A Strategic Look at What’s Driving COO Decision Making
In this session, you'll hear what leading independent health system COOs discussed during our Spring 2026 in-person gathering in Dallas, TX — and we'll share our perspective on the key themes and what they mean for industry organizations that work with them.
Below are key takeaways from our in-person forum with Independent Health System Chief Physician Executives, offering insights on their top-of-mind issues
Key Themes Discussed
Internal capacity recovery over greenfield expansion: How virtual care, care-at-home models, and AI-embedded analytics are freeing beds and surfacing underutilized assets
AI as operating discipline, not experimentation: Governance structures, clinician veto power, and the gap between vendor savings claims and measurable financial impact
340B under converging pressure: The proposed rebate model, accelerating manufacturer restrictions, and how Medicaid cuts could compound eligibility risk
Rethinking the operating model: A three-business framework — mission, regulated operations, and growth lines — and the capital allocation tensions it surfaces
Workforce redesign over workforce recruitment: Job design, training partnerships, and AI as a labor strategy when the pipeline is structurally broken
"The cavalry is not coming — there is no more workforce coming to save us. We can't find nurses, we can't find doctors. So, we need to leverage tech to be assistive."
By the numbers: One system freed 19 beds through care-at-home, serving 4,500 patients annually at a daily census of 100. One system saved 1.6 million nursing hours through AI. The proposed 340B rebate model could cost hospitals over $1 billion industry-wide. Six new manufacturer contract pharmacy restrictions appeared in the last three months alone. One partnership reduced CRNA attrition from 25% to 6% through job redesign — not compensation changes.
Why This Matters for Industry
For industry partners, these conversations reveal where COOs are making near-term operational bets and where structural risk is forcing hard choices. Understanding the capacity strategies gaining traction, the AI governance standards that are emerging, and the 340B and workforce pressures reshaping priorities is critical context for how you position your solutions and engage at the operational level.