Aspirus Health CEO Matt Heywood: 'You've got to be pragmatic'

As president and CEO of Aspirus Health, Matt Heywood says he embraces being pragmatic.

He says that approach extends to planning for the future, including preparing for, and even expecting, tough times.

Heywood tells Chief Healthcare Executive® that he wasn’t surprised by the planned cuts in Medicaid that will reduce spending by $1 trillion over the next decade, leaving millions without coverage. He also says he’s expecting modest funding from Medicare programs in the near future.

He says he’s not pessimistic, but he is realistic. He calls himself a “positive pragmatist.”

And he says that approach to planning has paid dividends for the health system, which operates 18 hospitals in Wisconsin and parts of Michigan and Minnesota.

“I would say, unfortunately, we've been more right than wrong about the view of the future,” Heywood says. “And I know sometimes I'm considered to be Mr. Bleak, but it's the reality that you’ve got to be pragmatic. And I hate to say it, not every picture is rosy.”

• See more: Matt Heywood is featured in Changes, our new video series

He also credits the team at Aspirus for being willing to adapt and make difficult decisions.

“We really created a culture here at Aspirus where the ability to have foresight that may not be overly optimistic, sometimes to have people deal with friction when other people don't want to change, but we're willing to change,” he says.

A $1 billion gap

Heywood has led Aspirus Health for 13 years, and the health system has expanded significantly under his watch. In 2024, Aspirus completed the acquisition of St. Luke’s in Duluth, Minnesota, a system operating two hospitals. Aspirus purchased seven Wisconsin hospitals from Ascension Health in 2021.

Even as Heywood cites the need to be pragmatic, he’s not exactly promoting a philosophy of austerity. The system is in the midst of expanding Aspirus Wausau Hospital to accommodate anticipated growth, and the project’s price tag is around $250 million, he says.

“You’ve got to be proactive,” he says.

Aspirus is also building a small, 10-bed hospital in Chippewa Falls, Wisconsin, a facility that is slated to open later this year. The move comes after The Hospital Sisters Health System closed two hospitals in western Wisconsin two years ago: Sacred Heart Hospital in Eau Claire and St. Joseph’s Hospital in Chippewa Falls.

Heywood says the new hospital is the right size for the area.

“We went with, I think, a more reasonable footprint, a small hospital, and that's going to be built and up and running very quickly,” Heywood says.

While he says Aspirus Health has made good decisions, he also explains that the $3 billion system is still facing a “$1 billion gap that we have to deal with over 10 years.”

He says that could be viewed as pessimistic, but he’s planning with the idea that HR 1, the domestic policy package signed by President Trump last year, is here to stay, and Medicaid changes won’t be overturned or modified down the line. He also isn’t expecting big changes in Medicare reimbursements for hospitals.

“The reality is we’ve got to find out how to become $1 billion more efficient over 10 years through cost growth, operational changes, and if you don't start today for some of this, you won't be able to get it later,” he says.

The health system said Wednesday that it is shutting down Aspirus St. Luke’s Home Health Services in Minnesota, citing the need to “focus our resources where they can have the greatest positive impact in meeting the evolving needs of our communities.” The move affects 29 employees, and Aspirus says it is looking to offer those workers different roles in the system.

Heywood says the system has to look at delivering services in a changing environment.

When Heywood spoke with Chief Healthcare Executive a few weeks ago, he said that Aspirus is looking to maintain services, but the delivery could change as communities change. And he says services may not end if some communities see shrinking populations, but there could be a “remodeling” in care delivery.

“If a community is shrinking from 10,000 to 2,000 they may not need a hospital. They might need more of an outpatient center if they have access to a hospital 30 miles away,” Heywood says.

“There's certain things we might have to do a little differently,” he continues. “And we might not be able to, with the world that we have, to be able to provide physicians at certain sites. It may have to be remote, like with AI, or it might be telehealth. So I think the way care is going to be delivered definitely will change. So I think the people have to be prepared the way the world was, is not going to be the same, but it doesn't mean we won't still give you great care, and be there for our communities.”

Fast followers

Heywood talks about looking forward, but he also says he hasn’t necessarily wanted to rush to adopt artificial intelligence solutions. He says AI is going to be a helpful tool for health systems, but he says he doesn’t see the need to be first in adopting AI solutions. He says he is comfortable with Aspirus being “fast followers.”

He points to ambient documentation tools, which use AI technology to record and quickly summarize physicians’ conversations with patients. More hospitals and health systems are using ambient documentation to help doctors reduce the time they spend on updating patient records, and as a tool to reduce burnout and improve retention.

By waiting on adopting ambient technology, Heywood says the system has seen significant savings. Three years ago, Heywood says ambient documentation solutions would have been far more expensive, and he would be tied into a multi-years contract. Now, he says he can use ambient documentation tools with Epic’s electronic health record system for a fraction of the cost.

Heywood says he sees a significant expansion in the use of AI to deliver care. In five years, he says he could see the potential of AI agents handling some basic primary care services, with doctors focusing on more “higher level” primary care appointments.

“We see two pieces to this AI change: a more pragmatic, fast follower, enabling technology version, and then a transformative version. And we're trying to bridge the two and put them together,” Heywood says.