From the top of OSF Healthcare's organizational flow chart, Sister Judith Ann Duvall oversees a $5 billion not-for-profit enterprise that includes seven hospitals and medical centers. Ostensibly, Sister Judith Ann's role puts her among the ranks of healthcare executives increasingly concerned about cutting costs, finding efficiencies, and Medicare reimbursement rates. Except for her—and the Sisters of the Third Order who own and operate OSF Healthcare—health care is first, and foremost, "a sacred ministry."