Balancing long-term strategy with short-term wins is getting tougher as cost pressures rise and policy keeps shifting—yet health systems are finding ways to adapt. In this session, three CSOs walked through the strategic levers they’re leaning on to stay steady in a volatile environment.
Even with very different local challenges, CSOs agreed they’re all searching for reliable value engines as federal funding tightens. Performance assessment, community-focused strategy, and intentional AI innovation are no longer “nice to have”—they’re becoming core drivers of growth.
Leaders emphasized that early investment in key service lines, combined with disciplined long-term performance tracking, is helping systems maintain financial momentum. Many organizations were already working to optimize assets and reduce costs, but the expected HR1-related shortfalls have accelerated those efforts. Session speakers described integrated financial and operating plans built around top-line growth, diversification, administrative simplification, and operational excellence.
This shift also shows how research-heavy or traditionally structured markets must prepare for revenue exposure beyond the classic care delivery model. Leaders described a dual focus: reducing costs through service line optimization while expanding ambulatory access and inpatient capacity to create new value. The message was clear: today’s structural imbalances can’t be fixed with small tweaks. Some academic systems may need new partnerships or operating models to keep their portfolios stable.
Participants also underscored that long-term plans now have to flex easily. They shared examples of simplifying access, unifying care coordination, and reassessing portfolios in response to major Medicare changes. For systems with integrated plans, tight alignment between the health plan and delivery arm is becoming essential for affordability, consumer experience, and growth. And for mixed urban–rural systems, efforts like AI-enabled redesign and selective market participation show how to recalibrate when demographics limit old growth assumptions. In today’s environment, strategy isn’t fixed—it’s an ongoing cycle of evaluation.
Key takeaways
Refresh multi-year plans on a predictable cycle, linking capital choices, operational targets, and growth priorities.
Build ambulatory capacity and shift volume into lower-cost environments.
Strengthen operational alignment across the enterprise, especially when systems run both a delivery network and a health plan.
Evaluate participation in Medicare Advantage and other products based on structural fit—not just past practice.
Use transformation efforts to correct structural cost issues, including AI-enabled redesign, and clarify where the system truly creates value.