Top executives at the AHA Leadership Summit are emphasizing action to push through the uncertainty of the current climate.
At the AHA Leadership Summit in Nashville, the message from hospital and health system CEOs is undeniable: healthcare transformation is no longer optional or theoretical—it must happen now.
With financial strain, shifting care expectations, and major policy reform converging, industry leaders urged action over caution in the face of an uncertain and evolving environment.
"There's no better time than right now," Marty Bonick, president and CEO of Ardent Health, said on day two of the three-day event. "This is not just headwinds, this is ingredients for transformation."
OBBBA brings pressure and opportunity
One of the biggest drivers of urgency is the One Big Beautiful Bill Act (OBBBA), a sweeping legislative package that poses major challenges for providers by cutting Medicaid funding, increasing administrative burden, and expanding performance-based payment requirements. While full implementation is still ahead, CEOs made it clear the industry is already bracing for its impact.
Laura Kaiser, president and CEO of SSM Health, said leaders have a responsibility to anticipate OBBBA's implications. She described the legislation as fundamentally different from prior reform efforts and emphasized the need for proactive communication and clarity.
She also called the bill a valuable chance to rethink care models and public health priorities. The bill is a great opportunity for hospital decision-makers to lean forward, but the question is how? Kaiser's recommendation to fellow CEOs is to move with "purposeful urgency."
Innovation can't wait for policy
Eugene Woods, president and CEO of Atrium Health, challenged the tendency of health systems to wait for optimal policy conditions before taking action, but noted: "There's not going to be a savior in terms of policy or reimbursement model."
He argued that leaders must make forward-looking bets today or risk falling behind. Woods shared that Atrium, for example, is currently piloting artificial intelligence to support rural facilities, enabling greater access to care regardless of location.
If hospital executives aren't spending at least 50% of their time on bets for the future, they're doing the industry a disservice, according to Woods.
Redefining the center of care
Wright Lassiter III, CEO of CommonSpirit Health, highlighted that many organizations have delayed necessary transformation. However, economic pressures aren't going to ease anytime soon and the urgency to evolve has never been greater.
Hospitals must stop treating what happens within their four walls as the hub of healthcare delivery and instead shift toward broader community-focused models, Woods argued. The mindset of slow, incremental change must also be replaced.
"We need to rid our organizations of incrementalism," Woods said, using ambient listening technology as an example of how systems often overthink innovation and take baby steps towards solutions. "We have to presume we're in a sprint, not in a marathon."
Collaboration over blame
Bonick emphasized that innovation also requires a mindset shift, not only toward embracing technology, but also toward collaborating across the healthcare ecosystem.
He posed a critical question for health systems: What do patients want as customers? He acknowledged that return on investment may not come right away with certain innovations, but said the long-term payoff is worth the leap.
He also pushed back on the blame game between providers, payers, and pharmaceutical companies. Every group is under the microscope, and with policy changes impacting the entire industry, it's counterproductive for providers to point fingers at payers or pharma.
"It's incumbent upon us as leaders, as a total system, to work together," Bonick said.
Stay tuned for more AHA Leadership Summit coverage.
The nonprofits are pursuing consolidation with the aim of expanding access, scaling innovation, and strengthening financial resilience.
ChristianaCare and Virtua Health are exploring a potential merger that could create a nonprofit health system spanning four states and more than 600 care locations.
The two organizations signed a non-binding letter of intent to co-found a new regional system with more than $6 billion in combined annual revenue and nearly 30,000 employees.
The proposed partnership would join Delaware-based ChristianaCare, an academic health system consisting of three hospitals and a wide network of primary care and outpatient services, with New Jersey’s Virtua Health, which includes five hospitals, two freestanding emergency departments, and 42 ambulatory surgery centers. If finalized, the merger could span 10 contiguous counties across New Jersey, Delaware, Pennsylvania, and Maryland.
“We are excited to take this bold step to double down on our mission, multiply our excellence and ensure our legacy of high-quality care in our local communities for generations to come,” Janice Nevin, president and CEO of ChristianaCare, said in the announcement.
Neither health system appears to be pursuing a merger due to financial distress. In its most recent earnings report, ChristianaCare posted $3.1 billion in total operating revenues for the year ended June 30, 2024.
Virtua Health also reported robust earnings, recording $3.2 billion in revenue for the year ended Dec. 31, 2024.
The unified system would prioritize urgent and primary care access, behavioral health, and a proposed maternal risk management program covering 15,000 births annually, according to the news release.
“We see this as a unique opportunity to shape the future of care in this region with innovation and intention,” Dennis Pullin, Virtua Health’s president and CEO, said in a statement. “Together, we aim to create an integrated regional health system built on human connection, clinical excellence and a deep commitment to all people in the communities we serve.”
The potential merger between Virtua Health and ChristianaCare could better position the combined system to navigate growing uncertainty around Medicaid policy and reimbursement.
Both organizations draw a substantial portion of their net patient revenue from public payers, especially Medicaid, and scaling up could provide the operational cushion and negotiating power needed to withstand future funding cuts. In 2024, ChristianaCare brought in an estimated $400 million in net patient revenue from Medicaid, accounting for roughly 16% of its total.
Virtua Health, meanwhile, derived approximately $672 million from Medicare and Medicaid combined, making up 21% of its total patient service revenue. That financial exposure makes the policy environment a critical factor in strategic planning for both systems.
“Our vision for this new health system – when Medicare and Medicaid are facing cuts and many hospitals are struggling to stay open – gives me hope and excitement for our future and for the health of our neighbors,” George Foutrakis, chair of the ChristianaCare’s board of directors, said in a statement.
The organizations will begin due diligence and work toward final agreements and regulatory approval, with patient care and day-to-day operations continuing as usual in the meantime.
Hospital CEOs must proactively address areas where trust may be lagging within their organization and communities to ensure they can deliver care and operate effectively.
Public confidence in physicians and hospitals has recently plummeted, driven by perceptions of profit motivation, politicized messaging, and frustrating care experiences.
In the latest installment of HealthLeaders' The Winning Edge series, Glencoe Regional Health CEO Ben Davis and Vernon Health CEO David Hartberg share how they're rebuilding public trust by first identifying specific trust gaps and then implementing clear, plain-language communication, expanded access to care, and internal culture strengthening to foster both staff and patient confidence.
Two hospital leaders share methods to quantitatively and qualitatively understand where your organization is falling short with trust among patients and staff.
Without first identifying trust gaps, hospital CEOs can’t begin to rebuild their organization’s reputation or restore public confidence.
In HealthLeaders’ The Winning Edge for Rebuilding Patient and Public Trust, Vernon Health CEO David Hartberg and Glencoe Regional Health CEO Ben Davis highlighted strategies providers can utilize to detect breakdowns in trust within their organization and communities they serve.
From combatting misinformation to reaching as many patients as possible, these hospital leaders are working to repair their communities' confidence in healthcare.
Trust in providers has eroded in recent years and hospital CEOs are seeing the effects across their organizations. The pandemic may have sparked the decline, but misinformation, politicization, and access disparities have kept the issue front and center.
In HealthLeaders'The Winning Edge for Rebuilding Patient and Public Trust this week, Glencoe Regional Health CEO Ben Davis and Vernon Health CEO David Hartberg shared how they're addressing the challenge through strategies spanning internal culture, community engagement, and operational transparency.
Here are four approaches CEOs are using to restore confidence in their institutions:
Identify trust gaps
Before rebuilding trust, hospital leaders must first recognize where and why it's broken.
Davis and Hartberg emphasized the importance of listening, both formally and informally, to detect early signs of distrust within your organization and in your communities.
Feedback from conversations with staff, patients, civic groups, local influencers, and public forums can surface concerns not captured quantitatively.
"I asked 'who are the informal leaders that are in the community that might not show up on a list somewhere, but they had a large influence?'" Hartberg said. "I was trying to establish those relationships so that I could be seen as a connection from Vernon Health out into the community and vice versa."
Hospital leaders can also utilize data-driven indicators like patient experience surveys, employee engagement scores, and market share shifts to systematically pinpoint trends in satisfaction, morale, and quality.
While trust is not easily measurable, the combination of data-driven insights with human-centered listening can allow CEOs to proactively identify trust gaps and tailor their strategies to address them.
Simplify transparency
Transparency is essential to creating an environment of trust, but too much technical detail can overwhelm patients, which means CEOs must work to strike the right balance with communicating complex medical information.
Davis and Hartberg both acknowledged the importance of simplification to clearly and effectively convey the full message.
"We want to look like the smooth gliding duck on the top of the water," Hartberg said. "They're already dealing with lots of things as patients. They're dealing with pain and confusion and frustration over what's going on in their life."
Leaders should engage in selective public messaging to avoid alarming their community, while also training their staff on communication techniques like AIDET (Acknowledge, Introduce, Duration, Explanation, Thank You) to make patients feel comfortable.
Using plain language to explain technology and procedures is another way to communicate without overwhelming patients. Hartberg shared an example of a physician at his organization explaining ambient AI listening to a patient by saying, "'I've got my robot friend here… it's going to help me keep track of what we're talking about.'" The plain-language approach helped the patient feel at ease without diving into technical jargon.
Expand access to care
How providers communicate with patients is vital, but that can only happen if they meet them where they are. Without providing necessary access to care, reducing barriers, and reaching underserved populations, organizations risk losing credibility.
"You can't let access slide," Davis said. "That's key to keeping trust within the community—that you have access to the services your communities are depending on you for."
One way both Glencoe Regional Health and Vernon Health have strived for that is through primary care expansion by hiring providers to improve availability. Additionally, Vernon Health is adding a psychiatrist and licensed social worker to meet rising behavioral health needs.
Meanwhile, Glencoe Regional Health has deployed on-site interpreters and bilingual providers to serve its Hispanic population.
Addressing health literacy and social determinants of health like food insecurity also allow organizations to better serve populations.
"We're trying to explore food pantries in our clinics and work with some area high schools to create some food pantries out into the communities," Hartberg said.
Strengthen internal culture
Though public perception often dominates the conversation around trust, hospital CEOs increasingly recognize that rebuilding it starts within their own walls.
A strong internal culture, defined by shared values, psychological safety, and frontline engagement, is not only essential for staff morale, but also directly influences patient experience and community perception.
"We can't be the provider of choice if we're not the employer of choice," Davis said.
To achieve that, Hartberg and Davis emphasized the importance of involving frontline staff in decision-making. Whether it's redesigning workflows, shaping patient experience initiatives, or contributing to strategic planning, staff engagement fosters ownership and trust.
Recognition can also be a powerful tool for reinforcing culture. Hartberg shared how he publicly celebrated a team's emergency care success after receiving a heartfelt call from a former community member. Sharing these stories internally helps staff see the impact of their work and strengthens their connection to the mission.
By investing in internal culture, hospital leaders are laying the foundation for rebuilding trust externally.
Davis said: "It's having great people doing great work caring for our community."
Providers can't just sit back and wait for their credibility to be restored—they need to proactively build it back themselves.
Public trust in healthcare and particularly in providers took a major hit during the COVID-19 pandemic—and it hasn't fully recovered.
Misinformation, inconsistent communication, and widening disparities in access to care have left many communities questioning not just the system, but the institutions at the center of it.
Now, hospital and health system CEOs shoulder responsibility that extends past the management of their organizations—they must rebuild the credibility and confidence that are foundational to delivering quality care.
The stakes are high
Trust in physicians and hospitals plummeted over the course of the pandemic, from 71.5% in April 2020 to 40.1% in January 2024, according to a survey study published in JAMA Network Open. Lower levels of trust mean a lesser likelihood that the public pursues vaccinations or seeks out care, which can lead to worse outcomes and a sicker population.
Not only does that go against providers' mission of caring for their communities, a decrease in utilization of services also threatens the financial viability of hospitals. Public perception can impact everything from patient volumes to payer relationships and philanthropic support. In this sense, trust is even a revenue issue.
Meanwhile, regulatory scrutiny continues to amp up with lawmakers demanding more transparency around pricing, quality, and equity. Trust and compliance are converging, putting more onus on hospital CEOs to treat transparency as a strategic asset and not just a requirement.
Though much of the focus will be external, one critical element of trust can't be overlooked: its impact on the workforce. If frontline staff like nurses and physicians feel ignored, unsafe, or undervalued, it reverberates directly into patient experience and public perception.
Change starts at the top
The path forward for hospital and health system CEOs cannot be paved without restoring the reputation of providers and their essential role in aiding and maintaining the well-being of communities.
The next webinar in our The Winning Edge series will explore what it takes for hospital leaders to restore that trust, both within their walls and throughout the population they serve. For CEOs, this effort goes beyond a PR initiative—it directly impacts patient outcomes, staff morale, and long-term sustainability.
Our distinguished panel includes:
David Hartberg, administrator and CEO of Vernon Memorial Healthcare, and HealthLeaders Exchange member
Ben Davis, president and CEO of Glencoe Health, and HealthLeaders Exchange member
Jay Asser, event moderator and HealthLeaders CEO editor
This isn't just another webinar—it's your chance to learn from the best in the business and walk away with strategies you can implement immediately.
Join us as we face the problems, share solutions, and help you rebuild trust in your organization and in providers at large.
Register here to reserve your spot and see what other topics we have coming up.
Are you a CEO interested in attending our event and strategizing with other attendees? To inquire about attending the HealthLeaders Exchange event, email us at exchange@healthleadersmedia.com.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Hospital leaders from across the country will convene in Nashville to share best practices for navigating change in an ever-evolving landscape.
Healthcare continues to face significant economic and regulatory change, forcing hospital decision-makers to strategically adjust to meet the demands of a shifting industry.
For hospital and health system CEOs, the stakes have arguably never been higher for solving workforce challenges, ensuring financial stability, and delivering better care.
At this year'sAHA Leadership Summit in Nashville from July 20-22, CEOs and a range of other C-suite executives will get together to discuss innovative approaches to the most prominent pain points facing providers.
Redesigning the workforce
Among their staff, CEOs are confronting persistent burnout, labor shortages, and cultural fatigue, all of which directly impact clinical quality, safety, and the patient experience.
The Summit will spotlight talent retention strategies, workforce transformation, and leadership-led culture resets, with focus on engaging clinicians and rebuilding morale. A featured session, "7 Minutes to Innovation: Care Model and Workforce Redesign," will delve into how new models are reshaping workforce challenges and offer actionable steps for building sustainable care teams.
Rebuilding public trust
In the post-pandemic era, CEOs must also contend with eroded public trust and growing skepticism, both within their organizations and from the communities they serve. The Summit will feature conversations on transparency, internal trust-building, and equity as a leadership imperative.
One of the sessions, "Building Public Trust and Confidence in Health Care," will feature executives guiding fellow leaders on evaluating their current practices, recognizing strengths and gaps, and effectively communicating their hospital's story.
Revamping financial models
There's no shortage of financial pressures pressing down on hospitals and health systems, creating a difficult environment to operate within. Margin compression, inflation, and evolving reimbursement models are forcing tough decisions at every level.
Hear from leaders in "Building High-Performing Organizations: Strategies for Sustainable Operations," in which panelists will share how their organizations have overcome financial challenges with cost-effective strategies that maintain quality.
Rethinking care delivery
The harsh reality is that traditional healthcare models are no longer viable, whether for today or tomorrow. Care delivery must evolve to drive meaningful change for everyone involved, from patients to providers.
The panel "Designing the Future of Care Delivery" will explore how leaders can balance incremental improvements with transformation to enhance access, affordability, and equity in care delivery, while confronting what that means for the future of healthcare organizations.
HealthLeaders will be in Nashville to deliver on-the-ground coverage and real-time insights from the frontlines of the Summit. Stay tuned for more coverage.
Nonprofit hospitals are particularly under duress to remain financially viable, says Novant Health’s COO.
As hospitals and health systems face unprecedented financial pressures, Novant Health executive vice president and COO John Gizdic recognizes that innovative cost-containment measures aren’t a luxury, but a necessity for long-term sustainability.
From skyrocketing labor expenses and inflation to increasingly acute patients and rising pharmaceutical prices, nonprofits like North Carolina-based Novant Health are strained to do more with less, all while remaining committed to the mission of serving every single patient.
“Throughout all of those challenges, we’re also investing in our community’s health infrastructure and really serving as that safety net,” Gizdic told HealthLeaders. “So having that additional factor of making sure we’re here for our community has contributed as well.”
Gizdic’s assessment is backed by new data from Emory University’s Rollins School of Public Health, which shows hospital expenses per adjusted admission rose nearly 40% between 2013 and 2021. The study found steep increases in payroll (31.3%), pharmaceutical spending (42.2%), and other operational expenses (53%) during that time. Labor alone made up 56% of total hospital costs by 2024, and rising case complexity contributed to financial burden.
Nonprofits, meanwhile, experienced a faster rise in per-admission costs than for-profit hospitals by 2021, with nonprofits exceeding for-profit costs by approximately $1,287.
Rethinking care delivery
To counteract rising expenses, Novant Health is reengineering how and where care is delivered by prioritizing lower-cost, higher-convenience ambulatory settings.
“We’ve really tried to approach it from several different ways, one of which is trying to really reimagine care delivery and focus on an aggressive shift to lower-cost ambulatory settings,” Gizdic said. “Whether it’s ambulatory surgery centers, outpatient imaging centers, even outpatient infusion centers, as well as care at home.”
The organization has set a goal to double its ambulatory surgery centers in the next three to five years, Gizdic stated.
This strategy is also a hedge against potential policy shifts, including federal site-neutral payment proposals that would reduce or eliminate reimbursement differentials between hospital-based outpatient departments and independent sites of care.
“By really moving care towards that ambulatory setting and having those alternative sites of care when and where clinically appropriate, we believe that better prepares us for things like site neutrality and certificate of need and other regulatory changes that may be coming,” Gizdic said.
Complementing the outpatient shift is a commitment to clinical excellence.
“By improving safety and quality, it reduces clinical variation and improves outcomes. In the end, that lowers cost of care,” Gizdic said, noting Novant Health leads North Carolina in A’s for the Leapfrog Hospital Safety Grade and ranks among the top in Vizient’s quality database.
Pictured: John Gizdic, executive vice president and COO, Novant Health.
Supporting the workforce
Gizdic knows that any long-term cost strategy must include workforce sustainability. The Emory study reinforces that, citing a 15% increase in case mix severity and an 11% rise in full-time equivalent (FTE) employees per hospital bed from 2013 to 2021. Higher FTEs correlated with increased costs per admission.
“Our number one expense in healthcare is labor,” Gizdic said. “We are people taking care of people. Creating an environment that people want to come to and stay is going to help reduce that labor expense and reduce turnover.”
To combat burnout and turnover, Novant Health has made employee well-being a board-level goal. The system solicits staff input and is exploring offering concierge perks like dry cleaning, meal delivery, and on-site car maintenance. It also invests heavily in leadership development and career pathways.
“People don’t typically leave organizations—they leave their leader,” Gizdic said. “Working with them on that career path… creates retention and helps us develop their skills for roles that are hard to recruit for.”
Impactful medication management
Going forward, Gizdic sees opportunity in preventative and value-based models of care, particularly around chronic disease management. Novant Health’s Mediful program, which is part of MedVenta Health Solutions, launched last year and offers patients free consultations with pharmacists, is delivering clinical and financial results.
“Eighty percent of the more than 15,000 patients we had as part of the Mediful program saw a reduction in their out-of-pocket expense for their medication,” he said. “Even better, on average, those patients enrolled that are diabetics saw their A1C level lowered by over 2%. So we're not only seeing a financial impact, we're seeing a clinical impact as well.”
These outcomes echo the findings of the Emory study, which indicate that hospitals will need to move toward prevention and tailored interventions to solve for the financial constraints of high-complexity populations.
With the healthcare landscape continuing to shift, Gizdic is focused on ensuring Novant Health can adapt without straying from its mission
"We know patients want more access, they want more convenient access,” he said. “We have it in every other aspect of our life—why not healthcare?"
The industry has, for the most part, withstood the economic challenges that have plagued job growth in other sectors.
Healthcare employment remains a consistent engine of growth in the broader economy, even as signs point to a cooling labor market across other industries.
The healthcare sector added 39,200 jobs in June, accounting for more than a quarter of total gains across all industries last month, according to the latest report from the Bureau of Labor Statistics. That figure is slightly below the 12-month average of 43,000 and a steep decline from the 62,200 jobs added in May, but it reinforces the trend that healthcare continues to outpace many other sectors in hiring demand.
Persistent workforce needs across the continuum of care were reflected in hospitals, ambulatory care, and nursing and residential care facilities leading the way for growth in June.
Hospitals added 16,100 jobs while ambulatory healthcare services contributed 8,700 jobs. Within ambulatory care, physician offices accounted for 3,800 jobs and home healthcare services chipped in 2,800 jobs.
Nursing and residential care’s growth of 14,400 jobs was driven by skilled nursing care facilities delivering 6,800 jobs and continuing care retirement communities and assisted living facilities for the elderly supplying 5,500 jobs.
Across all industries, the U.S. added 147,000 jobs last month, in line with the monthly gain of 146,000 over the past year and a modest jump from the 139,000 added in May.
The unemployment rate, meanwhile, was at 4.1% in June, compared to 4.2% in May, and has remained between 4% and 4.2% since May 2024.
Though the overall job growth and unemployment rate show that the labor market is holding firm, increases in healthcare and state and local government education are covering up for downturn in other sectors.
Federal government, for example, lost 7,000 jobs last month and has seen employment fall by 69,000 since hitting a peak in January. Jobs also dwindled in professional and business services—a white-collar sector—and manufacturing, which each shed 7,000 jobs as well.
Healthcare may be doing well, especially relative to other industries, but it isn’t completely immune to market conditions.
Many hospitals and health systems have taken action to cut labor expenses by instituting hiring freezes and layoffs. Vanderbilt University Medical Center was one of those organizations in June, when it announced it would lay off up to 650 employees as it worked to reduce costs by $300 million.
Martha Henley is striving to build on Unity Medical Center's reputation for delivering a top-notch experience.
In this episode of HL Shorts, Unity Medical Center CEO and Java Medical Group COO Martha Henley shares how doing the little things can go a long way for delivering a high-quality patient experience.
