in technology to support their workforce, such as Paramus, N.J.-based Bergen New Bridge Medical Center. President and CEO Deborah Visconi told Becker's the system has boosted retention by implementing an app that allows registered nurses, certified nursing assistants and other employees to pick individual shifts rather than adhere to traditional schedules. The hospital plans to expand this functionality to include social workers, respiratory therapists, physical therapists and radiology technologists, Ms. Visconi said.
3. Multiple CEOs noted a desire to fairly compensate workers. Matt Heywood, president and CEO of Wausau, Wis.-based Aspirus Health, said: "We're going to treat people fairly [with respect to compensation]. And I think that comfort in honesty and transparency, in the world we have today, is welcomed."
Strategic partnerships
1. CEOs highlighted partnership as essential for addressing social determinants of health, including those with community organizations and other healthcare institutions. Gaithersburg, Md.-based Adventist HealthCare collaborates with competitor hospitals on community health needs assessments, CEO John Sackett said. Johns Hopkins Medicine partners with other health systems to bring "uniquely differentiated care to markets often adjacent to core service areas" Dr. DeWeese added.
Maywood, Ill.-based Loyola Medicine partners with organizations such as food pantries and mental health providers through the West Cook Coalition to address complex challenges and improve patient care, President and CEO Shawn Vincent told Becker's.
2. Partnerships vary by organization and address different issues. For example, Cottage Hospital provides ancillary services that a nearby federally qualified health center may need, while the health center serves as a referral option for the hospital's discharged patients who choose not to use the hospital's rural health center. Children's Minnesota collaborates with community organizations to sponsor a gun-buyback program.
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