When Erik Wexler became president and CEO of Providence in January, one factor was already working in his favor: the board’s decision to promote an internal candidate.
“I had been with the organization for almost 10 years at that point, and it allowed me to step right in and begin working on our strategy and forward-looking objectives for the year — rather than spending six months to a year learning a new organization, as I would have if I were coming in from the outside,” Mr. Wexler told Becker’s. “That momentum was more important than ever. Given the headwinds healthcare is facing in the U.S., we don’t have a minute to lose.”
Mr. Wexler joined Providence — a 51-hospital organization with system offices in Renton, Wash., and Irvine, Calif. — in 2016. Before becoming CEO, he served as COO, president of operations and strategy for the southern region, and regional chief executive for Providence Southern California.
Among his first moves as CEO was streamlining executive leadership. The changes took effect Feb. 1 and aimed “to help us sharpen our focus on care delivery, expedite decision-making, accelerate our path to transformation, and increase subsidiarity at the local level,” Mr. Wexler said in a message to employees.
Providence aligned leadership responsibilities more closely with areas of greatest need and, by the end of the first quarter, had board approval on a strategic plan. That plan, followed by a new operational framework, helped Providence shift from years in the red to a path toward financial sustainability. In the third quarter of 2025, the system reported $21 million in operating income — a 0.3% margin — compared to a $208 million loss during the same period last year.
As Providence continues on that path, Mr. Wexler said the organization remains focused on external risks and internal transformation. He described the current environment as a “polycrisis,” shaped by overlapping economic, regulatory and environmental threats.
Regulatory volatility remains a top concern. “Even seemingly minor adjustments can be very impactful, especially to rural hospitals,” Mr. Wexler said, citing the 340B drug pricing program as one example. “A pilot program could eventually lead to an adjustment that would destabilize or even close many rural hospitals.”
He also highlighted other disruptions such as climate change, flooding and wildfires, which have affected manufacturing and caused supply shortages. “Manufacturing plants should think about how to prevent floods from shutting down critical work,” he said. “That proactive approach will support sustainability and public welfare in this country.”
The legislative climate is also a concern. Mr. Wexler called out provisions of the One Big Beautiful Bill Act — including limits on state-directed payments and provider taxes — as challenges that could reduce access and reimbursement for vulnerable populations. Providence, he said, is reducing duplication in programs that do not improve quality and lifting administrative burden from caregivers and clinicians as part of its strategy to adapt.
These efforts tie into broader restructuring efforts underway across Providence. Over the past year, the health system announced workforce reductions and service line changes. In total, hundreds of roles were eliminated across Providence Swedish, Providence Oregon and other ministries. Providence also closed four occupational medicine clinics in Portland, Ore., and in June implemented a restructuring plan that affected 600 full-time-equivalent positions across seven states.
“We made a commitment to be courageous and respond to the signs of the times,” Mr. Wexler said. “That meant leaning into the core services most in demand, especially those that impact community health status.”
Providence has made other business decisions in the process. It sold 10 skilled nursing facilities across four states to The Ensign Group, transitioned its home health and hospice services to a joint venture with Compassus, and sold revenue cycle company Acclara to R1 RCM.
“These were important and courageous decisions that allow us to focus on and invest in the core services we provide,” Mr. Wexler said. “This will be critical for 2026 and beyond.”
Despite the disruption, he said morale remains strong among staff. “I believe there’s an optimistic view of where we’re headed, even though the changes are difficult.”
In parallel with structural changes, Providence has also reevaluated its approach to innovation. The health system’s venture capital arm has spun off and rebranded as Allumia Ventures. Internally, Providence’s innovation efforts have shifted toward pragmatic, clinician-facing solutions.
“In fact, the third pillar of our 2030 strategic direction focuses on using innovation for positive change,” Mr. Wexler said. “We reorganized our Digital Innovation Group into what’s now called the Office of Transformation. The goal is to create a more focused discipline around the types of internal technologies that reduce administrative burden and revitalize the practice of medicine and care delivery.”
He noted that previous efforts to build scalable technology for external use have been de-prioritized. “Now, we feel the greater priority is internal,” he said.
Mr. Wexler also emphasized the importance of transparent leadership during times of change.
“Instead of trying to convince people that these changes are the right thing to do, we’ve focused on helping them understand the ‘why,'” he said. “By enhancing the ‘why’ and treating people as professionals and adults, we’ve seen much more support.”
Looking to 2026, Providence remains focused on building a sustainable system centered on community health and clinical quality — even amid uncertainty.
“When more of the population stays well, everyone benefits,” Mr. Wexler said. “We believe that’s central to this transformation.”
