Inside the C-suite: Health system leaders on AI, access and a tough 2027

Health system leaders are heading into 2027 facing Medicaid cuts, workforce strains and growing pressure to show real results from artificial intelligence.

During the Becker's CEO + CFO Roundtable in Chicago earlier this month, Chief Healthcare Executive sat down with executives to talk about how they're handling the real challenges facing their systems. They came from academic medical centers, rural hospitals and some of the country's largest health systems.

Starting this week, we'll publish a new interview each day. Several themes came up across the conversations:

• AI in practice. Leaders are seeing gains in documentation and administrative work. Several urged caution about costs, governance and hype.
• Access to care. Executives said the real bottlenecks are coordination, referrals and handoffs, not just open appointment slots.
• Financial pressure. Federal Medicaid changes, state cost controls and site-neutral payment proposals loom over 2027 planning.
• Workforce. Systems are building their own pipelines and working to keep nurses and physicians at the bedside.
• Rural care. Leaders described how they're keeping care close to home through partnerships, telehealth and new funding.

A preview of the conversations

• Erik Wexler, president and CEO, Providence, on the system's financial turnaround and the tough decisions still ahead. "These Medicaid changes, among other things, supply chain costs, pharmaceutical costs … it's really what I call a polycrisis," he said.
• Mandy Richards, president of Intermountain Children's Health and chief nursing executive, Intermountain Health, on the new children's hospital in Nevada and keeping nurses at the bedside. "For Nevada, it's all about bringing the kids home," she said.
• Richard Mulry, president and CEO, Northwell Holdings, on how Northwell invests in and builds health care companies, and what it looks for in a startup. On bringing AI into clinical care, he said, "Speed moves at the rate of trust."
• Chris Van Gorder, president and CEO, Scripps Health, on reducing violence against health care workers and building a strong culture. "You can't write a memo and change culture," he said.
• Albert Wright, president and CEO, WVU Medicine, on growing while many health systems pull back. "Health care finances these days are held together with toothpicks and bubblegum," he said. "But if we're going to be a large top academic quartile health care system, we need to be bold."
• Dr. Jay Grider, president of acute hospitals, UofL Health, on managing capacity as one system and why change has to come from the front line. "Every operational improvement initiative that starts in a C-suite should just be stopped immediately," he said. "It has to start at the frontline with the people that are doing the work."
• Dr. Nolan Chang, executive vice president, The Permanente Federation, on value-based care and why AI should make patient visits more meaningful. On the idea of AI letting primary care doctors manage 10,000 patients: "That excited nobody. People want more meaningful interactions."
• Biju Samkutty, chief operating officer, Mayo Clinic International, on how operations leaders should prepare for the next five years. "Great COOs have to continue to focus on the needs of the people in front of them and the patients that they're serving," he said.

After the series, Chief Healthcare Executive will publish deeper analysis of the trends from these conversations, bringing several leaders' views together on the issues shaping health systems.

Check back each day for the latest interview, and follow Chief Healthcare Executive on LinkedIn for highlights.