As 2027 comes into view, healthcare leaders are weighing U.S. healthcare as it stands against the system they wish they could build. Medicaid cuts, shifting policy, the accelerating pace of AI, and rising demands for access and quality are pressing on their organizations from every direction.
We asked members of the Becker’s Healthcare Leadership Council to consider the year ahead from two angles: the one structural feature of U.S. healthcare they would redesign if they could, and the biggest challenge they expect to face and how they’ll meet it. Their responses trace a common thread — bringing care closer to patients, stripping out needless complexity, and holding access and quality in focus as the ground shifts beneath them.
Bradley Haws, CEO, Clinical Enterprise, UI Health Care (Iowa City)
If I could redesign one structural feature of the U.S. healthcare system, it would be the administrative structures across the insurance industry. While value-based care is intended to improve quality and efficiency, differing payer requirements often add complexity, increase administrative burden and divert time and resources away from patient care.
Greater alignment on administrative processes, performance measures and patient-centered goals would create a more streamlined and efficient system for providers and patients. Reducing unnecessary complexity would allow healthcare organizations to focus more on quality, access, outcomes and innovation, ultimately benefiting the patients and communities we serve.
Pete November, CEO, Ochsner Health (New Orleans)
The biggest challenge in 2027 will be helping our organization navigate an increasingly complex healthcare environment shaped by compounding realities of reimbursement pressures, regulatory changes, rapid advances in AI and demographic shifts. We’ll meet that challenge with optimism and by being honest about the realities in front of us. We’ll keep our leaders and team members informed, aligned and focused on what matters most: access, quality and experience.
While we can’t control every challenge we face, we can choose how we respond and show up for our patients and each other.
Robert C. Garrett, CEO, Hackensack Meridian Health (Edison, N.J.)
The biggest challenge we will face in 2027 is severe fiscal pressure from federal and state Medicaid funding cuts under HR 1, which impacts 350,000 people, or about 20% of enrollees in New Jersey. We will continue proactive strategies to address this through expanded ambulatory and outpatient care, which includes our investment in two dozen new facilities throughout the state, as well as better digital access points.
We are also doubling down on value-based care and early interventions, and proactively protecting enrollment pipelines. This includes working with community partners and county family services to guide vulnerable patients through the Medicaid redetermination process.
Robert Stone, CEO, City of Hope (Duarte, Calif.)
Too often in our health system, patients are treated as just another stakeholder. Nowhere is that more true than in the lack of access we see to expert cancer care — despite advances in cancer science, most patients still can’t access the cancer centers offering the latest treatments and trials. I would make sure that a patient’s chance of surviving cancer didn’t depend on geography.
City of Hope is working to share clinical expertise with community partners, open trials more quickly in more locations, and push for policy changes requiring that health plans include an NCI-level cancer center. We need more of these efforts. The “tradeoff” isn’t one at all, but would ensure patients benefit from the best expertise and latest treatments regardless of where they live.
William Morice, MD, PhD, CEO, Mayo Clinic Laboratories (Rochester, Minn.)
One feature I would redesign is for our healthcare delivery systems to have more of a hub-and-spoke model that enables distribution of care closer to the patient and increases access and improves patient experience. It would require investing in both quality systems and medical record interoperability, which would be necessary to ensure an outcome-focused model and prevent fragmentation of care.
Our biggest challenge will be the meaningful incorporation of AI to improve operations and scale access to diagnostic information and insights. We are meeting this challenge through both workforce development and infrastructure and informatic systems investments, and by setting objectives that are specific, measurable and timebound.
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
