As health systems head into 2026 amid margin pressure, policy uncertainty and rising demand, executives are converging around a shared set of priorities. Across responses from CEOs, CFOs and senior leaders, the message was consistent: growth must be disciplined, operationally grounded and closely tied to mission and access.
Becker’s gathered insight from 89 hospital and health system executives from across the U.S. who will speak at the 16th Annual Meeting, April 13-16 at the Hyatt Regency in Chicago. Here are the 10 themes cited most often by healthcare C-suite leaders when asked how they plan to balance stability with growth in the year ahead.
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1. Workforce stability as the foundation for everything else. Workforce stability is the prerequisite for both financial performance and growth. CEOs and CFOs emphasized that retention, engagement and staffing sustainability matter more than recruitment alone. Several noted that premium labor, turnover and burnout directly erode margins and limit capacity. Investments in leadership development, scheduling flexibility, housing, well-being and practicing at the top of license were consistently framed as growth enablers, not cost centers. Without a stable workforce, growth strains the organization rather than strengthens it.
2. Disciplined operating models and cost transformation. Executives repeatedly stressed that stability in 2026 depends on operational rigor and cost discipline. CEOs described the need to execute quickly, eliminate waste and standardize work before pursuing expansion. CFOs highlighted margin protection through labor management, expense control and productivity improvements rather than blunt cost cutting. Many leaders said they are embedding operating systems, Lean management and daily performance management to hardwire discipline. They noted operational excellence creates the financial headroom required for responsible growth.
3. Intentional, mission-aligned growth. Bigger is not inherently better. Growth decisions are increasingly being filtered through mission, community need and long-term sustainability. CEOs described focusing on where to win — specific service lines, geographies or populations — rather than broad expansion. Several cautioned that pursuing volume without operational readiness leads to instability and staff fatigue. The shared priority is purposeful growth that strengthens access, outcomes and financial resilience simultaneously.
4. Technology and AI as efficiency levers, not disruption. AI and digital tools appeared frequently, but rarely as standalone strategies. CEOs and CFOs framed technology as a way to reduce administrative burden, automate routine work and scale operations without adding linear cost. Leaders emphasized platform consolidation, governance and reliability over experimentation for its own sake. Many noted that AI must be paired with workflow redesign to deliver real ROI. The dominant theme was pragmatic adoption by using technology to fund growth by stabilizing operations.
5. Revenue cycle performance and denial reduction. Financial leaders highlighted revenue integrity as a top 2026 priority. Reducing denials, improving documentation, accelerating authorizations and tightening front-end processes were cited as essential to stability. Multiple CFOs stressed that organizations cannot afford uncompensated effort as reimbursement tightens. Leaders framed revenue cycle improvement as both a defensive and growth strategy, protecting earned revenue while freeing capital for reinvestment.
6. Access expansion through ambulatory, virtual and digital care. Many CEOs identified access, not inpatient volume, as the primary growth lever for 2026. Ambulatory care, virtual services and outpatient capacity were described as lower-cost, higher-leverage ways to meet demand. Leaders emphasized aligning access expansion with throughput, length-of-stay reduction and capacity management. Several noted that growth increasingly means seeing more patients without adding beds.
7. Standardization and systemness across the enterprise. Large system leaders frequently pointed to the need to operate as one system rather than a collection of sites. Standardized platforms, clinical pathways, staffing models and governance are seen as critical to absorbing growth without introducing variability. CEOs described systemness as a way to unlock scale advantages while improving reliability. CFOs linked standardization directly to cost control and predictability. Then growth works best when it plugs into a system that already functions well.
8. Culture, trust and leadership alignment. Culture surfaced as a recurring and operational priority. Leaders emphasized transparency, shared accountability and frontline trust as essential to executing difficult changes. Several CEOs noted that stability comes when teams understand the “why” behind decisions and feel included in them. Culture was framed not as a soft concept, but as a driver of performance, retention and adaptability. In uncertain times, aligned leadership and consistent messaging were seen as stabilizing forces.
9. Value-based care and population health focus. Many executives highlighted deeper investment in value-based care, population health and care management as part of their 2026 strategy. Leaders cited the need to manage risk, reduce avoidable utilization and align incentives across the continuum. Technology and data were frequently mentioned as enablers of these models. While acknowledging the complexity of the transition, CEOs and CFOs agreed that long-term stability depends on moving beyond pure volume-based growth. The emphasis was on balancing near-term margin needs with longer-term value creation.
10. Financial resilience and capital stewardship. Leaders returned to the importance of balance sheet strength and financial resilience. Maintaining bond ratings, liquidity and disciplined capital allocation were cited as prerequisites for growth. CFOs emphasized scenario planning, conservative assumptions and protecting core services. CEOs are describing “resilience” as the ability to invest through uncertainty rather than react to it.
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