AdventHealth CEO David Banks looks to build on first year

As an avid cyclist who has gone on biking trips covering hundreds of miles, David Banks moves at a fast pace.

But even he marvels at how quickly he has completed his first year as president and CEO of the AdventHealth system.

“It's amazing how fast a year can go,” he tells Chief Healthcare Executive®. “I really can't believe it's been a year. It has been such a fast year.”

Banks began leading the faith-based health system in April 2025, succeeding Terry Shaw, who served as CEO for eight years. AdventHealth operates 57 hospitals and more than 2,000 care sites in nine states.

Banks has spent more than three decades with the health system, and he served as AdventHealth’s chief strategy officer before becoming CEO.

“The role I served directly prior to becoming CEO gave me a very clear line of sight into our strategy, our culture, our mission,” Banks says.

“We've been able to keep moving in the same direction,” he explains. “And so as chief strategy officer, a lot of what we're doing, I helped co-create. And so in some ways, I'm living with a little bit of my own cooking as from my previous roles, which has made the transition actually quite smooth.”

In a recent interview, Banks talked about taking over the top spot and managing services in several very different markets. He also outlined the challenge of cuts in Medicaid and why he doesn’t expect AdventHealth to roll back services.

‘Pressure and responsibility’

Banks drew on his experience as a cyclist during a keynote address at the HIMSS Global Health Conference & Exhibition last month. He talked about how cyclists don’t like riding into headwinds, but sometimes it can’t be ignored. He urged healthcare leaders to find ways to deal with the headwinds.

“Hoping the headwind goes away, likely moves to complete disruption,” Banks said, adding, “There's actually not much hope, as you know, for those who choose complacency, ignoring trends.”

Even though he says the transition to CEO has gone well, Banks says it has been an adjustment.

“You definitely feel a level of pressure and responsibility and accountability that you know exists,” he says. “But until you're sitting in the seat, you know, as they say, the buck stops here. You really feel the weight of that. So yes, that takes a little bit of adjusting additionally.”

Banks says the system hasn’t pivoted under his leadership as CEO, but he says the system was at “a natural inflection point.”

While some of those efforts in improving the patient experience had been underway, Banks says it was time to move forward.

“I shifted the focus really into consumer experience, clinical quality, strategic growth,” Banks says. “It takes the organization a minute to get used to your voice and cadence, as it were, but overall, it's been pretty well accepted and has gone fairly smoothly.”

Managing different markets

With hospitals and nine states, AdventHealth deals with different challenges in very different markets.

AdventHealth sees tailwinds in Florida and Texas, since the states are business-friendly and are seeing steady population growth.

“We have a lot of history and momentum in these communities,” Banks says.

AdventHealth has focused attention on its hospitals in Colorado. The system took over management of the Colorado hospitals in July 2023 after ending an affiliation with Catholic Health Initiatives, now part of CommonSpirit Health.

AdventHealth has been working “to get our footing” in Colorado, Banks says.

“We've really been focused on that for the last two years, have made great progress in that,” Banks says. “But yeah, there's a heavier lift in places like that.”

AdventHealth also serves in rural areas, such as Clay County, Kentucky.

“Those are just healthcare challenged markets, communities, if you will,” Banks says. “And our teams work really hard to ensure access, availability of key services in a fairly resource-constrained environment.”

Preparing for Medicaid cuts

Hospitals and health systems around the country are bracing for more financial difficulties with Medicaid cuts unfolding over the next decade. Medicaid spending is expected to be reduced by $1 trillion over the next 10 years over previous spending projections, and millions of Americans are expected to lose Medicaid coverage. Hospital executives say some systems could end up cutting services or even closing facilities.

States also face new rules in how they can finance their Medicaid programs, and will have to make choices about what services are covered and how many will have coverage.

With AdventHealth operating in nine different states, the system must prepare for different approaches.

“We have different environments with each state, but the strategies are pretty consistent,” Banks says. “Ensure you have the right access points for care delivery, and in Medicaid, that often means more community access points. Medicaid populations tend to have more psychosocial determinants and psychosocial issues that often can be addressed in community settings versus the heavy acute care settings.”

AdventHealth is working to ensure access to primary care, specialty care, and other community-based services. He also notes that the expiration of tax credits for the Affordable Care Act also put more people at risk for losing coverage.

“We're investing quite a bit in new primary care models, in home models of care that allow care to be provided, but at lower cost points to ensure that people can have access to the services they need,” he says.

Banks says AdventHealth will need to continue to exercise fiscal discipline, but he says he’s not anticipating the need to reduce services.

“It is an advantage of being a system,” Banks says, “If I was just a standalone facility in Kentucky, yeah, I would be very nervous. But being tucked inside of a system the size of AdventHealth that has scale and efficiency, it really allows us to take a longer term view in those communities that are more resource-constrained, or rely much heavier on governmental payment, whether it's Medicare or Medicaid.”

“Being part of a system and creating efficiencies lowers our costs, and allows us to, I think, have longer staying power,” he adds. “And so no, we're not real worried about not being able to maintain. We do focus on efficiency, though, and making sure we have the right access points.”

AdventHealth is also looking to make sure that people aren’t going to the emergency department for basic health care needs. Some hospital leaders worry that emergency departments will become packed with uninsured patients seeking care.

“Obviously, emergency departments are a critical part of a delivery system, but they've got to be used correctly …. that's not a great place to get primary care,” he says.

The system has been investing in virtual primary care solutions to try and offer other avenues for care. AdventHealth has also invested in urgent care centers, which offer more access at a much lower cost than a visit to the emergency room.

“If we can get patients who have that clinical level of need into those venues, we think that's the right solution for the community,” Banks says.