The American Hospital Association represents hospitals and health systems across the United States, along with the patients and communities they serve. Based in Chicago and Washington, D.C., it works on behalf of its members on issues affecting care delivery, access, quality, and hospital operations. Its work spans advocacy, policy, education, and support for hospitals navigating a changing health care landscape.
As chair of the American Hospital Association, how would you describe the state of U.S. hospitals in 2026?
Working in healthcare is a privilege and a calling, driven by incredible individuals dedicated to caring for humanity. Management analyst Peter Drucker once noted that healthcare is the most complicated business there is, and I agree. While patients travel from around the world to access our compassionate, technologically advanced care, we still face deep systemic challenges. Universal access remains elusive, and many people lack coverage entirely.
Consequently, hospitals provide massive amounts of charity care, often functioning as a de facto social services agency—a highly suboptimal setup. Affordability is a major crisis, largely because the system is patched together with government underpayments, administrative inefficiencies, middlemen, and payers who deny necessary care. Ultimately, America’s hospitals are the best-positioned conveners to lead the way forward and make the system better.
What part of the financial picture worries you most?
Running hospitals is highly complicated, and we are currently facing two massive issues. First is affordability, driven by the sheer intensity of services and a population that is not nearly as healthy as it could be. We desperately need more wellness, prevention, and logical care models. We also need proper coverage so patients avoid using emergency rooms for longitudinal care, which is highly inefficient and expensive.
The cost side is equally challenging. Post-COVID inflation and burnout have heavily pressured employment costs, which make up 55% to 60% of a hospital’s entire budget—and, of course, nobody wants fewer nurses or doctors at the bedside. The remaining 40% goes toward supplies, pharmaceuticals, and capital, and drug costs are spinning out of control. In fact, America's hospitals saw a 13% increase in pharmaceutical costs from 2024 to 2025 alone. U.S. drug prices are three times higher than the rest of the world. The U.S. represents just 4% of the global population, yet accounts for 24% of drug use and 62% of pharmaceutical company revenue. That system is broken.
From the hospital perspective, what has become more difficult about ensuring patients can access the care they need?
Affordability means ensuring the average individual can actually access care, and right now, that is becoming increasingly difficult. We have to embrace an "and" mindset. Instead of choosing one priority over another, we must simultaneously provide superior quality care, deliver excellent service, innovate, and do it all cost-effectively.
That responsibility doesn't fall solely on hospitals. It requires working alongside payers, suppliers, pharmaceutical companies, communities, and government leaders. Because hospitals and clinicians are closest to the people we serve, we can convene these vital conversations—but it will take everyone adopting that "and" mindset to build a better tomorrow.
As hospitals invest in technology, workforce, and new models of care while absorbing reimbursement pressures, how do leaders decide what to prioritize?
The potential of new technology is incredibly exciting, even as we manage the risks. Over the next quarter-century, the U.S. working-age population will grow by just 4%. Meanwhile, the over-65 population will rise by 42%, and the over-85 demographic—the population requiring the most medical care—will surge by 168%. Facing a 4% workforce growth against a 168% explosion in demand is a massive problem. We have to leverage technology to support the people we have.
Our overarching goal is to improve the lives of patients, families, and communities, while simultaneously easing the burden on clinicians. Technology should free staff to do what only human beings can do. An AI robot cannot pray with a patient before surgery, rub someone's back to ease pain, or offer a comforting hug. When technology handles the busywork so a nurse or doctor can provide that human touch, it is a beautiful thing.
How do you measure whether AI and digital transformation are delivering value?
Investments must deliver a return, defined broadly. It could mean improved safety, quality, or service, but it ultimately needs a financial payback. The holy grail is an investment that enhances care while decreasing overall costs. Take ambient listening: you cannot simply layer on millions of dollars in technology costs without a return. It improves documentation and the clinician’s quality of life, and by streamlining the workflow, it allows clinicians to see a few more patients to help offset the cost.
Without a doubt, this technology is already helping reduce burnout and improve retention. Healthcare is a meaningful calling, but it is also stressful. We cannot change the inherent hardships of dealing with illness, loss, and difficult news. What we can change are the administrative frustrations that drive people away—the clunky computers and technical obstacles. Primary care physicians have told us that ambient listening literally gave them control of their lives back.
Houston Methodist is also using remote patient monitoring tools that continuously monitor patient vitals in regular medical-surgical hospital beds. Instead of waking a patient at 2 a.m. just to take their vitals, we can improve safety, sleep, and patient satisfaction while optimizing staff efficiency. It is a win across the board and the ultimate example of "and" thinking.
How has telehealth changed the role of the hospital?
Telehealth has had a massive impact, and we are still only scratching the surface. People usually think of a virtual doctor’s appointment, which is a significant component, but it is also a powerful tool inside hospital walls. For acute stroke care, you cannot efficiently station a neurologist in every single emergency room 24/7. However, via telestroke support, a remote expert can help an on-site emergency doctor make immediate, life-saving therapeutic decisions.
In rural areas, these virtual partnerships keep patients closer to home, or help transition them back to their communities sooner after receiving specialized care at a major urban center. The number of successful partnerships emerging across the country is incredibly exciting.
At Houston Methodist, what opportunities do you see through the Rice University Digital Health Institute?
Our partnership with Rice University is an ideal match. Houston Methodist brings deep clinical expertise, digital experience, and a massive data set. Rice University counters with an incredible bench of data scientists, digital health innovators, and engineers. Bringing those two worlds together is a beautiful thing.
The collaboration is about 18 months old and has significant momentum. We are leveraging our data and AI to solve major systemic challenges, moving from high-level research down to practical, nuts-and-bolts digital health tools.
