As he approaches his second year leading the Columbus-based health system’s seven hospitals and network of outpatient centers, including the 900-bed University Hospital flagship facility, Dr. Warner is prioritizing innovations in patient care and research.
Dr. Warner shared insights with Becker’s on his 2025 strategy for OSU Wexner, touching on financial challenges, capital investments, partnerships and employee retention.
Editor’s note: Responses were lightly edited for length and clarity.
Question: What do you expect to be the biggest financial challenge facing health systems in the coming year, and how are you preparing to address it?
Dr. John Warner: Health systems have been facing numerous financial challenges as we work to make high-quality care more accessible to patients and also keep up with increased costs. Unfortunately, some insurers haven’t been adjusting their reimbursement rates to keep up with price increases, so I expect reimbursement instability will be one of the biggest financial challenges facing health systems in 2025.
Industrywide, we’re seeing policies that change reimbursements mid-contract cycle, along with increased administrative burden from prior authorizations that results in higher denial rates, and rising labor and supply costs that aren’t reimbursed by managed care payers. These challenges have led some health systems to go out of network with select Medicare Advantage plans and have also resulted in contentious contract negotiations with managed care payers.
At Ohio State, we’re collaborating with managed care payers to help solve these challenges, including partnering with third parties to monitor denial rates and administrative burdens, enabling us to find ways to improve and enhance our ability to make world-class care accessible to our patients.
Q: Given the current economic climate, how are you prioritizing capital investments for the upcoming year? In what specific areas do you see the highest ROI?
JW: We’re focused on improving health for all Ohioans and across the world through innovations in research, education and patient care.
That mission drives our capital investments, which include building a new 1.9 million-square-foot hospital tower and constructing a 200,000-square-foot ambulatory site in a growing Columbus suburb — our fourth such facility to open in five years. These facilities, opening in 2026, will expand access to the caliber of care Ohio State provides.
As part of a large, public, land-grant university, we measure our ROI against not just our mission or the city where we’re located, but our broad impact statewide. So, we’re dedicated to making investments that extend academic medicine beyond our local market to underserved communities, including those in rural and Appalachian areas of Ohio through either digital consults, virtual health or on-site provider appointments at our affiliate hospital network.
Q: How is your M&A strategy evolving to support OSU Wexner’s long-term goals, and how do you determine which acquisitions will add the most value to your organization both operationally and culturally?
JW: Fundamentally, we believe in working with alliances, partnerships and collaborations across our region and state to expand access and make advances in research, education and patient care. For example, we recently established a 10-year partnership with Siemens Healthineers to advance imaging research, expand access and develop innovations in clinical operations. And we’re partnering with Helix to launch Ohio’s largest precision health initiative, aimed at improving health outcomes and delivering more personalized care across the state.
We also have a broad network of affiliate hospitals through the Ohio State Health Network to support care being available locally while also creating pathways for transfers when a patient needs complex, sub-specialized tertiary or quaternary care. The OSHN allows us to:
- Extend our instance of Epic to community hospitals through our Community Connect program
- Reduce costs for pharmaceuticals and supplies through group purchasing
- Operate Ohio’s largest telestroke network, with more than 1,000 monthly digital consults in specialties like teleneurology, tele-ICU and tele-infectious diseases, among others
Historically, our model has been to grow organically, with year over year growth occurring across the organization. Any M&A needs to be a win-win-win for the community, our partners and Ohio State. A thoughtful M&A strategy coupled with internal growth and superior execution positions us to meet the needs of the growing community.
Q: What strategic moves is OSU Wexner making to expand outpatient and ambulatory services, and how do you plan to balance this with maintaining inpatient care?
JW: People want and deserve to have their healthcare needs met simply, quickly and close to home. That’s why we’re transforming our delivery to a patient-centered model to meet patients where they are and make their needs and comforts the priority, instead of following outdated linear approaches.
As care is shifting from inpatient services to ambulatory locations and even into the home, we need to adapt accordingly while maintaining the appropriate strategies for inpatient volumes. Some of the things that are top of mind for us are:
- Moving diagnostics out of inpatient settings when appropriate
- Providing observation-status patients with a location to be treated and recover outside of inpatient settings
- Leveraging technology, such as remote patient monitoring, to shorten the length of stay and enable some appropriate acute care delivery in the home
- Moving ambulatory surgical cases outside flagship-hospital-based perioperative platforms
- Providing alternative locations to emergent care for patients whose acuity does not require ED visits
By investing in preventative, urgent care and ambulatory services closer to where people live and work, we’re creating capacity throughout the system without requiring significant capital investment while improving patient outcomes and experience.
Q: What specific strategies will your health system deploy in the coming year to improve employee retention, particularly in critical front-line roles?
JW: We’re continuously focused on our workplace culture and ensuring team members have opportunities for meaningful impact, including engaging in developing solutions that impact their work. For example, nurses nationwide spend significant time on the computer, and that’s not what they come here to do — or what our patients need most. So we’re leveraging technology to transform and reduce that administrative burden. By providing and using AI-enabled ambient listening tools, physicians and advanced practice providers are able to have a more natural, engaging and purposeful conversation with a patient.
We’ve seen success on the clinician side as well as the patient side. In the first two weeks of expanded use of the Microsoft Dragon Ambient eXperience (DAX) Copilot program at Ohio State, 100 clinicians regained 64 hours of time, and patients reported more valuable conversations with their physicians. We plan to extend this capability to nursing and other care settings as the technology matures. We’re also considering other technology for chart summarization, tailoring communication and automating insights.
Q: How are strategic partnerships with community organizations and other healthcare institutions shaping your efforts to address key challenges within your health system and drive long-term success?
JW: There’s no doubt that health systems have an important role to play in addressing key challenges in healthcare, but we can’t do it alone. Strategic partnerships across industries and sectors — from local health systems and federally-qualified health centers to government and business partners — make it possible to tackle complex healthcare challenges and ultimately provide better care to the patients we serve.
For example, our State of Ohio Adversity and Resilience (SOAR) Study, which is made possible by a $20 million grant from the Ohio Department of Mental Health and Addiction Services, brings together a network of Ohio universities and hospitals led by the Wexner Medical Center to identify and address root causes and risk factors for mental health that will help shape future care.
And we’re addressing the national issue of workforce shortages through partnerships. Working with Columbus State Community College, we’re increasing enrollment capacity in their surgical technology program. Students will train in our surgical skills lab at Ohio State, which will create additional pathways to meet our hiring needs in this high-demand field. Additionally, the Healthcare Career Collaborative of Central Ohio, a joint effort with four regional health systems, aims to expand access to health education and workforce readiness.
We recognize that when we focus our attention on identifying and addressing root causes and risk factors — like in these examples — we can make a real difference in improving and saving lives.