Becker's Hospital Review

20 THOUGHT LEADERSHIP integration, our focus is on purpose — not size. We will pursue relationships that create meaningful value for patients, caregivers, and communities — whether through shared innovation, expanded access, or the seamless coordination of care. Ultimately, our growth is defined not by how many hospitals we have, but by how effectively we meet the needs of every patient who entrusts us with their health. Darrell Bodnar. CIO of North Country Healthcare (Flagstaff, Ariz.): Over the next three to four years, I believe hospital consolidation will accelerate, driven largely by the financial and regulatory ripple effects of leadership changes in Washington. e policy shis we're seeing, combined with tightening reimbursement models, inflationary pressures, and mounting compliance costs, are creating a level of financial headwind that many standalone hospitals, particularly rural and community- based systems will struggle to sustain. As these pressures intensify, we'll see not only more hospital mergers but also the absorption of smaller clinics and FQHCs into larger health systems as a survival strategy. Mary Martin. COO of Duke University Hospital (Durham, N.C.): Given the current financial headwinds, hospital consolidation will continue over the next few years. Additionally, I believe healthcare systems will expand partnerships and ownership of retail pharmacies, AI companies, and other healthcare-adjacent industries to diversify revenue streams. Providing efficient care while lowering cost will be the primary focus of all healthcare service providers for the foreseeable future. We must not, however, sacrifice the quality of this care nor divest in the critical funding of research to advance medical science. Michele Szkolnicki, RN. Senior Vice President and Chief Nursing Officer of Penn State Health Milton S. Hershey Medical Center: As a hospital nursing executive in a health system that is early in its "systemization" journey, I find that the shi toward systematization is more than operational; it's deeply cultural. e challenge isn't just aligning processes or standardizing care models, but also about navigating the human side of change. Nurses, leaders, and frontline teams are being asked to think beyond their individual sites and embrace a broader identity, one that prioritizes shared goals over local traditions. at's a significant mindset shi, and it doesn't happen overnight. One of the most tangible opportunities my organization has to support this shi is our current journey to convert our EHR to Epic. at transition is forcing us to take a hard look at how we do things across our hospital. We are examining our policies, workflows, and documentation standards; and asking what needs to be consistent across the board. In planning that system, we're implementing technology as well as streamlining and aligning practice. It's a catalyst for change that supports the broader goal of becoming a more cohesive, high-functioning system. But even with that momentum, the real work lies in how we lead this transition through clear communication, thoughtful engagement, and a steady hand through the discomfort of transformation. It has been reported that hospital consolidations are expected to accelerate over the next three to four years, driven by financial pressures, workforce challenges, and the need for greater operational efficiency. In response to the question, "What's your outlook on hospital consolidation over the next three to four years?" I believe we'll see a continued trend toward mergers and strategic affiliations, particularly among smaller hospitals seeking stability and access to broader resources. However, this consolidation must be approached thoughtfully to preserve community access, maintain quality of care, and ensure that nursing leadership remains deeply involved in decision-making during these transitions. Nariman Heshmati, MD. Chief Physician and Operations Executive at Lee Physician Group (Fort Myers, Fla.): I believe we will see more and more regional hospital consolidation in the next three to four years. Reimbursement continues to be challenging and the economies of scale in regional systems allow resource allocation in a sustainable manner for success. Complex IT systems are needed for quality reporting and value-based care, more AI enabled technologies are available to improve care delivery but at a cost, and adequate scale is important to be successful. All of this is difficult to accomplish in a stand-alone hospital but more feasible with regional consolidation of several hospitals so I believe the market dynamics will continue to favor that consolidation. On the other hand, perhaps because of the continued regional nuances of healthcare delivery, national consolidation approaches have been less successful and may not advance as much as regional consolidation. D. Richelle Heldwein. Chief Risk and Compliance Officer of St Johns Health (Jackson, Wyo.): St. John's Health is an independent community hospital with local governance, and we have worked hard to maintain that status over the years. As a community hospital facing strong financial headwinds, we are working to ensure that our strategic plan focuses on our core services and our continued financial viability. e quality of care that we provide is critical for maintaining community support. at community support is also key to maintaining our independent status moving forward. Our hospital CEO Jeff Sollis has renewed our commitment to keeping our quality healthcare mission focused on local community needs. is is a timely topic for Becker's to address, and it was addressed by our CEO in our local paper recently as well. See local article here: Jackson Hole News and Guide-Keep It Local James Mladucky. Vice President of Design and Construction at Indiana University Health (Indianapolis): e economic realities of healthcare will continue to drive consolidation as health systems face shrinking margins, rising costs, and workforce challenges that make it harder to sustain operations independently. Consolidation allows hospitals to achieve the scale needed to operate efficiently, share resources, and deliver high-quality, affordable care through value-based care models. Looking ahead, smaller and rural hospitals may join larger systems, gaining critical financial stability, access to resources, and support for maintaining local services – helping communities continue to receive care close to home. Academic health centers will remain uniquely positioned, leveraging patient care, education, and research to drive innovation and long-term efficiencies. Damon Blankenbaker. Workplace Violence and Public Safety Manager of Integris Health (Oklahoma City): My time in healthcare has been relatively short compared to my 30 years in law enforcement and behavioral threat assessment, but it's been long enough to see how consolidation creates both opportunity and risk to our patients and caregivers. When I joined Integris Health in 2021, the system had already begun expanding and consolidating hospitals across Oklahoma. Since then, we've continued to grow, by adding two more rural hospitals. at expansion and consolidation have brought real challenges, especially around violence prevention, caregiver safety, and behavioral risk management. Every merger has brought with it challenges by introducing new cultures and expectations. I believe hospital consolidation will

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