The way health systems are organized is being tested as reimbursement, workforce and technology pressures reshape what it takes to succeed. Leaders are rethinking how their organizations are built, not just what they deliver.
Becker’s asked CEOs, CFOs and other leaders from hospitals, health systems and academic medical centers across the U.S. how they expect their organization’s structure to evolve to support sustained success.
Every executive featured in this article will speak on panels at Becker’s 14th Annual CEO + CFO Roundtable, taking place November 2-5, 2026, in Chicago. Attendees will have the opportunity to hear these and other health system leaders discuss the challenges shaping strategy for the year ahead, from financial sustainability and workforce retention to AI governance and rural healthcare access.
Registration is open now for the 14th Annual CEO + CFO Roundtable. Register here to secure your spot and join the conversation with the executives featured below.
If you would like to join as a speaker or a reviewer, please contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com.
For more information on sponsorship opportunities, please contact Jessica Cole at jcole@beckershealthcare.com.
Question: How will your organizational structure evolve for sustained success through 2030?
Bob Riney. President and CEO of Henry Ford Health (Detroit): By 2030, we expect our organizational structure to continue evolving to support a more integrated, agile, and expanded health system. As healthcare becomes increasingly complex, success will depend on our ability to align care delivery, health plan capabilities, physician partnerships, digital technologies, and community resources around a shared goal of improving health outcomes, enhancing the patient experience, and making care more affordable.
Our focus is on creating a structure that enables faster decision-making, clearer accountability, and greater coordination across the enterprise. We will continue to standardize functions where scale improves quality, efficiency, and affordability, while maintaining the local leadership and responsiveness necessary to meet the needs of the communities we serve. We anticipate leveraging technology, analytics, automation, and artificial intelligence to redesign work where possible and better support our workforce, allowing team members to focus more of their time on activities that create value for patients and consumers. We will also remain open to strategic partnerships that enhance capabilities, expand access, and strengthen our ability to fulfill our mission.
Ultimately, the measure of success will be delivering better health, a better care experience, and greater affordability for the people and communities we serve. Our structure will continue to evolve to support those outcomes while ensuring Henry Ford Health remains strong, innovative, and sustainable for the long term.
Michael Wagner, MD. President and CEO of Care New England Health System (Providence, R.I.): Three organizational changes will matter as we continue our success over the next four years.
1. Clinicians as true partners in running the clinical enterprise. We will keep empowering our physicians, advanced practice clinicians, and all of our clinicians to help drive the enterprise. As a physician, I believe the people who understand the moment of care should have a paramount voice in how we lead. Many organizations call themselves patient- and clinician-centric, then lose that focus in the growing complexity of healthcare management. Structure should bring us back to that moment and the two people in it, the patient and the clinician.
2. A digitally driven organization. We have already become much more digitally sophisticated. We’ve adopted tools that help clinicians do their jobs and give patients a more frictionless experience. Staying on that path will take continued structural change: how the board engages with digital strategy, how we allocate resources, and how digital capability shows up in our organizational design.
3. A bigger role in bending the cost curve. Health systems are often the largest employers in their communities, and rising healthcare costs affect us just as they affect every other employer. Our structures need to give more time and attention to identifying the drivers of cost and the sources of waste. The aim is better patient experience and higher quality at lower cost. This requires dedicated attention of the executive management team and board.
These three priorities will help shape how we organize ourselves through 2030.
Ric Ransom. CEO of University of Missouri Health Care (Columbia): The Mizzou School of Medicine and MU Health Care have navigated several organizational changes in recent years that position us well for the foreseeable future. We’ve embraced a triad model for business unit oversight in both our ambulatory and inpatient settings, and we’ve streamlined leadership layers to keep decision-making close to the work. I don’t anticipate structural changes that would affect the core of our teaching, research and patient care missions. But I do expect the pressures on health systems to keep compounding, and it’s our job as leaders to keep asking how we can be more effective and efficient.
For academic health systems, ‘form follows function’ is the right guide when evaluating organizational structure. The functions we see evolving fastest are ambulatory care, information technology, and finance and revenue cycle. On top of that, patients increasingly expect a simple, coordinated experience, and that expectation is shaping how we organize. Billing is a good example: a patient seeking care shouldn’t have to work with multiple teams to manage an account, and a centrally managed approach is better for patients and more efficient.
Academic systems also have to organize shared services like HR, IT, finance, communications and strategy across the clinical and academic enterprises, so we meet the needs of a complex organization without duplicating resources. Keeping our structure aligned to function is how we stay positioned for sustained success.
Conor Delaney, MD, PhD. President of Cleveland Clinic Florida: In Florida, Cleveland Clinic’s continued expansion in Palm Beach County represents an important next step in meeting the healthcare needs of a rapidly growing community and supporting sustainable growth across our region. Building on our presence in the community, we are expanding our footprint with a comprehensive outpatient center and new hospital in West Palm Beach, bringing our clinical expertise, research and innovation closer to patients and families in the region. Equally important, this next phase of growth strengthens our ability to recruit exceptional caregivers and support a more coordinated and connected care experience across our South Florida and Treasure Coast hospitals. By leveraging the scale and collaboration of an integrated health system, we will be well positioned to meet the region’s healthcare needs for years to come.
Jeffrey P. Gold, MD. President of University of Nebraska System (Lincoln): The healthcare organizations that succeed through 2030 will be those structured to respond to change while remaining grounded in their mission, accessible, affordable high quality care. That flexibility starts with recruiting and retaining exceptional talent, bringing together the right people in the right roles to build strong teams, and investing in the resources and opportunities that allow these talented individuals to succeed.
In an academic health system, flexibility also comes from strong clinical, education, research and innovation enterprises and opportunities for people to collaborate across disciplines. At the University of Nebraska Medical Center, being part of a comprehensive university gives us the chance to connect exceptional clinicians and researchers with expertise in fields such as engineering, agriculture and data science, while a myriad of public-private partnerships further expand those connections and create new opportunities.
The strength of those teams and relationships allows us to respond to changing needs and take advantage of emerging technologies. Artificial intelligence is a good example, as realizing its potential in healthcare requires the right people and partnerships to identify where it can meaningfully support high quality clinical and administrative work and improve how we deliver care without diminishing the human touch.
Sustained success will depend on organizational structures that bring out the best in people, strengthen collaboration and create the flexibility to respond to change while maintaining an unwavering focus on the highest levels of quality, safety, access and the patient experience.
Bradley C. Bond. CFO of University Hospitals (Cleveland): The healthcare landscape is evolving rapidly, driven by policy changes, consumer expectations and emerging technologies. As care continues to shift from inpatient to outpatient settings, and as patients gain greater access to price transparency and AI tools that help with consumer choice, health systems must compete on quality, affordability and convenience.
To position University Hospitals for sustained success, we are evolving our organizational structure and investment strategy in three key ways. First, we are accelerating investment in ambulatory and outpatient care, bringing services closer to where patients live and work while expanding access to high-quality, lower-cost care settings. Second, we are leveraging human-centered AI across the enterprise, not only to improve operational efficiency, but also to enhance patient navigation, access and the overall consumer experience. Finally, we are optimizing our care delivery platform to ensure patients receive the right care, in the right place, at the right time, creating a more seamless, efficient and patient-centered healthcare experience.
Ultimately, our focus is on building a more agile organization that can adapt to ongoing market changes while delivering exceptional clinical outcomes, improving affordability and expanding access for the communities we serve.
Shane Strum. President and CEO of Broward Health (Fort Lauderdale, Fla.); President and CEO of Memorial Healthcare System: I think the organizational structure of the future is less about trying to bring everything under one roof and more about creating ways for strong health systems to work together around the needs of patients. We are already seeing what that can look like through collaboration. In pediatrics, Broward Health’s affiliation with Nicklaus Children’s Health System and Memorial Healthcare System’s Joe DiMaggio Children’s Hospital bring tremendous expertise to Broward County. Rather than looking at those organizations and capabilities in isolation, we are finding opportunities for physicians and health systems to work together around a shared goal: keeping more children close to home for the specialized care they need.
That same philosophy is at the heart of Better Together. Broward Health and Memorial remain two strong, independent public health systems, but we are looking across both organizations and across Broward County to identify gaps, reduce unnecessary duplication and determine where collaboration can expand access and improve care. As we look toward 2030, success will not be about every organization trying to do everything on its own. It will be about understanding what each health system does best, connecting those strengths and building an organizational structure that supports greater collaboration while keeping patients at the center of every decision.
Roberta Schwartz, PhD. Executive Vice President of Houston Methodist Hospital; Chief Innovation Officer of Houston Methodist: As we look toward 2030, I expect our organizational structure to become more agile, interdisciplinary and technology-enabled, while remaining firmly centered on patients. Our goal is to empower clinicians and create balance in their lives using technology that reduces administrative burden, improves decision-making and allows them to spend more time focused on patient care using technologies such as ambient voice, AI identification and summarization of conditions and telemedicine to augment weekend or night shifts or areas with occasional and non-predictable physician needs.
We also want to empower our patients with technologies that allow for control over time and care, personalizing care using technologies such as agentic AI for scheduling; the ability to ask questions of your record; having passive monitoring using remote devices; and being able to go to a physician in person or online. At the same time, strong governance and accountability will remain essential to ensuring innovation delivers measurable value and supports our mission. Ultimately, our success will depend on maintaining the culture we’ve worked so hard to establish where every employee is empowered to innovate, adapt and contribute to the future of health care.
Jandel Allen-Davis, MD. President and CEO of Craig Hospital (Englewood, Colo.): We are executing a significant capital expansion that will enable us to serve more patients with traumatic or acquired spinal cord and brain injuries, more quickly. As we scale our rehabilitation bed capacity, we are also launching a new service line for patients who are not yet ready to participate fully in four to six hours of rehabilitation per day, allowing us to manage complications and address other physiologic issues tied to their injury. Our research team will occupy dedicated space in our first Human Movement Lab, working alongside clinicians and research scientists to advance our translational research program and strengthen the field of neurorehabilitation and neurorecovery. At the same time, we are investing strategically in leadership development, equipping our teams to grow their capabilities, while evaluating how new business and operational capabilities enabled by AI can position us to adapt, learn, and respond to a rapidly shifting social, economic, and geopolitical landscape. Anchored in our mission, this ‘reimagining the possible’ sharpens our ability to shape our future.
Matthew Fry. President and CEO of Freeman Health System (Joplin, Mo.): As healthcare continues to evolve, agility will be critical to long-term success. At Freeman, we’re creating a more connected organization with a streamlined leadership model that empowers teams, increases transparency, and aligns everyone around a shared vision. As a rural health system, we must leverage technology, develop great leaders, and use our resources wisely to expand access and improve care across the region. Healthcare is a team sport, and our role as leaders is to provide the tools, autonomy, and support our teams need to succeed. If we do that well, we’ll be positioned to serve our communities for generations to come.
Christine Schuster, RN. President and CEO of Emerson Health (Concord, Mass.): Through 2030, Emerson Health’s organizational structure will evolve to strengthen our financial sustainability, expand access to care, and preserve the local decision-making that defines us as an independent community health system. We are aligning leadership responsibilities more closely across operations, workforce planning, financial performance, and business development so that decisions reflect both patient needs and available resources. That includes clearer accountability for productivity, staffing, and service-line performance, with clinical and administrative leaders jointly responsible for results.
We will also strengthen coordination among Emerson Hospital, Emerson Practice Associates, and our community physicians to improve access and the patient experience across settings. Our affiliation with Mass General Brigham and other strategic partnerships will continue to extend our capabilities and bring advanced care closer to home.
As technology and AI become more integral to care delivery and administration, we will embed oversight into our leadership and governance structure, focusing on quality, measurable value, and responsible adoption. These changes will be supported by succession planning and leadership development to sustain the collaborative, patient-centered culture that makes Emerson successful.
Chuck Porth. CEO of Uncompahgre Medical Center (Norwood, Colo.): We are investigating the expanded use of fractional staff to obtain expertise as opposed to the continued use of traditional full and part-time employees. Increasingly, we must ‘grow our own’ content experts e.g. compliance, and the use of this type of arrangement to provide mentorship has proven successful. We are also increasingly asking how much time some of our administrative positions spend working at tasks at the top of their license. If it’s less than full-time, we’re asking if that skill set can be obtained with a fractional staffing arrangement.
Haroon Ansari. CEO of Pinnacle Hospital (Crown Point, Ind.): I think going forward and with the help of AI, many admin tasks will require people with multi job understanding and cross fit qualifications.
For instance, integration of patient financial services , accounting, billing, insurance contracting, and purchasing may actually be administered through consolidation of these functions into one integrated department as reimbursements get tighter and expenses are increasing in several areas for operations by almost 12 to 15 percent per year. Relying on AI tools to administer hospital functions will require on demand intelligence data to make decisions on service lines Maintenance and continued development to keep up with the changing technology and innovations for clinical treatment.
Additionally, cross trained RNs will be required including MAs to cover clinic and surgical space requirements. NPs will need to be trained for various sub specialty physicians where supply / demand issues will become more critical in meeting community needs in both economically deprived urban locations and for extremely rural markets.
Nancie Trueman. Market CEO of Kindred Hospitals of Chicago, ScionHealth: One thing I’ve learned in leadership is that organizational structure only works when the people within it are connected, empowered, and working toward the same goals. As we look forward to 2030, I believe our structure will need to become even more flexible and collaborative, with fewer silos between clinical, operational, and business development teams. Leading multiple hospitals has reinforced for me how important it is to develop strong leaders at every level and give them the ability to make decisions closer to where the work is actually happening. Technology and data will continue to play a larger role, but I believe they should support our people, not replace the relationships, experience, and judgment that are so important in healthcare. We also have to continue strengthening partnerships across the healthcare continuum and remain willing to adapt as the needs of our patients, partners, and communities change. Ultimately, sustained success through 2030 will come down to having the right people, clear accountability, strong partnerships, and a structure that allows us to move quickly while keeping patients at the center of every decision.
Jim Andrews. President and CEO of Deborah Heart and Lung Center (Browns Mills, N.J.): By 2030, Deborah will reframe how a healthcare organizational model should look and operate by branding a People Centered Organization model to drive the necessary changes our industry must undertake to evolve. Today, we are documenting our journey from the traditional hierarchy structure toward a circular organizational model that truly puts the patient at the center of everything we do. Our model revolutionizes the matrixed department/service line structures bogging down decision making and features interconnected care rings that bring clinical and operational expertise together to address all of the needs of the people we serve.
These care rings reduce silos, strengthen collaboration, and create clearer accountability for outcomes across our heart and vascular and pulmonary enterprises. This structure is supported through a common foundation of high reliability, process improvement, effective communication, issue resolution, and leadership development for sustainability and reinforcement of our leaders’ role as facilitators of resources, expertise, communication, and decision-making. While the market continues to think bigger is better, we are leaning into our independent/concierge care model to create nimbleness as an advantage, empowering teams to solve problems more quickly while maintaining strong accountability for quality, safety, financial sustainability, and growth. Ultimately, by 2030, we want Deborah to not only provide people-centered care, but to be organized in a way that visibly and consistently reflects the people-centered organization we have been for more than a century.
Scott Polenz. Market CEO of OakLeaf Surgical Hospital (Altoona, Wis.): Very simply, no AI. I just took over and there were trust issues within leadership, staff, the board, and physicians. So our number one priority is not structural changes but good old fashioned trust building with presence, being authentic, empathy, and logical decision making and communications. Nothing else will make a difference if we don’t build trust and alignment.
Denise Chadwick Wright. CEO of Birmingham Green (Va.): As Birmingham Green approaches its 100th anniversary in 2027, my priority over the next four years is to further strengthen our organizational structure, building upon the foundation that has served us for nearly a century and positioning Birmingham Green to thrive for the next 100 years. This means evolving toward a more integrated and agile leadership structure, with clearer accountability, stronger collaboration across departments and communities, and shared responsibility for strategic priorities and organizational outcomes.
We must develop the next generation of leaders through succession planning, professional development, and greater opportunities for staff to contribute to organizational improvement. Our structure must also support emerging priorities, including technology integration, innovative care models, and future campus development, by ensuring the right expertise and leadership capabilities are in place. We are strengthening our performance management approach to create greater alignment between organizational goals, measurable outcomes, and continuous improvement.
Financial stewardship and operational efficiency will remain essential as we balance innovation with the responsibility of sustaining our nonprofit mission. Ultimately, our goal is to build an organization whose leadership, systems, and culture are strong enough to adapt to changing needs while preserving the dignity and compassionate care that have defined Birmingham Green for nearly a century.
Martha Henley. CEO of Unity Medical Center (Manchester, Tenn.): For most of its history, Unity’s world mostly ended at its own walls. That will not be true for the Unity of 2030. Our structure is shifting from a hospital that tries to do everything itself to one that is deliberate about what we build, what we share and who we build it with. Academic partners are at the center of that. Working with our high schools, colleges and technical programs is how we grow the nurses, techs and leaders who will run this place, because in a small town your next director is often still sitting in a classroom down the road. Technology is the other side of it.
Through our partnership with Ascension for telecardiology, along with tele neurology, our ER and inpatient teams have specialists at the bedside when they need them. That lets us keep patients here at home without compromising their care. Our work alongside community organizations stretches what one independent hospital can do even further. Inside our walls, we will stay lean, with leaders who carry real responsibility and spend real time on the floor. And we will grow, but on purpose. Coffee County and the communities around us are changing, and our job is to understand where that growth is headed and be ready to meet it.
Unity will look different in 2030, but it will still feel like home, and every family we serve will know we grew right alongside their needs.
Arsenial Runion. CEO of East Liberty Health Care Center (Pittsburgh): Through 2030, East Liberty Family Health Care Center will continue evolving its organizational structure to ensure long-term sustainability, operational efficiency, and high-quality, patient-centered care. Our strategy will focus on strengthening executive leadership, developing internal talent, and implementing a succession planning framework that ensures continuity across all levels of the organization. We will further align our clinical, operational, and administrative functions to improve accountability, enhance productivity, and maximize financial performance. As healthcare reimbursement models and federal funding priorities continue to shift, we will prioritize revenue diversification, strategic partnerships, and the expansion of financially sustainable service lines. Investments in technology, workforce development, and data-driven decision-making will strengthen our ability to respond to changing community needs. We will also enhance board governance and leadership oversight to support transparency, organizational accountability, and strategic growth. Ultimately, our goal is to establish a resilient, adaptable, and financially sound organization positioned to expand access to comprehensive healthcare services while remaining true to our mission of serving vulnerable and underserved populations.
Zachary Yoder, RN. President of St. Mary Medical Center, Holy Family Medical Center and St. Luke Medical Center, OSF HealthCare (Peoria, Ill.): Our organizational structure will continue to evolve toward a more integrated market model that enables us to operate as one connected ecosystem rather than three individual hospitals. We will strengthen market-level leadership and accountability while maintaining strong local leadership at each hospital to ensure decisions remain close to the communities we serve. Shared resources and centralized services will allow us to leverage scale, improve efficiency, and reduce duplication across the market. This will include greater integration of clinical support, workforce resources, operational expertise, technology, and other key services.
We will continue developing shared workforce models, including local float pools, to provide greater flexibility and capacity across all three hospitals. Our hospitals will increasingly function as a coordinated network, improving transfers and access between hospitals, ambulatory sites, primary care, specialty care, and diagnostics. This integrated approach will allow us to keep more patients within our market while providing the right care, in the right setting, at the right time. Ultimately, our goal is to create a sustainable organizational structure that combines local presence with system-level scale, strengthens financial and operational performance, and positions the market for continued growth through 2030.
Arthur Gianelli. President and Chief Transformation Officer of One Brooklyn Health (N.Y.): One Brooklyn Health is, by history and by design, a traditional safety-net health system. We are inpatient dominant. We carry a large specialty footprint, fed in great measure by active emergency departments. And we operate some of the largest long-term care facilities in Brooklyn. That structure served Central and East Brooklyn for generations. It will not serve them well through 2030.
By the end of the decade, OBH will be an ambulatory-forward health system. The front door will be digital as often as it is physical, so patients can find us, schedule, and be seen without first passing through an emergency room. We will expand outpatient services and open new locations closer to where our patients live. Behind them will stand a smaller, leaner, highly efficient inpatient platform, reserved for patients who truly need a hospital bed. Around all of it, we are building support services that connect patients to food, housing, and other resources, because in our neighborhoods, the health of our residents is often decided at their kitchen tables. And for older and disabled residents, we will offer real alternatives to institutional long-term care, including video visits and other health services that let people remain at home.
None of this is easy for a system with safety-net margins. Yet the greater risk is standing still, keeping a hospital-centered structure while care moves decisively beyond the hospital walls.
Margaret Dimond, PhD. President of UM Health Regional Network (Ann Arbor): Healthcare faces numerous challenges and headwinds in the next few years and the University of Michigan Health Regional Network has been working for some time to address them.
Workforce retention is essential as we address a fluctuating job market and compete with many other industries to fill positions. We are committed to enhancing our workplace and improving the well-being of our team members. We are taking proactive actions to address the impact of federal and insurance reimbursement cuts on our revenue cycle. And we are implementing financial efficiencies in our supply chain to take advantage of our system approach. We also are prioritizing cost reductions and increased efficiencies…outpatient surgical throughput as an example. The cost vs. net revenue returns are much better that the inpatient operative environment Also, efficiencies and staffing flexibility are paramount.
David Burmeister, DO. President of Jefferson Medical Group; Associate Chief Physician Executive of Jefferson Health (Philadelphia): Jefferson Health is a large, multi-state healthcare delivery system, and our success is reliant on operational agility and strong, unified standards of excellence. Our organizational structure continues to evolve toward greater clinical integration and systemness across the enterprise. As healthcare becomes increasingly complex, our focus is on aligning physicians, advanced practice clinicians, operational leaders, and care teams around a shared strategy, common standards, and coordinated accountability for quality, access and patient experience.
The Jefferson Medical Group plays a central role in this transformation by creating a unified clinical infrastructure that supports high-performing ambulatory and inpatient care across diverse markets. Rather than operating as a collection of individual entities, we are building an integrated health system that leverages scale, shared expertise, and standardized processes while preserving local engagement, transformation, and innovation. To achieve this, we have created a regional physician and operational dyad leadership structure to manage local clinical operations while maintaining a focus on organizational unity. These leadership roles connect through a centralized leadership structure which works to support and manage continued integration throughout the medical group.
This approach positions us to consistently improve outcomes, enhance patient access, and create a sustainable platform for growth through the end of the decade. Our dedication to integration will allow Jefferson Health to enjoy sustained success while providing excellent care for the communities we serve.
Mark G. Moseley, MD. President of USF Tampa General Physicians; Executive Vice President, Tampa General Hospital (Fla.): Through 2030, our organizational structure must remain grounded in our shared purpose, vision, and values while building the agility needed to navigate an increasingly disruptive environment. Healthcare and academic medicine are being reshaped by powerful forces; artificial intelligence, changing reimbursement models, and significant regulatory and policy shifts. These changes are occurring simultaneously and at an accelerating pace. Success will depend less on preserving any particular organizational structure and more on strengthening our adaptive capacity to absorb change.
We will need to remain disciplined about our priorities, resist distraction, empower the people closest to the work, and maintain clear accountability across the organization. Our greatest strength in healthcare is our people. As the pace of change accelerates, our responsibility is to provide the clarity, support, and stability they need to remain focused on what matters most and continue serving others at the highest level. The goal is not change for its own sake, but to create an environment where our teams can adapt, stay aligned around shared priorities, and execute our mission effectively. Organizations endure not because they avoid change, but because they help the people doing the work adapt to it and thrive amid uncertainty.
Kurt Forsyth. President of Delta Community Hospital and Fillmore Community Hospital (Utah), Intermountain Health: As the leader of two critical access hospitals, I’ve seen the value of Intermountain Health’s shared services model firsthand. By centralizing specialized expertise while keeping it accessible to hospitals, clinics, and providers across multiple states, we can deliver consistent, high-quality care while remaining responsive to local community needs.
Looking toward 2030 and beyond, I expect this model to continue strengthening quality outcomes, patient experience, and operational efficiency. While I do not anticipate significant changes to our individual hospital structures, we are finding success in aligning leadership roles across multiple locations and service lines. This approach creates opportunities for leaders to take on broader responsibilities, increases engagement at all levels, accelerates process improvement efforts, and supports long-term financial sustainability. Ultimately, it allows us to do more for the communities we serve while maintaining the local focus that is so important in rural healthcare.
Timothy Layman, DNP, MSN, RN. President and Chief Administrative Officer of St. Mary’s Hospital, Hospital Sisters Health System (Decatur, Ill.): From the St. Mary’s Hospital perspective, I would frame the evolution of our organizational structure through 2030 around greater accountability, operational agility, technology-enabled care, and leadership development, while preserving the local leadership and clinical relationships that distinguish a community hospital.
Through 2030, I see St. Mary’s evolving toward a more agile, integrated, and data-driven organizational structure that strengthens local decision-making while leveraging the scale, resources, and capabilities of the broader HSHS system. Technology will also fundamentally influence our structure. As we expand our use of artificial intelligence, predictive analytics, virtual care, and clinical intelligence capabilities, we will need stronger integration across clinical operations, information technology, finance, and quality. The objective is to embed these capabilities into everyday operations rather than create isolated initiatives that do not translate into measurable value.
Operationally, I anticipate greater emphasis on interdisciplinary teams, standardized processes, centralized expertise where scale adds value, and local accountability where proximity to patients, physicians, and staff matters most. We must also align our workforce and service-line structures with changing patient demand, reimbursement pressures, and the evolving healthcare needs of our community.
Ultimately, success through 2030 will not be defined by adding organizational layers or simply reducing management positions. It will be defined by creating the right structure to support high-quality, technology-enabled care; develop and retain exceptional people; respond quickly to changing market conditions; and consistently deliver sustainable financial and clinical results. Our organizational design must remain flexible enough to evolve as healthcare changes, while keeping our mission, our patients, and our community at the center of every decision.
Daffodil Baez. President of Fort Washington Medical Center (Md.), Adventist Health: When we evaluate what we intend to accomplish by 2030, the ability to balance strategic efforts while maintaining operational integrity will remain critical. At Adventist Healthcare, we are growing service lines and sites, expanding our clinical talent pipeline pathways, and just started the Epic implementation journey, all while maintaining state-leading quality outcomes at the system level. When considering structural evolution, we find that disseminating a clear enterprise playbook that each team member understands, decentralizing strategic initiatives to allow for site-specific expertise, and encouraging team members to craft a long term journey within our system are current tactics allowing us to expand our momentum.
John Harding. Executive Vice President and Chief Operating Officer of Children’s Minnesota (Minneapolis): We recently created a new position on our executive team, a senior vice president of clinical service lines and chief ambulatory officer, to reflect the increasing importance of the ambulatory environment and care coordination for our future. We are also further developing our precision medicine strategy and evaluating how our organizational structure should evolve to support that work. Looking toward 2030, we will need to work both internally and externally to adapt to changing pediatric specialty care needs and ensure that the best care is provided in the optimal setting. That will likely require us to think differently about how we organize around care delivery and partnerships rather than simply around our traditional structures. We have also recently transitioned to Epic as our EHR, which will help us connect better with our patients and care partners.
John Flanagan. Senior Vice President and COO of Blythedale Children’s Hospital (Valhalla, N.Y.): As a safety net pediatric specialty hospital, Blythedale has always had to do more with less. As we think about our strategic plan for the next 3 years, we are evaluating which roles need to be elevated and/or added to the Table of Organization. For example, Blythedale is considering whether it needs a higher level informatics position to help address the increasing clinical technology needs and data analytics required. This is the type of position we are looking closely at as we begin to think about navigating the next 3 years under a tougher regulatory and payer landscape.
Brad Bivens. CFO of Parkside Psychiatric Hospital & Clinic (Tulsa, Okla.): By 2030, I believe Parkside’s organizational structure will be leaner, more integrated and much more data-driven. As a freestanding behavioral health organization, we cannot afford to have finance, operations, clinical leadership, revenue cycle and technology functioning in separate lanes. We are already working toward an operating model where leaders have greater visibility into volumes, staffing, productivity, reimbursement and financial performance so decisions can be made faster and closer to where care is delivered. Technology and automation will also allow us to reduce administrative burden and spend more of our resources on patient care rather than processes that do not add value.
I also believe the role of the CFO will continue to expand beyond traditional finance. Finance should help connect strategy, operations, technology and growth while giving leaders the information and accountability they need to run their areas effectively. For Parkside, sustained success through 2030 will not come from simply adding more layers or resources. It will come from building a simpler organization with clear ownership, better information and leaders who understand how their decisions affect both patient care and the long-term sustainability of the organization.
Rob Chestnut. Senior Vice President and CFO of LMH Health (Lawrence, Kan.): Success is predicated on planning. As we look strategically at our organization going forward, we need an end game in mind. This means that we will review each vacancy with the same question. Does backfilling this position work toward the goal of a more efficient and effective delivery of care?
Bradley R. Hipp. Vice President and CFO of Tucson Medical Center (Tucson, Ariz.): By 2030, TMC Health’s organizational structure will be less focused on individual facilities and more focused on an integrated health system operating model. We will continue aligning care delivery, physician services, ambulatory care, and digital capabilities around shared outcomes and accountability. Success will depend on creating an agile, data-driven organization that combines local responsiveness with enterprise-wide alignment. Investments in technology, analytics, AI, and leadership development will allow us to operate more efficiently, adapt more quickly to change, and continue investing in the health of our communities. Ultimately, our focus is not on changing the organizational chart, but on creating a stronger, more connected health system capable of delivering exceptional care for the long term.
Perry Sham. CFO of Niagara Falls Memorial Medical Center (N.Y.): Our organization is looking to develop a leaner structure that can operate nimbly in anticipation of the increased pressures due to changes in reimbursement and coverage. The approach will rely on innovations, automations, and the support of our partners to drive success.
Warren Ladner. Senior Vice President, CFO and Treasurer of Southern Illinois Healthcare (Carbondale): From my perspective, an organization like ours, with roughly 60% market share, must increasingly look beyond its traditional market to sustain long-term growth. Our existing corporate infrastructure gives us the capacity to absorb incremental revenue from new markets without a comparable increase in overhead, helping us stay ahead of rising costs.
Before COVID, inflation averaged about 2.1%–2.2%, while Medicare increases generally ran modestly above inflation. That environment allowed us to remain focused on our primary and secondary service areas and still keep pace with the cost curve. Post-COVID, reimbursement has not kept pace with inflation, and with our local market already highly saturated, organic growth alone will not be sufficient. To remain financially sustainable over the long term, we have to expand beyond our current market, something other health systems are likely to recognize as well.
John Mallia. CFO of Lee Health (Fort Myers, Fla.): Since Lee Health converted from a public hospital district to a not-for-profit 501(c)(3) two years ago, we’ve had the flexibility to design our organization around what our community and region will need through 2030, beyond what they needed in the past. That starts with our centers of excellence in heart, cancer, GI, brain/neuro, and musculoskeletal, which bring specialized expertise and coordinated, world-class care to our patients. We are also focused on improving access, especially through our primary care, pediatrics, and women’s services programs. Above all, our executive team is aligned around our strategic plan that takes us through 2030: strengthening operational discipline, expanding access to care across a growing Southwest Florida, and evolving with emerging technology to change how we deliver care and run the business.
Kellan Tittle. CFO of People Incorporated Mental Health Services (Eagan, Minn.): For People Incorporated, our structure will evolve to strengthen the capabilities that are most critical to our mission and long-term sustainability. We expect greater integration across finance, revenue cycle, data and analytics, development, compliance, and operations so leaders have better information and can make faster, more informed decisions. As reimbursement models, regulatory requirements, and workforce challenges continue to change, we will invest in leadership development, succession planning, and stronger management capacity throughout the organization. We also anticipate expanding our use of technology, automation, and business intelligence to improve efficiency and reduce administrative burden. At the same time, we will ensure local operational flexibility so programs can respond to the unique needs of the communities we serve.
Nikki McLain. Interim CFO of Piedmont Augusta Hospital (Ga.): As we look toward 2030, I believe the Piedmont Augusta Hub’s organizational evolution will be less about changing our relatively flat structure and more about enhancing how we work together across the organization. Our focus will be on deepening collaboration among clinical, operational, financial, and support teams, ensuring we remain aligned around shared goals and priorities. By strengthening these connections, we can identify opportunities earlier, solve challenges more effectively, strengthen accountability, and make thoughtful decisions that balance exceptional patient care with operational and financial sustainability.
At the same time, our long-term success will depend on our people. We must be intentional about developing sustainable workforce pipelines, cultivating internal talent, strengthening succession planning, and creating career pathways that enable team members to grow and build meaningful careers within Piedmont. Ultimately, our organizational evolution will be defined not simply by structure, but by how effectively we collaborate, invest in our people, and stay aligned around the needs of our patients and communities.
Susan Chubinskaya, PhD. Senior Vice President of Provost, and Chief Academic Officer at The University of Texas Medical Branch (Galveston): By 2030, the academic enterprise of the University of Texas Medical Branch will operate through a leaner, more agile, and highly collaborative structure. It will align schools, departments, and programs around shared goals in education, research, and community impact. Cross-disciplinary collaboration will accelerate growth in areas such as AI, digital health, precision medicine, and translational research. UTMB will continue investing in leadership development across all career stages. It will strengthen the workforce pipeline in critical healthcare fields. This approach will ensure the institution remains innovative, adaptable, and positioned for long-term success.
Kim Sweeney, RN. Vice President and Chief Patient Experience Officer of Roswell Park Cancer Center (Buffalo, N.Y.): Effective organizational structure in healthcare is never just about who reports to whom; it takes an entire organization to listen to and engage patients, families and employees and to shape truly impactful care delivery. At Roswell Park, we’re working to make sure our organizational structure is both patient-centered and team-based so we can fully integrate the patient, caregiver and employee experiences. Success will come from breaking down silos and creating stronger partnerships, and to get there we are really focusing on communication across clinical, operational and administrative teams. We’re also investing in employee engagement, well-being and leadership development to support a culture of listening. When employees feel supported, valued and connected to our mission, they are better able to deliver the compassionate, personalized care that defines the Roswell Park experience.
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