Where the Field Drew the Line: Findings from the 2026 Service Line Portfolio Strategy Survey
Health systems increasingly say they're rationalizing their service line portfolios to balance financial performance with access, quality, and mission, yet execution often tells a different story: financial signals quietly override stated priorities, service lines rarely get cut due to mission commitements, and ambulatory strategies frequently lag behind stated intent. The challenge isn't a lack of consensus on what matters—it's the gap between what leaders say drives their decisions and what actually does.
This webinar shares findings from the 2026 Strategy Catalyst Service Line Portfolio Strategy Survey, which sampled 40 Chief Strategy Officers, Chief Operating Officers, EVPs/VPs of Strategy and Operations, and service line executives across U.S. health systems with over $500M in annual net patient revenue. The survey investigated how health systems balance financial performance with access, quality, and mission as they optimize their service line portfolios.
Strategy Catalyst leaders are joined by executives from Ohio State University Wexner Medical Center and Baptist Health Care, who share how these tensions play out inside their own organizations. Together, they examine which service lines are sustained as core pillars for strategic or mission-critical reasons, the factors actually shaping portfolio decisions, and how service line strategy is evolving in practice.
Read the full report findings here
Member Speakers:
Hannah King Boyles, Advisor, Strategy Capacity-Building, Ohio State University Wexner Medical Center
Krystle Fernandez, Executive Director of Strategy, Planning & Performance, Baptist Health Care
Ashley Hodge, Executive Director, Strategic Outreach & Provider Development, Baptist Health Care
Key Takeaways
The Valuation Paradox: Leaders rate mission, quality, and margin all highly. When they choose, the financials sort the portfolio.
The Rationalization Paradox: Nearly every system is rationalizing (90%), but the leaders who set the agenda rarely control the constraint most likely to stall execution: physician alignment.
The Ambulatory Paradox: The most exposed service lines sit at the intersection of ambulatory migration and intensifying competition. The recurring risk: stated ambulatory intent outrunning actual execution.