Health systems facing financial pressure are focused on approaches that move the needle in a meaningful way, and for several large organizations, those approaches have led to swings of hundreds of millions of dollars in operating performance.
Becker’s talked to leaders and reported on turnarounds at five systems that were posting operating losses in recent years. Their paths differed, but common threads ran through them: streamlining management structures, narrowing their focus to core services and markets, and holding operators accountable to a small set of standardized metrics. Some have returned to positive margins, while others are closing in.
Here’s what leaders at the five systems did:
1. Allegheny Health Network (Pittsburgh): AHN went from a $140 million operating loss in 2024 to $100 million positive operating income in 2025. President and CEO Mark Sevco credited a rebuilt leadership team, volume growth and benchmarking that yielded about $40 million in supply chain and revenue cycle improvements.
2. Ascension (St. Louis): Ascension cut $3 billion in 2023 operating losses to a $120 million loss in fiscal 2026. CFO Saurabh Tripathi pointed to divesting weaker markets, reinvesting about $1 billion in remaining facilities and daily tracking of core metrics, an approach he called “relentless incrementalism.”
3. CommonSpirit (Chicago): CommonSpirit narrowed operating losses to $430 million in fiscal 2026, before special charges, from $687 million in fiscal 2025. Including $2.8 billion in special charges, mostly tied to its exit from Conifer Health Solutions, the system posted a $3.2 billion operating loss, and it remains in the middle of a multiyear turnaround plan. It is bringing revenue cycle in-house and consolidating five regions into three to cut management layers.
4. Hospital Sisters Health System (Springfield, Ill.): HSHS went from losing more than $100 million per year to break-even in under two years. COO Kathy Donovan said the system consolidated into three accountable markets and standardized how its EDs, inpatient units and ORs operate.
5. Providence (Renton, Wash.): Providence improved first-half operating income by $400 million year over year, moving from a $225 million loss in 2025 to $175 million in operating income in 2026. The system cut leadership layers, scaled back underused programs, reduced agency staffing and delayed some investments, which President and CEO Erik Wexler said kept the focus on returning to financial sustainability.
