Health system CEOs and compliance leaders say expanding federal enforcement activity is pushing systems toward earlier cross-functional coordination, more proactive compliance monitoring and greater use of AI-driven risk analytics.
Within the past two weeks, federal officials took actions involving medical school admissions practices, Medicaid funding and gender-affirming care, underscoring how enforcement scrutiny is expanding across multiple areas of healthcare operations.
Becker’s connected with four health system leaders who addressed the following question: With federal enforcement activity expanding across health system operations, what’s one thing you and your leadership team are doing differently in 2026 to stay ahead of a faster-moving regulatory environment?
For some leaders, the response has been less about creating new structures and more about strengthening compliance systems already embedded across their respective organizations.
Arturo Polizzi, president and CEO of Toledo, Ohio-based ProMedica, said the system’s long-standing commitment to a strong compliance culture has kept its team well versed in monitoring regulatory changes, conducting risk assessments, performing audits and implementing creative risk mitigation strategies. That structure also promotes collaboration across departments, including a close relationship between compliance and operations that helps the organization adapt to a rapidly shifting regulatory environment.
“Each compliance officer is dedicated to specific areas, which enables them to stay informed about ongoing and rapidly emerging initiatives,” Mr. Polizzi said. “Further, I meet regularly with our chief compliance officer to discuss key regulatory risks, emerging changes and broader compliance priorities, which helps reinforce a strong culture of partnership, accountability and proactive oversight across the organization.”
For 2026, ProMedica is focused on refining those processes and layering in technology.
“We are committed to thoughtfully evaluating and integrating technology to support our compliance efforts,” Mr. Polizzi said. “This includes exploring ways to further leverage AI, claims monitoring and data analytics, while continuing to evolve our cybersecurity and data governance practices to stay ahead of the curve.”
While some systems are refining existing compliance infrastructure, others said the biggest change has been bringing operational, financial and clinical leaders into risk discussions earlier. Terry Murphy, CEO of Dover, Del.-based Bayhealth, said the federal regulatory environment is moving faster and reaching deeper into core health system operations than at any point in recent years.
“In 2026, our leadership team is focused on building greater organizational agility by aligning compliance, operations, finance, clinical leadership and governance teams much earlier in decision-making,” Mr. Murphy said. “This way we can anticipate risk rather than simply react to it. Our priority is creating a culture of continuous readiness while still protecting patient access, operational stability and long-term strategic growth.”
Louisville, Ky.-based UofL Health is taking a similar approach, with CEO Jason Smith, MD, PhD, describing it as a sharper focus on regulatory awareness and operational compliance.
“We closely monitor emerging federal and state enforcement trends and make sure there is strong communications between operations, compliance, legal, and clinical leadership, and continue to develop a culture where compliance and accountability are part of everyday decision-making,” Dr. Smith said. “At the end of the day, our focus really remains unchanged: We strive to deliver high-quality care while making sure we comply with all applicable federal and state laws and regulations. We view that commitment not only as a regulatory obligation, but as an important part of maintaining trust with the patients and communities we serve.”
Several leaders also pointed to technology as both an opportunity and a new area of oversight. At Marietta, Ga.-based Wellstar Health System, AI is becoming increasingly central to how the organization identifies and prioritizes compliance risks. Beth Kost, senior vice president and chief compliance officer, said regulatory complexity remains one of healthcare’s most significant operational challenges, with AI playing a growing role in how the system responds.
“Using AI to enhance predictive analytics, we can more efficiently identify the most probable compliance risks, decreasing the number of manual audits or reviews, and more effectively pointing our people to the areas with the most probable exposure,” Ms. Kost said. “This includes a focus on AI governance and compliance, ensuring that the tools we use in our clinical and business applications undergo comprehensive reviews from a compliance perspective.”
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