Becker's Hospital Review

14 THOUGHT LEADERSHIP Top health system leaders' outlook for the next era of consolidation By Mariah Muhammad B ecker's asked C-suite executives from hospitals, health systems, academic medical centers and universities across the U.S. to share their outlook on the future of hospital consolidation. e 68 executives featured in this article are all speaking at the Becker's Healthcare 16th Annual Meeting, from April 13-16, 2026 at the Hyatt Regency Chicago. As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. e following are answers from our speakers at the event. Question: What's your outlook on hospital consolidation over the next three to four years? Pete November. CEO of Ochsner Health (New Orleans): As we approach the cuts outlined in the One Big Beautiful Bill Act for 2028, I believe consolidation will accelerate because organizations may not be prepared to handle these changes, making scale increasingly more important as hospital systems adapt. When executed effectively, consolidation has the potential to enhance quality, improve patient experiences and deliver better financial results. However, history is full of examples of poorly executed transactions, highlighting the critical challenge for healthcare organizations to plan and implement consolidations successfully. John D. Couris. President and CEO of Tampa General Hospital (Fla.): I believe that hospital consolidation will continue, but to what extent will vary region to region across the United States. e same will be true for health systems and physician groups as they continue to focus not only on cost containment, revenue generation and clinical integration, but work to increase scale, diversify services, enhance payer relationships, expand ambulatory care and invest more heavily in digital health. But I'd like to take this question and push it a bit further. e traditional consolidation strategy among hospitals and health systems is increasingly outdated. e assumption that larger systems inherently deliver better care is flawed — size does not equate to quality. Instead, value creation for the consumer — defined as the patient, payer and employer — must be the central focus. Numerous studies have shown that consolidation tends to increase costs without corresponding gains in care quality (Levins, 2023). In fact, as health systems grow, they oen become more expensive, and the anticipated efficiencies or improvements in outcomes rarely materialize (Hulver, 2024). is disconnect suggests we are operating within an antiquated paradigm. It's time to rethink the status quo and embrace innovative models that prioritize affordability, access and measurable improvements in patient outcomes. Health systems and health system leaders must ask: How can we deliver higher-quality care at lower cost — and share that value with the consumer? e future of healthcare depends on answering that question with bold, consumer-centric solutions. Nkem Chukwumerije, MD, MPH. President and Executive Medical Director of e Southeast Permanente Medical Group (Oakland, Calif.): Major health systems throughout the country have been expanding their influence for years by acquiring smaller hospitals. Financial pressures on smaller hospital systems are a primary driver of this trend, oen resulting in partnerships with larger, more profitable organizations. roughout these transitions, it's essential to keep quality, patient-centered care at the forefront while maintaining affordability for individuals and families. Leong Koh, MD. Executive Medical Director of Northwest Permanente (Oakland, Calif.): e outlook on hospital consolidation for the next three to four years is mixed. On the one hand, many hospitals, including a growing number in suburban and urban areas, are still struggling with rising operational costs and staffing shortages following the pandemic. On the other, some financially stable health systems are acquiring other hospitals to expand into new markets. Larger health systems are looking beyond traditional hospital mergers to acquire outpatient facilities, such as ambulatory surgery centers, urgent care centers, and physician practices. However, ongoing uncertainty in the economy and changes in federal policy are likely to result in a lower number of hospital mergers than the 72 transactions reported in 2024. Stephen Parodi, MD. Executive Vice President of External Affairs, Communications and Brand at e Permanente Federation (Oakland, Calif.): Rising costs, staff shortages, and increasing patient needs continue to challenge the health care industry's existing approach to care. Economic pressures have driven hospital consolidation, and I do not see those abating any time soon. We need to search for true solutions and modern innovations that can address the changes we are seeing in population demographics and a new health care workforce. Delivering more care into homes through team-based approaches that address social, mental, and physical health will be a critical move necessitated by these emerging realities. Part of this strategy is providing advanced care at home, a setting where patients feel more comfortable and empowered to address some more complex medical conditions. Working together across the continuum of cases, these programs must scale so we can address the real-world challenges of overcrowded emergency departments and communities where hospital bed capacity is insufficient. We will need clinician expertise, regulatory reforms, and significant innovation to address the acute care needs of the U.S. population. Jochen Reiser, MD, PhD. President and Professor of John Sealy School of Medicine, and John D. Stobo, MD Distinguished Chair, e University of Texas Medical Branch; CEO of UTMB Health (Galveston, Texas): e pace of hospital consolidation has slowed but will continue over the next few years. is will continue as a function of economic pressure on smaller institutions that lack the resilience necessary to withstand increasing consolidation in the market and increased competition from unconventional and non-traditional sources. Established systems will focus on integration to leverage scale and look to expand new sources of revenue. Peter Pronovost, MD, PhD. Chief Quality and Clinical Transformation Officer and President of UH Veale Healthcare Transformation Institute (Cleveland): Hospital consolidation will increase in the coming years, but for different reasons than in the past. Historically, mergers were driven by the desire to expand market share and negotiate higher prices, oen without improving value. Neither quality nor total cost of care improved. Many systems operated independently, lacking the

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