Becker's Hospital Review

19 THOUGHT LEADERSHIP erosion in pediatric care quality. During financial strain, children's hospitals too oen become "smoothing errors" in the broader system's accounting. is issue is personal for me. As the father of a child with a neurological condition, I've witnessed firsthand the superior quality and advocacy provided by independent children's hospitals like Akron Children's. From faster procedures to stronger insurance advocacy and child-centered care, these institutions consistently go beyond the expected. As the industry faces mounting fiscal pressure, I urge leaders to resist the easy button of consolidation. Protecting independent pediatric systems isn't just about financial stewardship, it's about preserving access, quality, and the well-being of our future: the children. David Marcozzi, MD. Chief Clinical Officer of University of Maryland Medical Center; Associate Dean of Clinical Affairs of University of Maryland School of Medicine (Baltimore): Over the next few years, hospitals will face even greater margin compression amid rising service demand and acuity. oughtful consolidation can improve payer negotiating position, align market-competitive salaries, and enable consistent standards of high-quality care through a unified EMR and automated clinical practice guidelines. Moving patients to the right setting at the right time and ensuring frictionless handoffs to outpatient care — 'systemness' could become an operating and financial advantage. e outcome, if successful: higher reliability at scale with lower unit cost. Imran Qadeer, MD. President and CEO of Allegheny General Hospital (Pittsburgh): In this environment, financial sustainability requires greater scale or an extremely favorable patient mix, and the latter is difficult for hospitals to achieve in aging, slow-growth states like Pennsylvania. With patients shiing into government-sponsored insurance programs in ever-greater numbers and healthcare expenses continuing to grow, hospitals will continue to explore mergers and affiliations as a matter of survival. e kinds of technological, capital and personnel investments required to keep acute-care facilities afloat in a competitive healthcare landscape will be increasingly inaccessible for independent hospitals or small systems, especially as insurers themselves continue to consolidate and pursue value-based and risk-based contractual arrangements. Hospitals will also continue to eye strategic affiliations with regional and national health insurers — here in Pennsylvania, for example, Highmark Health and others have demonstrated that innovative relationships between payers and providers can benefit both parties. Cody Walker. President of Baptist Health Medical Center – North Little Rock (Ark.): M&A will reach an all-time high. Independent hospitals and health systems alike will seek to enhance their ability to weather the cost-to-revenue mismatch. Consolidation with a focus on systemness can lead to new operational synergies and, in some cases, a more integrated approach to patient care and community needs. Rural healthcare will be in the spotlight due to recent federal legislation. Successful systems will focus on leveraging these consolidations and will be experts at navigating the complexities of integration. At Baptist Health, serving smaller communities and ensuring their needs are met is integral to our culture and will remain a primary focus in the years to come. Dani Hackner, MD, MBA. Senior Vice President and Chief Clinical and Academic Officer at Southcoast Health System (New Bedford, Mass.): At Southcoast Health, a health system not consolidated with large, national systems, we have seen the benefits of integration regionally. Bringing our system together under one medical staff and one medical executive committee with one board has reduced practice variation. Deploying system clinical and operational leadership supporting sites across the system from hospitals to cancer centers to urgent care to ambulatory care has enhanced continuity, consistency, and operational efficiency. With a robust information technology framework meeting Level 10 CHIME criteria and recognized analytics, we have been able to drive hardwired care and improved safety. Sharing patients and care, working with academic and community systems, partnering with schools and colleges, or supporting chambers of commerce and local businesses does not require endless consolidation. Increasingly, at Southcoast Health, we are asking ourselves how we can work better with those who we serve as well as those who compete with us. It is a broader pie vision of health that goes beyond zero- sum gains. We recognize that consolidation has shown few signs of slowing and that in the coming 3-4 years some small systems will survive through consolidation. At Southcoast, our approach will be to sustain a journey of both integration and regional focus, a journey of affiliation and collaboration, and a journey to thrive and support communities across southeastern Massachusetts. Chad Konchak. System Assistant Vice President of Data Analytics at Endeavor Health (Evanston, Ill.): Hospital consolidation will continue, although the focus and pace will evolve. Financial pressures and economies of scale, particularly as it relates to bargaining power with the increasingly strong payers, along with shis in care delivery away from the hospital setting and regulatory and payment changes will all continue to drive fewer and larger health systems. e increasing investment required for advanced technologies, including AI, may present a significant financial hurdle for smaller, independent facilities, potentially making partnerships or integration more attractive. ese new technologies could allow new entrants to shake up the healthcare market, accelerating the pace of consolidation, with larger health systems having the resources to invest in and implement these technologies at scale, ultimately enhancing the quality and efficiency of care delivery for their patients. Airica Powell-Steed, MBA, RN. Interim Executive Vice President and Chief Operating Officer of Loretto Hospital Network (Chicago): Over the next three to four years, I definitely see hospital consolidation continuing, but the real question will be why organizations choose to come together. e future is not about getting bigger, it's about getting better and more connected to the people we serve. As we shi toward keeping communities well and out of the hospital, the demand for inpatient beds will continue to decline, while the need for innovative, comprehensive ambulatory and community-based care models will rise. is evolution will push leaders to pursue more strategic, mission- aligned consolidations and partnerships that extend beyond traditional brick-and-mortar systems. e organizations that thrive will be those that choose to strategically integrate with purpose while aligning scale, health equity, and innovation to truly transform outcomes and create healthy communities. Molly Biwer. Chief Marketing Officer of Emory Healthcare (Atlanta): e next few years will bring continued transformation across healthcare — whether that takes the form of consolidation, collaboration, or new delivery models. But at Emory Healthcare, our perspective is clear: the conversation begins and ends with the patient. Every strategic decision we make is rooted in how it will improve the experience, access, and outcomes for those we serve. While market dynamics may drive

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