In nearly two years leading Trinity Health Mid-Atlantic, Andre Boyd has overseen the integration of operations across three states, adjusted services at hospitals where patient volumes no longer supported existing models and worked to prepare the region for additional financial pressures tied to HR 1. As he looks toward 2027, he remains focused on expanding access to care, particularly through primary care and outpatient services, even as the organization evaluates where it needs to reduce costs.
“You can’t cut your way to success, regardless of the payment model or HR 1,” Mr. Boyd, regional president and CEO, told Becker’s. “You still have to grow.”
Philadelphia-based Trinity Health Mid-Atlantic is part of Livonia, Mich.-based Trinity Health. Its six hospitals span Pennsylvania, Delaware and Maryland, with Holy Cross Health operating as the organization’s Maryland market. Mr. Boyd was named regional president and CEO in 2025.
Much of his time in the role has been devoted to bringing those markets together under a regional leadership structure while navigating financial challenges that preceded HR 1. The federal legislation, he said, has added to the pressure to reconsider how and where services are delivered.
“The big thing that stands out for me during that time is the resilience of our people,” he said. “There’s been a lot of work over the last two years on integration, along with the financial challenges we had before HR 1, which HR 1 compounds.”
Under the regional structure, executives overseeing clinical, financial and development operations now help guide strategy across the markets rather than working within individual states. Mr. Boyd said that has made it easier to share practices and expertise, particularly as the system expands community-based care and works to strengthen physician relationships.
“My regional leadership has ownership of both markets,” Mr. Boyd said. “My chief clinical officer, my chief financial officer and my chief development officer all have the opportunity to help guide our strategy for every market we serve, and that’s starting to show a lot of progress.”
One initiative being expanded across the region is relationship-based care, a patient experience and clinical care model for nurses and other caregivers. About 1,000 employees at St. Mary Medical Center in Langhorne, Pa., and Nazareth Hospital in Philadelphia have completed the training, which Mr. Boyd said has contributed to improved net promoter scores. Trinity Health Mid-Atlantic plans to bring the model to its remaining hospitals.
“We’re not 100% as unified as we want to be,” Mr. Boyd said. “There’s still more work to do to unify the region, but we’ve come a long way.”
That regional approach is also informing decisions about which services hospitals can sustainably provide. Mr. Boyd said the organization has been evaluating operations across its six hospitals rather than trying to maintain the same services at every location, particularly as reimbursement pressures make it harder to support lower-volume programs.
“Within our organization, we have a term, called repositioning,” he said. “We’ve had to identify certain services that may not have been as advantageous. There was a need, but we can’t meet it everywhere. We can’t do everything the same way at all six of our hospitals, so we’re determining which sites can do certain things best so we can keep providing care and access for that patient population.”
At Nazareth Hospital, for example, Trinity Health Mid-Atlantic reduced overnight operating room hours and adjusted staffing because surgical volumes were too low to support the previous operating model. The organization also made changes to the cardiac catheterization lab at Saint Francis Hospital in Wilmington, Del.
Mr. Boyd said the organization is approaching administrative expenses with a similar focus on preserving resources for clinical services. Trinity Health reduced its revenue cycle workforce by 10.5% in January as it moved certain nonpatient-facing functions to an outside partner, and he expects support operations to remain a priority for cost reduction as federal reimbursement changes take effect.
“We made the change in revenue cycle this past year to minimize the impact on clinical care, knowing we have headwinds to our reimbursement from HR 1,” Mr. Boyd said. “As a whole, we’ll continue to look at support areas first, to minimize impact on direct patient care, based on the earnings we get as an organization.”
Technology is expected to play a larger role in that work. Mr. Boyd said Trinity Health has a systemwide AI committee, with representation from the Mid-Atlantic region, that evaluates opportunities to use the technology. He sees revenue cycle and coding as areas where AI could help reduce administrative costs.
While the organization continues to evaluate expenses and reposition services, Mr. Boyd said it is also investing in areas intended to improve access and move more care into lower-cost settings. Primary care is a particular priority, in part because of the number of patients seeking treatment in emergency departments for conditions that could be addressed elsewhere.
“Like everybody across the country, our ER volume has skyrocketed, and a good bit of it is level 4 and 5 visits that are really urgent care or primary care,” Mr. Boyd said. “We have to make sure those patients have a place to go in the right setting, because the ED is more costly.”
The organization is also continuing to invest in cardiology and neurosciences, although its physician relationships differ by market. In Pennsylvania, Trinity Health Mid-Atlantic employs cardiology practices and partners with physicians for neurosciences services. In Maryland, independent physicians account for most surgical volume, and the organization recently added six employed primary care providers, doubling the size of its primary care group in that market.
Women’s health remains another priority in Maryland.
“Holy Cross has been the No. 1 hospital for births in the state of Maryland for a number of years, and we never want to lose that badge of honor,” Mr. Boyd said.
Maryland’s reimbursement structure adds another consideration to those investment decisions. The state, which sets hospital rates through its Health Services Cost Review Commission, entered the federal AHEAD model in January. The program is designed to control healthcare spending and strengthen primary care, with changes to how Medicare hospital budgets are determined beginning in 2028. Mr. Boyd said the organization is preparing for the shift but is still evaluating how it will affect operations.
“How that cost shift plays out, with the federal government managing Medicare and the state managing Medicaid and commercial, will be an interesting dynamic,” he said. “I don’t have an answer for you today other than that we’re preparing for that shift.”
For Mr. Boyd, the challenge over the next several years will be continuing to make those investments while adjusting operations to account for reimbursement pressures. He said he wants the organization to make necessary changes without disrupting employees, physicians or patients, even as the financial decisions become more difficult.
“My goal as CEO is to find creative solutions with my team to minimize the impact on our people, meaning our colleagues and our doctors, and on the patients we serve,” he said. “I want it to be so seamless that they don’t even know we had to change something.”
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