Cedars-Sinai CEO talks about meeting financial challenges at ViVE 2026

As the president and CEO of Cedars-Sinai, Dr. Peter Slavin is accustomed to dealing with financial headwinds.

But the current moment for nonprofit health systems and academic medical centers is especially daunting, he tells Chief Healthcare Executive®.

“I would say there's no doubt that the financial headwinds are growing, and probably more ominous than I've ever seen in my career in healthcare management,” Slavin says.

Slavin will be participating in a discussion about this challenging environment for hospitals at the ViVE digital health conference this month. The event takes place at the Los Angeles Convention Center Feb. 22-25.

• Read more: ViVE aims to tackle big problems in the healthcare industry

Hospitals and health systems are facing some difficulties due to federal legislation and policy changes. The enhanced tax credits supporting the Affordable Care Act expired at the end of December, and millions are expected to lose coverage due to big increases in premiums. So hospitals are expecting to see more patients who may not have the ability to pay.

Health systems are also bracing for cuts in Medicaid and millions more losing coverage due to the HR1 tax package President Trump signed last summer. The changes will unfold over the next several years, but analysts expect a cut of $1 trillion in Medicaid over the next 10 years, with more than 10 million possibly losing coverage.

“Hospitals like Cedars-Sinai are committed to those patients, and patients who are now covered by government programs will become uninsured, and that will have a significant impact on our finances,” Slavin says.

“So that's one headwind, on top of the basic flawed economics of teaching hospitals that we've been dealing with for many years, and for which there's no end in sight,” he adds.

For academic hospitals and many health systems, costs are rising at a faster rate than revenues, he notes.

(See part of our conversation with Dr. Slavin. The story continues below.)

Devising a game plan

With Medicaid cuts looming, Slavin stresses the need to be planning now.

“We’re looking top to bottom at our organization through an initiative that we've launched called ‘Accelerating Excellence,’” he says. “We're trying to find ways to grow revenue, reduce expenses, and come up with a game plan with respect to those headwinds before they hit. So we're trying to be as proactive as possible so that we have time to think through ways that we can pursue our mission on lower octane fuel than we've been used to.”

“We don’t want to wait until we're underwater and have to do some desperate things. So we were trying to do this proactively and so that we can be as thoughtful and comprehensive as possible,” Slavin says.

With the “Accelerating Excellence” initiative, Cedars-Sinai is looking at making its operating room more efficient. The system is also looking at ways to reduce the length of time patients stay in the hospital. And Cedars-Sinai is looking to help expand access to outpatient locations as well.

“We do all those things that will not only provide better, more accessible care for people, but will enhance the finances of the organization as well,” he says.

Cedars-Sinai is going to work to expand its fundraising efforts, he says.

“We're trying to grow our philanthropic program. It's grown significantly in recent years, but we think there's significantly more potential to turn to philanthropists and ask them to support our mission,” Slavin says.

Cedars-Sinai operates one of the 10 largest hospital-based research programs in America, and Slavin says he sees the potential for more revenue to come from that research.

“We have a lot of exciting intellectual property that comes out of our research, and so we want to try to commercialize that, not only because of the financial opportunity associated with it, but even more importantly, if we don't commercialize it, it's never going to benefit people in the world,” he says.

• Read more: AI takes center stage at ViVE 2026

Don’t get distracted

At the ViVE panel, Slavin will be discussing ways hospitals and health systems can be more efficient and generate more revenue. He’ll be joined in the discussion by John Couris, president and CEO of Tampa General Hospital.

In his conversation with Chief Healthcare Executive, Slavin offered some advice for other health systems as they confront a turbulent time.

“The first thing that I always advise people is never take your eye off the ball,” he says.

“The most important thing that we do here at Cedars-Sinai every day is care for 1,000 inpatients and thousands of outpatients,” he continues. “And I think making sure that we meet and exceed the expectations of those people is our most important responsibility. And I think too many healthcare organizations I've seen over the years get distracted by some business challenge or opportunity or another, and take their eye off that ball. You can't ignore that. That has to continue to be job one.”

Even though running a health system means dealing with many complexities, he says, they should find ways to be more efficient and to generate more revenue.

“I would encourage leaders to think as thoughtfully as possible about ways to pursue their mission, but do it in an economically sustainable sort of way,” he says. “And don't wait until the storm has hit, because then it's too late.”

Chief Healthcare Executive® will be reporting from the ViVE conference in Los Angeles Feb. 22-25. Look for our coverage.