Becker’s asked C-suite executives from hospitals and health systems, along with academic medical centers and universities across the U.S. to share which alternative revenue streams wil reign supreme in 4 years.
The 36 executives featured in this article are all speaking at the Becker’s Healthcare 14th Annual CEO + CFO Roundtable, from November 2 – 5, 2026 at the Hyatt Regency Chicago.
To learn more about this event, click here.
If you would like to join as a speaker or a reviewer, contact Mariah Muhammad at mmuhammad@beckershealthcare.com or agendateam@beckershealthcare.com.
For more information on sponsorship opportunities, contact Jessica Cole at jcole@beckershealthcare.com.
As part of an ongoing series, Becker’s is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.
Question: Which alternative revenue streams will define survival by 2030?
Jochen Reiser, MD, PhD. President of The University of Texas Medical Branch; CEO of UTMB Health (Galveston, Texas): As reimbursement pressure continues to mount, healthcare’s future will be defined less by volume and more by quality, value and patient experience. That reality demands new operating models, including AI-enabled care journeys that enhance every step of the hospital and clinic encounter from intake to follow-up. Providers that lead in this transformation will be the ones that thrive.
Equally important, health systems that build strategic partnerships with AI technology companies today will create new opportunities for growth, innovation, and diversified revenue streams. Those that adapt with speed and purpose will be best positioned to lead the next era of healthcare.
Peter D. Banko. President and CEO of Baystate Health (Springfield, Mass.): Western Massachusetts is defined as a market with an aging demographic and limited-to-no population growth. Consequently, our community’s payer mix is 70% government payor (48% Medicare and 22% Medicaid before the One Big Beautiful Bill Act) and growing. In Baystate Health 2030 (our enterprise strategic plan developed last year), we defined a resilient and sustainable health system as one that was clinically driven and physician-led with a seamlessly accessible care model and coordinated care networks. So, we view a future of alternative revenue streams with an interconnected ecosystem of providers, our integrated health plan, independent health plans and the state government using shared technology (including AI) and unified, holistic care plans to manage member health and total cost of care proactively, efficiently and effectively.
Rob Chestnut. Senior Vice President and CFO of LMH Health (Lawrence, Kan.): LMH Health is focused on developing several alternative revenue streams over the next few years. We are moving into the specialty pharmacy space in 2026 and will expand our retail footprint in our service area over the next few years. Our second initiative is to expand corporate health services in our service area. As a sole community hospital we believe both of these markets have significant potential over the medium-term.
Jeffrey P. Gold, MD. President of University of Nebraska System (Lincoln): By 2030, the health systems that will continue to succeed will be those that recognize high performing workforce as a core driver of the foundation behind every viable revenue stream. Organizations of any size, service line, or type of facility will struggle without the right people who are motivated together around a shared mission. Those with strong, cohesive teams will have the greatest chance at sustainable success. Therefore, the focus must be on recruiting and developing a workforce oriented toward the next generation of care.
The University of Nebraska Medical Center intentionally seeks colleagues, from top surgeons to those who maintain our facilities, who want to be part of something bigger than themselves, and who are deeply committed to every level of patient-centered care. This shared sense of purpose has translated into measurable gains in quality, safety and patient experience, which are increasingly tied to successful financial performance.
Just as important, we foster a culture where individuals work at the top of their training, silos are broken down, and teams are aligned around delivering the highest-value driven care. Competitive compensation and benefits are essential and expected, and long-term success depends on how well organizations develop and retain that talent within a working environment that reinforces excellence and accountability.
Ultimately, the most important alternative revenue stream is a high-performing, mission-driven workforce equipped to deliver the future of healthcare.
George Mikitarian. President and CEO of Parrish Medical Center (Titusville, Fla.): Hospitals have notoriously over built in the past, and with continuing shift from inpatient to outpatient programs/services, find themselves with an abundance of very expensive
space that they no longer need.
The opportunity exists for hospitals to begin leasing that space, thus reducing their expenses
while increasing their revenue. The leasing of that space can be to healthcare related, or
routine retail, creating almost a “medical mall” concept for both staff and the community.
It’s all about revenue per square foot!
Margaret Dimond, PhD. President of UM Health Regional Network (Ann Arbor): Within the UofM Regional Network, we are pursuing some key alternate revenue ventures that previously would not be top priorities. Our leaders felt that medical supply, hospice, and home care were not part of our ‘core services.’ We struggle with billing and coding, and having overall expertise in these post-acute areas. We are moving towards joint ventures that would enhance the business piece of the services. Our goal is to have the transactions complete, so we can focus on driving enhanced revenues, while ensuring quality and use of the business knowledge with a partner(s) that excel in delivering service and overall better results than the health system ‘going it alone.’ On the wellness front, we own a health club, which has begun to produce meaningful and sustainable alternate revenue for the system.
Wayne Gillis. President and CEO of Rehoboth McKinley Christian Health Care Services (Gallup, N.M.): Risk-based, or total cost of care revenue, stands out as the most critical path forward for rural healthcare — not because it is the most exciting option, but because it is the only one that protects the entire system at once.
Rural hospitals rarely fail due to a lack of ideas. More often, they struggle under the weight of structural realities: limited and inconsistent patient volume, a high fixed-cost base, a payer mix heavily weighted toward Medicare and Medicaid, and the quiet but persistent impact of outmigration draining margin from the system. While there are many alternative revenue streams — such as ambulatory surgery centers, imaging, or pharmacy — nearly all of them remain dependent on volume. Risk-based care fundamentally changes that equation.
It shifts the core question from “How do we get more patients through the door?” to “How do we manage the health and cost of the population we already serve?” That shift is where the transformation begins.
When done well, several important changes follow. Financial stability begins to replace volatility, reducing reliance on daily census fluctuations or surgical volume to sustain margins. Outmigration is no longer just a leakage issue — it becomes a strategic priority, as keeping care local directly impacts financial performance. Primary care, often undervalued in traditional models, becomes the economic engine of the organization. At the same time, post-acute services such as swing beds, home health, and care coordination evolve from perceived cost centers into essential tools for protecting margin and improving outcomes.
What many leaders underestimate, however, is that risk is not simply a contract—it is an operating model transformation. Success requires redesigning access to ensure timely primary care availability, building a care management infrastructure that actively supports patients, aligning physicians around standardized care pathways, and maintaining a relentless focus on reducing avoidable utilization. Without these foundational changes, risk-based models introduce exposure rather than opportunity.
Emily Moorhead. President of Macomb Market at Henry Ford Health (Detroit): As a hospital leader, this may not be a popular or traditional position, but I believe there needs to be greater capture of quality and cost incentives. The focus needs to be on keeping people healthier by moving care upstream and into lower-cost settings, such as primary care, clinics, ambulatory centers, and urgent care, rather than relying on higher-cost hospital environments. Strong alignment between payers and health systems will be essential to ensure shared financial success across the continuum of care.
Wyatt Brieser. CEO of Hammond-Henry Hospital (Geneseo, Ill.): By 2030, I believe there will be two healthcare shifts that will largely support organizational financial viability, and one other that I hope finds a way to support that viability.
First, employer‑contracted care models will continue to gain traction as both employers and health systems look for ways around rising premiums, administrative friction and misaligned incentives. Direct partnerships can create shared accountability for cost, access and outcomes while establishing more sustainable revenue frameworks for hospitals and businesses alike.
Second, at‑home care capabilities will expand as therapeutics, diagnostics and remote monitoring mature, enabling care delivery that improves access while meaningfully reducing fixed overhead.
Finally, I hope we see broader momentum toward proactive health and wellness. Our industry still operates largely in a reactive model, and meaningful improvement in population health will require coverage and benefit designs that prioritize prevention, nutrition, exercise, and mental health.
The direct‑to‑employer arrangements may be an opportunity to really start this trend. If the system can find a way to capitalize off of keeping people healthy, we could finally realize a real paradigm shift in health trends in America. Yearly physical therapy evaluations for workplace ergonomics, pelvic floor prehabilitation for expecting mothers, annual covered dietician consultations, annual wellness labs, mandatory colon screening for employees taking company insurance, mental wellness consultations, wellness chiropractic adjustments… Too utopian?
Adrin Mammen. Vice President and Chief of Ambulatory Patient Access at Mount Sinai Health System (New York City): By 2030, the systems that endure will be those that learn to capture the demand they are already losing today. For Mount Sinai Health System, that is less about entirely new revenue streams and more about unlocking access. That means getting patients in faster, reducing leakage, and converting referrals into care. The biggest opportunity is upstream: digital scheduling, smarter intake, and better alignment of supply and demand across ambulatory care. Virtual care and AI will help, but only if they are embedded into how care is actually scheduled and delivered. The real differentiator will be how effectively systems convert demand into visits and visits into longitudinal care.
Rick E. Smith. CEO of Troy Regional Medical Center (Ala.): At Troy Regional, we are constantly challenged to ‘Think Differently.’ We know that inpatient volumes will continue to decline so we must depend on our outpatient services to provide a margin. Those include same day surgery, imaging, and infusion services. We are also partnering with some of the community industries to provide on-site occupational medicine services, so their employees never leave the business site. We have also completed [joint ventures] with home health and rehab partners to keep our patients close and to prevent possible out-migration.
In rural facilities, we can’t always hire the specialists that we need so we look to telehealth services to assist. We are currently evaluating tele-nephrology so we can potentially avoid the 100+ transfers per year we currently experience. We also recognize that primary care is the foundation of everything we do in the rural community setting. By expanding the footprint of our primary care clinics to surrounding communities, we are keeping healthcare close to home.
At Troy Regional, we also provide niche services that some area hospitals do not provide. Services like geriatric psych, and medical addiction, are just two of the services that create a margin for our facility.
Lastly, we are always looking for additional funding sources in the form of grants, DSH payments and state and federal funding opportunities. It will not be the complete answer for growth, but it will be a lifeline for rural facilities.
Angelo Milazzo, MD. Chief Medical Officer of Duke Health Integrated Practice (Durham, N.C.): Over the next half-decade, subscription-based care will be an increasingly important area for revenue stream diversification in healthcare. Patients’ perceptions of quality are now bound up in how closely our offerings meet their expectations for convenience, customization, efficiency, and lack of friction. And many patients are willing to pay a premium for what they perceive to be a more tailored, more personalized experience of care. Generally healthy patients who might otherwise participate in high-deductible, high out-of-pocket-cost plans may seek alternatives with predictable costs. The question of how this will drive utilization is an open one and will have to be part of the calculus in the design of these models.
Lawrence Montgomery. Chief Marketing Officer of Baptist Health (Louisville, Ky.): Looking ahead to 2030, I believe alternative revenue streams tied to direct-to-consumer wellness and preventative care will be critical to organizational survival. We are already seeing growing demand from patients willing to pay out of pocket for services that fall outside traditional fee-for-service reimbursement — particularly in areas like longevity, metabolic health, and proactive diagnostics. This shift is being driven in part by younger generations who are more focused on optimizing long-term health and avoiding the chronic diseases they’ve seen impact prior generations. In many ways, the rise of health tourism reflects this demand, and I expect more of that spending to remain within the United States as domestic providers evolve to meet it. Organizations that can build trusted, consumer-facing wellness offerings — separate from traditional insurance models — will be best positioned to capture this emerging market. Ultimately, success will come from aligning clinical expertise with a more personalized, prevention-focused patient experience.
Elaina Schnoebelen, MSN. Market Chief Nursing Executive of Chicago North at Kindred Healthcare (Louisville, Ky.): Coming from the long term acute care side, to survive and continue to be marketable by 2030 it is vital to think outside the box when it comes to alternative revenue streams.
As we receive all our patients through the referral process, we will need to look at all areas for referrals. Not just through the short term acute care side which we currently do.
Exploring ways to bring in patients from the other side of the care continuum could be an option. Many of our SNF have high RTA rates and could we look to partner with them to bring patients to us first to treat and return, as compared to having them just send their patients to the ED. This could be an option if diagnosis has already been determined and additional treatment such a high flow O2 or blood transfusions are needed.
As a LTACH, we always want to be that other option.
Kristopher Doan. President of Augusta Medical Group at Augusta Health (Fishersville, Va.): I don’t know if it’s considered an alternate revenue stream any longer, but I am very focused on optimizing non-FFS revenue streams in the organization. We have an ACO that is making us more competent each year in value-based revenue streams and shared savings. We are also exploring more cash-based revenue streams in both traditional cash-based services (i.e. cosmetics) and services that have not traditionally been cash-based. With national increases in the utilization of high-deductible plans, increases in the numbers of uninsured patients, and increased friction between insurance companies and their members, I expect to continue to see an increase in the percentage of self-pay dollars coming into the system.
Another opportunity for health systems to explore alternate revenue streams is by selling your expertise as a product. That can be done on a smaller, local scale by selling management services and/or technology services to local private practices through a MSO model; or it can be a much larger scale if you have really solved a problem that the industry is facing by patenting medical devices or selling expertise in a particular area through consulting.
Perry Sham. CFO of Niagara Falls Memorial Medical Center (N.Y.): For hospitals, the alternative revenue stream that has the most potential for real impact by far are direct-to-employer arrangements. These are arrangements where hospitals work directly with employers to set up medical benefits for employees. Over the past few years, these arrangements have shown savings for employers ranging from 10% to 25%. For hospitals, this is a rare opportunity to drive growth. This should be an option every hospital CFO evaluates.
Boris Pasche, MD, PhD. President and CEO of Barbara Ann Karmanos Cancer Institute (Detroit): No single alternative revenue stream will guarantee success, so at Karmanos, we are leveraging multiple strategies to manage uncertainty around traditional funding sources, such as the 340B drug program and federal research support. First, we’re focused on becoming more self-sustaining and efficient. Part of that includes developing new revenue streams, such as our specialty pharmacy, which has grown steadily in recent years across our 17 locations in the Karmanos Cancer Network and our parent, McLaren Health Care. The specialty pharmacy is already a source of expanded revenue for us, but by 2030, it will contribute even more. Second, clinical trials, particularly early-phase and industry-sponsored clinical trials, will increasingly serve as both a clinical differentiator and a meaningful revenue contributor. Meanwhile, precision medicine and theranostics will drive higher-acuity, targeted care models, while our digital second opinion program will become a national front door, helping expand access and feeding downstream care. We are already seeing positive results from these strategies. For instance, in the past two years, Karmanos’ patient volumes have grown robustly from about 14,000 new cases two years ago to 16,000 in the most recent fiscal year, which, of course, also contributes additional revenue.
Marcus Lewis. CEO of First Care Health Center (Park River, N.D.): The individualization of rural hospitals creates both challenges and opportunities for the future of healthcare. Patient and community populations are exponentially evolving, and successful organizations must shape their delivery to meet these needs. Capturing revenue to match these is incredibly challenging, and I foresee this road being an uphill one. However, value-based initiatives, integrated telehealth delivery, and clinically integrated networks all provide individual roadmaps for stability in a tumultuous revenue cycle future. Successful collaboration, technological advancement, and interdependent relationships will drive revenue streams consistently across patient populations. Strategic alignment is paramount for leadership, clinical and financial teams, regardless of individual factors.
Craig Cheifetz, MD. President of Primary Care Service Line at Inova (Fairfax, Va.): Alternative revenue streams for a health system increasingly mean moving toward recurring, value-aligned income such as advanced primary care management, shared savings, employer partnerships, virtual and after-hours care, and services that capture work we have historically done but not been paid for. Primary care sits at the center of this shift because it is where attribution, continuity, and total cost of care are won or lost. By 2030, survival will depend on predictable, longitudinal revenue tied to population health, digital access, care management, and downstream integration—not just visit volume.
At Inova, our Primary Care Service Line is intentionally building these capabilities now — scaling advanced primary care management, shared medical visits, virtual and after-hours clinics, and tighter integration with our ACO, employer health, and specialty partners. We are treating primary care as an access engine and a value engine, not simply a clinic footprint. Our focus is to create a world-class patient experience and improved outcomes while also ensuring durable, recurring revenue in an increasingly volatile payment environment.
Roger Mitty, MD. President of Care New England Medical Group (Providence, R.I.): While the migration from traditional fee for service models to value based care models has been slower than many thought, alternate payment models will continue to grow over the rest of this decade. CMS has continued to promulgate the expectation that Medicare patients will be primarily on value based models within the next 10 years.
From the lens of someone leading an employed physician group, opportunities to explore other revenue streams such as partnerships in ambulatory surgery centers and the development of internal ancillary services programs remain in the forefront and will likely guide success over the next five to 10 years.
Finally, staying at the vanguard to leverage AI and other technologies to ultimately improve patient experience and care retention will be key to staying relevant in this space.
Megan Remark. Executive Vice President and COO of HealthPartners Care Group (Bloomington, Minn.): As revenue models evolve, the differentiator by 2030 will be the strength of a health system’s performance infrastructure and its ability to extend its capabilities beyond its own walls and with new partners. Data, analytics and AI-enabled tools will be essential to identify risk, guide decision-making and optimize performance in real time. These capabilities will underpin success in value-based arrangements and enable consistent, scalable outcomes. In parallel, health systems have an opportunity to leverage their clinical, operational and administrative expertise to support partners through services like care management, network development and technology enablement. This creates diversified revenue streams while strengthening the broader care ecosystem. Ultimately, organizations that pair advanced infrastructure with strategic partnerships will be best positioned for long-term sustainability.
Trevor Sawallish. CEO of North Memorial Health (Robbinsdale, MD): I don’t know that it’s a revenue stream per se, but I think partnerships with communities and local and state governments will be crucial. Whether that be clinical and social program partnerships, collaboration on care and social support innovations, or supplemental funding for services that are critical to a community. Health care organizations are here to help people and help communities and we share that charge with local and state governments. I believe there are even more opportunities to partner to make our shared work more effective and affordable for all.
Kerry L. Heinrich. President and CEO of Adventist Health (Roseville, Calif.): By 2030, we will sustain our system through a balanced portfolio of value-based care, ambulatory growth, and disciplined revenue capture while strengthening our hospitals and expanding access points that drive growth. We will deliver a consumer experience that earns trust, builds loyalty, and improves access, while exploring new revenue streams through innovation, AI, and strategic partnerships. We will support that foundation with targeted funding that recognizes the essential role of safety net hospitals.
Mark Brett. COO of Beacon Health System (South Bend, Ind.): Health systems will need to create a digital ecosystem as a future foundational pillar of their core business model, not a complement to traditional care. This includes telehealth and a comprehensive digital consumer strategy. Virtual chronic care, remote consults and urgent care will become minimum expectations by 2030. Remote patient monitoring and digital therapeutics will also gain traction.
Health systems that thrive will be those pursuing creative partnerships. One example is a clinical hybrid approach with employers with defined on-site care and a digital hub that supports the diverse needs of their employees. It’s all about meeting people where they live and work and responding at the speed they need, when they need it.
Victoria Hanson, PhD. Regional President and CEO of Avera Sacred Heart (Yankton, S.D.): By 2030, rural health systems will succeed or fail based on how intentionally they redesign their economic model today. Avera has been very successful prioritizing rural healthcare and focusing on the needs of the communities we serve. The next generation of rural CEOs will lead regional health enterprises built around predictable population‑based revenue, digitally enabled care, scalable behavioral health, advanced pharmacy and infusion programs, mobile and EMS‑based care, and monetized non‑clinical assets.
In the coming decade, sustainability will not be driven by where care is delivered, but by who owns the revenue model behind it — those who keep care increasingly virtual, distributed, and community‑based while maintaining margin discipline across the enterprise will define the future of rural healthcare. The Avera Health system has 22,100 employees and physicians, serving more than 315 locations and 100 communities in a five-state region. Our ministry, our people and our superior values distinguish Avera. We carry on the healthcare legacy of the Benedictine and Presentation Sisters, delivering care in an environment guided by our values of compassion, hospitality and stewardship.
Marc Augsburger, BSN. President and CEO of Edgerton (Wis.) Hospital and Health Services: My personal opinion is as follows: I believe that larger investment into wellness will help define survival. This revenue stream is largely based upon cash purchase and you get paid nearly 100% of reasonable charges for the services. The practice of marrying traditional western medicine and eastern medicine can go a long way in keeping people healthier for longer periods of time. Eastern medicine also has a way of being less stressful and more relaxing which tends to lengthen one’s life. These types of wellness care are often ongoing, creating a regular stream of income.
Deborah Visconi. President and CEO of Bergen New Bridge Medical Center (Paramus, N.J.): Looking ahead to 2030, I believe survival for health systems will depend on our ability to diversify beyond traditional inpatient and fee-for-service models. For us, that means expanding into ambulatory and community-based care, particularly in behavioral health and chronic disease management, where demand continues to outpace supply. We are also focused on building partnerships that extend our reach, whether through academic affiliations, community organizations, or public-private collaborations, to create new access points and shared value.
Another critical area is value-based care, where success will rely on our ability to manage risk effectively and demonstrate measurable outcomes, particularly for vulnerable populations. Digital health and virtual care will continue to open new front doors, but only if they are integrated thoughtfully into care delivery and reimbursement structures. Additionally, workforce innovation, rethinking how care is delivered and by whom, will be essential not just for cost containment, but for unlocking new models of care.
Ultimately, the organizations that thrive will be those that stay rooted in mission while being willing to fundamentally redesign how, where, and by whom care is delivered.
Amber Price. Enterprise Chief Nursing Officer of Sentara (Norfolk, Va.): Sentara is expanding nurse-led ambulatory and chronic care patient access through reimbursable tech enabled ambulatory remote monitoring and enhanced chronic care management services at scale. Diversifying ambulatory access and revenue channels is a core component of Sentara’s 2030 strategy. This strategy aligns with our care model redesign, which includes nurse-led clinics, virtual nursing, and AI support functions in all domains of the IDN.
Michael Hassell. CEO of Melissa Memorial Hospital (Holyoke, Colo.): From my perspective as CEO of Melissa Memorial Hospital, the future of critical access hospitals will be defined less by volume and more by how effectively we convert transformation funding into durable, recurring revenue. Rural Healthcare Transformation Program dollars flowing through Colorado Medicaid are catalytic — but they reward measurable outcomes, partnerships, and infrastructure, not traditional encounters.
By 2030, sustainability will hinge on building and participating in regional, distributed networks that monetize access, care coordination, and downstream services across multi-county footprints. The ability to align with partners and capture value beyond our four walls will be essential.
Growth will come from expanding core rural-relevant services — behavioral health, swing bed utilization, and chronic disease management — structured as ongoing care models rather than episodic activity. Just as important, data infrastructure and care management capability will themselves become sources of support and revenue.
The hospitals that endure will look less like standalone facilities and more like integrated rural health platforms—designed to coordinate care, extend reach, and sustain access in the communities that depend on us.
Kurt Barwis. President and CEO of Bristol Health (Orem, Utah): The year 2030 is literally right around the corner. It seems clear that price transparency for at least high volume services will be more ‘consumer usable’ while a combination of IA/affordability drives consumers to actually use the information to make decisions. While I’m not sure this supports a shift from fee for service to value based care in a big way at least a greater share of purchase decisions will be based on affordability. Patient convenience, provider shortages and the need for flexible work schedules versus in office costs will surely drive telehealth/virtual care.
Traditional diagnostic testing and invasive diagnostic screening procedures will continue to shift to targeted genetic and genome testing. For example there is already a prevalence of cancer recurrence blood tests for solid tumor cancers that will replace annual surveillance PET scans and other diagnostic testing. The shift from inpatient volumes to the ambulatory setting will continue onto new players, i.e. genetic/genome testing labs, as the evidence and confidence builds in them. The impact will likely be a matter of efficacy, with an emphasis on cost, noting that a lack of competition and replacement pricing as we have seen with drugs could slow adoption. And lastly, survival will require AI enabled revenue cycle management systems.
Timothy Layman, DNP, MSN, RN. President and Chief Administrative Officer of St. Mary’s Hospital, Hospital Sisters Health System (Green Bay, Wis.): Hospital survival by 2030 will depend on diversifying beyond traditional inpatient revenue into scalable, consumer-centric models. Systems that build robust ‘hospital-at-home’ and on-demand acute care services will reduce length of stay, free up bed capacity, and capture revenue at a lower cost structure. Subscription-based primary and specialty care models — paired with digital front doors and same-day access — will create predictable revenue while strengthening patient loyalty and referral capture. Hospitals that invest in ambulatory surgery centers, retail health, and employer-direct contracting will shift volume to lower-cost settings while maintaining margin. Ultimately, the winners will operate as hybrid care platforms — delivering care anytime, anywhere — while aggressively managing cost through on-demand staffing, supply chain optimization, and virtual care infrastructure.
Ray Vara Jr. President and CEO of Hawai‘i Pacific Health (Honolulu): For well over a decade, Hawai’i Pacific Health has pursued a vision of high-quality, integrated, patient-centered care through a value-based strategy we call “Healthier Communities.” We’ve made real progress by strengthening care teams, integrating services, and expanding access points beyond the hospital through investments in ambulatory surgery centers, imaging centers, urgent care, innovative health care companies, and clinical technology. These efforts have lowered the cost of care, improved clinical performance, and created alternative revenue sources essential to sustaining our mission.
But we’ve reached the limits of what we can accomplish on our own. Rising costs, increasing regulatory oversight, and persistent administrative burden on providers demand more than continuous operational improvement, they demand structural change. To truly deliver the right care, at the right place, at the right time, we can’t just optimize around the edges. We must better align the system itself.
That is the purpose of the proposed partnership between Hawai’i Pacific Health and HMSA. Through vertical integration of a leading provider and Hawai’i’s Blue Cross Blue Shield health plan, we can unlock an estimated $2 billion in value over 10 years — not by cutting corners, but by fundamentally changing how care is delivered and funded. The result: better access, more affordable care, less administrative burden, and a health system positioned to serve the people of Hawai’i for generations to come.
Leslie Dockan. Senior Vice President of Care Delivery and Value-based Strategy at HealthPartners Care Group (Bloomington, Minn.): By 2030, health systems that lead will be those that successfully shift care delivery into more accessible, lower-cost models that strengthen long-term patient relationships. Advanced primary care, virtual-first care and home-based medicine will be foundational, enabling earlier intervention and better management of chronic conditions. These approaches improve patient experience and outcomes while creating more predictable, longitudinal revenue streams. At the same time, scaling value-based care will be critical, as organizations take on greater accountability for total cost of care. Success in this environment requires aligning care models and operations around prevention and population health. The organizations that thrive will be those that can effectively move upstream, keeping patients healthier while managing risk.
Stephanie Prechowski, MSN, RN. Associate COO of Emergency, Psychiatry, and Surgical Services at Michigan Medicine (Ann Arbor): By 2030, survival for health systems will hinge on revenue streams that reduce reliance on inpatient volume alone. At Michigan Medicine, we see the greatest opportunity in tight integration of ambulatory growth, advanced access models, and digitally enabled care that meets patients where they are while lowering cost to serve. Academic medical centers will also need to better monetize their clinical expertise through risk‑bearing arrangements, specialty‑focused bundled care, and partnerships with employers and payers. Behavioral health, particularly psychiatry, represents both a mission‑critical and financially differentiating growth area when paired with innovative workforce and care models. Finally, operational excellence itself becomes a revenue strategy. Systems that can consistently deliver capacity, throughput, and reliability will be best positioned to attract patients, contracts, and strategic partners in an increasingly competitive market.
Imee Dahl, DNP, RN. Operations and Patient Care Executive of Adventist Health St. Helena (Calif.): I believe these two things must be optimized: Remote patient monitoring to reduce patient readmission; and optimization of AI in the diagnostics space such as in radiology which will reduce the radiology shortage.
Calvin Wheeler, MD, BS, PharmD. Pediatric Neurologist of The Permanente Medical Group (Ret) KP Bernard J Tyson School of Medicine: (Pasadena, Calif.) There are many approaches to care delivery across the country, varying from small individual physician offices in rural and urban areas to large physician group practices to boutique practices and many other options. Many physicians and other clinical providers are challenged by inadequate revenue generated by primarily individual patient visits. This revenue stream can be enhanced by the addition of procedures and product offerings. Alternative revenue streams will be critical to the survival of many practices. In this time of physician, nursing and other healthcare shortages, our population cannot afford premature exits from the healthcare field. The alternative revenue streams that will define survival to 2030 will include significantly improved productivity, through mastering the use of the electronic medical record, including interphase with AI in pre-visits ,visits , post-visits and documentation. This system should also be connected to at-home monitoring and data transfer as well as increasing health literacy of patients and their families. The overall technology interphase in healthcare will be critical to practice survival in 2030.
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