Health system CEOs who remain focused on access to care and thoughtfully incorporating AI into their organizations expect those core issues to continue dominating strategic discussions in 2026. But those priorities will exist in the context of HR 1, the One Big Beautiful Bill Act, adding complexity for leaders navigating stability and balance.
In conversations with Becker’s, Terry Gilliland, MD, president and CEO of Danville, Pa.-based Geisinger Health; Steve Markovich, MD, president and CEO of Columbus-based OhioHealth; and Christopher O’Connor, CEO of Yale New Haven (Conn.) Health, shared the word or phrase that captures their system’s 2026 focus and how they are positioning their organizations to lead on it.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: What emerging issue or opportunity do you expect will dominate strategic conversations in healthcare leadership in 2026 and why?
Dr. Gilliland: I narrow it down to artificial intelligence writ large. We think about it a little bit differently in that it’s augmented intelligence. Sometimes there’s automation that’s a little bit different, but augmented intelligence where you’re bringing the artificial intelligence really to the bedside, so you’re helping the clinician make better decisions. Ambient documentation is one of those types of things, because it allows them to record the entirety of the visit. Saves their time. It’s better for the patient as well.
Dr. Markovich: From my perspective, it’s not anything new or emerging. The regulatory uncertainty is going to dominate the conversation. Midterm won’t happen until late 2026, so if you look at the time between now and then, there are many implications to HR 1.
People are still trying to evaluate their strategies to respond to that. They’re trying to figure out what’s going to happen with rural healthcare dollars. And so I think it’s going to be volatile for the foreseeable future. It’s going to put pressure on the business model. People are going to be talking about coverage issues and payer mix, consumer spending, the cost structure — all those things that impact the underlying financial sustainability of the system at a national level. I think that’s going to be the buzzword. It’s what we’re talking about all the time.
Christopher O’Connor: AI is going to be something that will dominate over the course of the next 12 to 24 months — the increased reliance that we have and implementation on artificial intelligence in our space. The impact that it’s making. We’ve implemented a clinical deterioration tool called eCART that has proven to be incredibly helpful and advantageous to our clinicians. We’re going to see more and more of those types of systems develop over the course of the next 12 to 24 months.
Q: If you had to pick one word or phrase to describe where your system will focus most in 2026, what would it be?
Dr. Gilliland: We’ve gone all the way back to our roots with Abigail Geisinger, and she said, “Make my hospital right; make it the best.” So for us, it’s all about being the best. It’s our purpose. Drives our approach. Everything we do — access is one of those things. You have to be high quality, safety, patient experience, but none of that matters until you get the access. And so we’re all about being the best.
Dr. Markovich: Disciplined transformation. We’ve all been talking about transformation for a while, but now I think you’re going to have to be more methodical and deliberate. You’re going to have to make sure that your organization’s underlying performance is stable and balanced. And we can’t continue to do what we’ve been doing. We must leverage it. If you’re not stable, you’ve got to get stable. If you are stable, that’s going to give you options where you can make some moves to invest in the future, to continue to deliver high-value, high-quality safe care. But if you’re built on a rocky foundation, you’re going to have to shore that up to create the environment that you can maneuver it. People are still going to want to change. That idea of transformation. But you’re going to have to be very disciplined in your approach.
Christopher O’Connor: Our ambulatory expansion is the phrase that I would use. We’re continuing to bring care closer to our patients. The more sophisticated care is getting now more ambulatory and closer to home for our patients.
Q: How are you positioning your organization today to lead on that issue next year, whether it’s related to access, workforce, care models or innovation?
Dr. Gilliland: Take all those dynamics — whether it’s HR 1, workforce, access, care models — I look at it from a hierarchical point of view, which is, say, what are the things that we can invest in and focus our people on and position ourselves to solve for those things? And if you take some of those things that are constraining variables, and then figure out where you’re going to exact some leverage on those constraining variables, that’s where artificial intelligence comes in.
In terms of access, we have very static models for how we arrange a physician’s template for how they’re going to see somebody during the day that effectively dictates access to that particular physician. This is where artificial intelligence comes in. Artificial intelligence is going to dynamically assess a patient’s risk, whether it’s for hypertension or for stroke or congestive heart failure, also take into account all the things that are happening in that visit at that moment in time, and determine when you need to see that patient, by whom for how long.
If we were to solve those things, we would take out of the equation what really ends up being the whim of the provider — “I think I need to see you in 10 days to check your blood pressure” — and it makes it so that we can distribute what the patient needs amongst a variety of different caregivers. Maybe, for example, that patient doesn’t need to come and see the physician in 10 days; maybe they need to talk to a nurse on the phone. Or maybe we can apply patient monitoring to them. Being able to apply artificial intelligence to that system of access in a dynamic fashion — the airlines have been doing this for 40 years. We’ve — in healthcare — not done it dynamically at all.
And so to me, it’s applying artificial intelligence to a constraining variable: access. It affects your workforce, affects access, it defines your care models and makes it so that we’re much, much more efficient at solving those problems. So I put those two together, and that’s just one example. We’ve gone through a number of different pain points that we have, and with artificial intelligence we’re going to be very intentional and focused on figuring out where we’re going to apply that to our pain points.
Because when you look at the harsh environment in healthcare, and if we just try to do the same thing over again and hope for better results, or maybe you squeeze that last little drop of efficiency out, it’s not going to be enough for us. And so we have to figure out what are those things that we can use as levers, and then rank-order them, and that’s where artificial intelligence comes in for me.
Dr. Markovich: A lot of people had been asking me about our scenario planning. And from my perspective, it didn’t matter what scenario I looked at, the answer at the end was we had to stay focused on cost. If everyone stays focused on cost, that cuts across pretty much every trend that we’re seeing, and it’s core to being able to excel at our business.
That being said, as we think about transformation at OhioHealth, I’m really focused on the consumer. We’ve got a lot of work underway to more digitally enable our platform and to put analytics around understanding the consumer. We continue to focus on ambulatory and migrating business away from the hospitals, but you have to do that in a disciplined way because you can’t disrupt the financial model.
How quickly and how appropriately can we embrace technology? Everybody’s talking about AI. We are using AI in a number of different environments, but how quickly can you do that? And then just continue to adapt to the underlying financial system as things evolve. So make sure we get the right people, the right structures, the right incentives, the decision-making processes to be successful. The consumer, ambulatory, the operating model, technology — all those things. But the first thing we’re looking at right now is cost. What can we do to make sure that things stay stable?
Christopher O’Connor: Bringing care closer to the convenience of our patients, closer to home, is essential. So I think deploying our ambulatory environment more globally is important to us. We’re certainly focused on expansion, so that is absolutely a key driver for us over 2026.
