To gain deeper insights into how healthcare executives are approaching these challenges, Becker’s Healthcare and LeanTaaS conducted a survey of senior leaders across U.S. health systems. The findings highlight a sector preparing for prolonged financial strain, competitive threats and a future where AI-driven solutions and operational agility will be paramount.
Survey overview
This survey was conducted in January 2025 among 100 C-suite leaders, including health system CEOs, COOs, CIOs, CFOs, chief medical officers and chief nursing officers. Respondents represented large organizations, with 76% working at hospitals or systems with a flagship facility of more than 300 beds.
When asked about their organization type, 34% of respondents identified as for-profit, 29% as nonprofit and 18% as academic medical centers.
The new normal: financial and competitive pressures
A striking 100% of survey respondents agreed that hospital operating margins of 1% to 2% are expected to become the “new normal,” with 61% strongly agreeing. This unanimous expectation underscores the reality that health systems must operate efficiently under sustained financial constraints.
Competitive pressures are also top of mind for executives. The biggest concern, cited by 61% of respondents, is losing patients to other providers who can offer shorter wait times — an issue that has gained prominence as consumerism in healthcare rises. Respondents also identified new market entrants as a potential threat to the organizational bottom line (44%), but 30% felt that the adoption of innovative technology could impact revenue in a positive way, reducing operational bottlenecks and improving efficiency.
Health systems bracing for future challenges
C-suite leaders foresee multiple challenges testing health system resilience over the next five years. Over half of respondents pointed to cyberattacks, climate change/extreme weather events and shifting regulatory landscapes as critical concerns. Additional challenges include supply chain disruptions (47%) and workforce shortages (36%).
These findings reflect the growing complexity of healthcare operations. Cybersecurity threats continue to escalate, with hospitals facing increasingly sophisticated ransomware attacks. Climate change is also an emerging disruptor, as extreme weather events strain hospital infrastructure and disaster preparedness plans. Meanwhile, regulatory changes — such as new price transparency rules and evolving reimbursement models — add further uncertainty.
Capacity optimization as a strategic imperative
As financial and operational pressures mount, optimizing capacity has become a priority for health systems. For 87% of survey respondents, capacity optimization is a strategic focus, with 61% categorizing it as an “extremely high priority.”
Health systems are employing multiple strategies to address capacity challenges, including:
- Outsourcing certain healthcare services (50%)
- Network coordination (43%)
- Staff productivity initiatives (37%)
- Data-driven demand forecasting and workflow optimization (31%)
- Expanding physical infrastructure (29%)
- Implementing external, AI-powered solutions for scheduling, resource management and more (20%)
AI adoption gains traction across health systems
AI adoption in healthcare is no longer a distant vision; it is happening now. According to the survey, an overwhelming 95% of respondents reported some level of AI adoption across their health system, with 37% of respondents categorizing the adoption as “widespread.” Only 5% report minimal AI integration, and none (0%) say their organization has yet to explore AI.
Healthcare leaders recognize AI’s potential to transform operations, with respondents identifying benefits — most notably, eliminating operational bottlenecks (68%) and improving the care experience for physicians (65%). Other opportunities noted for AI include generating revenue (35%), improving the care experience for patients (23%) and increasing access to care (12%).
The rapid integration of AI aligns with industry-wide trends, as health systems increasingly invest in new technologies, including AI and robotic process automation for patient access, robust cybersecurity infrastructure and tools to improve throughput and capacity.
A future defined by efficiency, innovation and AI
As hospital operating margins stabilize at historically low levels, health system leaders are prioritizing strategies that enhance efficiency, optimize capacity and sustain financial viability. Key tactics to get there — reinforced by the Becker’s-LeanTaaS survey findings — include leveraging data analytics to forecast demand and optimize workflows and deploying AI-powered tools for scheduling and resource management.
As the healthcare landscape grows more complex, organizations that embrace data-driven decision-making and innovative operational models will be best positioned for long-term success.
The survey findings underscore a critical theme in healthcare today: The future will belong to organizations that can adapt swiftly, leverage technology strategically and build resilient, patient-centered operations.
