The financial supports that have long underpinned academic health systems are under pressure from multiple directions at once. Jody Reyes, COO of the clinical enterprise at Iowa City-based University of Iowa Health Care, believes the organizations that weather the current environment best will be the ones that act before that pressure forces their hand.
“You can’t open an article or read a journal or even talk to a colleague without this topic coming up,” Ms. Reyes said in a recent episode of the “Becker’s Healthcare Podcast.” “Academic health systems have historically relied on several mechanisms to help support the additional missions that we are accountable and responsible for, things like 340B, provider-based reimbursement, and other payment structures. They are all under significant scrutiny at this time.”
Ms. Reyes oversees operations across UI Health Care’s academic medical center, children’s hospital, community hospitals and ambulatory environment. She said the current moment in healthcare has “tremendous opportunity, but also a need for greater operational discipline.”
“Site neutrality is a particularly important issue because it challenges some of our underlying economics of providing complex care in our academic health systems,” she said. “At the same time, our underlying costs continue to rise. Labor, pharmaceuticals, supplies, implants, technology, capital, they are all so expensive, and health systems cannot simply pass those costs along to our patients.”
The path forward is not reactive cost-cutting when the pressure arrives, but a deliberate redesign.
“The question we’re really asking ourselves is, how do we redesign our operating model before those external forces require us to do it?” she said. “That means becoming much more intentional about productivity, site of care, clinical variation, supply utilization, and how we deploy our limited capital dollars.”
For the remainder of 2026, her priorities are improving operational performance, leveraging UI Health Care’s scale as a system and strengthening financial resilience. The work spans workforce productivity, capacity and throughput, supply chain management, high-cost clinical resources and standardizing operations across the enterprise.
“Our organization will be its strongest over the next several years if we are willing to make those changes proactively rather than waiting for reimbursement pressures to force the conversation,” she said.
Executing on that redesign requires more than strategy at the top. It requires leaders at every level who can spot operational problems in real time, not in a quarterly review but in the flow of a busy clinical day. Healthcare generates abundant data but has historically struggled to convert it into actionable information to spark even deeper operational efficiencies.
“In healthcare, we have an enormous amount of data, and the challenge is turning it into information that our leaders and our front line can actually use to make decisions and then creating accountability around those decisions,” she said.
She comes back to the same point repeatedly when she talks about performance improvement.
“One of the things that I say all the time — I think I say it at least five times a day — is that we need our leaders to be able to see problems,” Ms. Reyes said. “It’s very hard, in the middle of a busy day, to really be able to look across the processes, the workflows, and understand where the waste is, where we are asking people to do rework and redundant processes.”
Ms. Reyes began her career as an officer in the United States Navy Nurse Corps, serving from 1999 through 2004 and deploying to Iraq in 2003. The discipline and accountability she internalized in that environment inform how she approaches healthcare operations today and the clarity she brings to center transformation.
“Ultimately, I think the goal is really simple,” she said. “We need to make it easier for our teams to provide great care while making sure that the organization is positioned to remain strong for the long run.”
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