Endeavor Health is a not-for-profit integrated health system serving the Chicago metropolitan area. It operates nine hospitals and more than 300 care locations, providing inpatient, outpatient and community-based healthcare services across northeast Illinois.
You've helped bring together several health systems under Endeavor Health. What have you learned about building an integrated health system while still maintaining a local patient experience?
I've been with Endeavor Health for 20 years and had the privilege of being part of the integrations that have informed what is now Endeavor Health. We brought in Swedish Hospital six years ago with a firm commitment to maintaining its safety-net mission, then welcomed Northwest Community Healthcare and Edward-Elmhurst Health. Today, we serve communities across the Chicago area through nine acute care hospitals, one behavioral health hospital, 300 non-hospital locations, and care for almost 1,500 inpatients daily. But that's only a small percentage of what we do. Most care now happens in outpatient settings, immediate care centers, virtual care, and community locations.
Our vision is safe, seamless and personal care for every person, every time. Healthcare has done well on safety, but seamless and personal care is where we have work to do. We believe patients should receive world-class care close to home, only traveling elsewhere for the small number of highly specialized services that can't be provided locally.
What does delivering a seamless, personalized experience look like in practice?
It starts with consistency. Regardless of which Endeavor Health location you visit, you should have the same likelihood of the same outcome. By the end of this year, every hospital and location will be operating on a single Epic instance, allowing providers to seamlessly manage care for the 1.5 million people we're privileged to serve. That simply isn't possible when you're working across multiple medical records and different ways of doing things.
At the same time, inpatient care is becoming more expensive because patients are exponentially more complex than they were before COVID. We have to balance that by growing the parts of healthcare that sustain the system financially while continuing to provide the high-acuity care only hospitals can deliver. [We're particularly concerned about Medicaid cuts because they affect emergency room access for everyone.] We've also integrated personalized medicine into primary care, using genetic and family risk to customize screening and prevention rather than relying solely on population-based guidelines.
Why has Endeavor Health invested so heavily in specialist institutes and centers of excellence?
We've been moving in this direction for almost a decade. As inpatient volumes decline, quality depends on concentrating complex procedures in fewer locations. Our orthopedic and spine hospital at Skokie is now one of the busiest hip fracture hospitals in the country because we transfer those patients there for efficient, specialized care. We've expanded that model across cardiovascular care, neuroscience and cancer.
The research is unambiguous: the more often clinicians perform complex procedures, the better the outcomes. Specialization also helps recruit and retain talented physicians, nurses and advanced practice providers who want to build expertise rather than constantly switching between specialties. It improves quality, efficiency and patient experience, even if communities initially miss having every service at their local hospital.
How is precision medicine changing patient care today, and where do you see it going next?
We've been in personalized medicine for more than 30 years. Instead of applying population statistics to every patient, we're using genetics to identify individual risks and build care plans around what's unique to them. We've already identified families where early genetic testing allows preventative interventions before diseases such as breast cancer develop, giving patients far greater control over their future.
The next frontier is cognitive decline. Years ago, many people didn't want to know their Alzheimer's risk because there was nothing they could do about it. That's changing. As effective therapies emerge, genetics can help us intervene earlier, just as we've done with cancer genetics, giving patients the opportunity to reduce risk before it's too late.
Where do you see the biggest opportunities for outpatient care and the role of AI?
The greatest opportunity is creating an affordable, accessible system that helps patients navigate uncertainty. If you wake up with back pain and numbness in your foot, the internet may tell you to see a neurosurgeon immediately. That's exactly what you shouldn't do. We need consumer-centered tools that guide people to the lowest-intensity resource most likely to solve their problem, while also considering cost and personal preferences.
AI has tremendous potential, but not because it replaces caregivers. I'm excited about AI replacing repetitive, non-value-added work that takes clinicians away from kindness and compassion. Nobody entered healthcare to process prior authorizations or manage reports. We've used predictive AI for years to identify patients at highest risk. Going forward, we'll continue taking a problem-based approach, using AI where it genuinely improves access and the patient experience.
You've spoken openly about Medicaid funding and the healthcare safety net. What concerns you most?
What saddens me most is that we made tremendous progress expanding access for vulnerable populations, and [with the stroke of a pen] we've taken much of that away. If the new work requirements stand, we'll create the most difficult Medicaid access environment we've ever had. Sick people will still come to hospitals—they'll simply arrive later, when they're much sicker. That creates access problems for everyone and drives costs throughout the system.
I'm incredibly proud of Swedish Hospital, the largest safety-net provider on Chicago's north side. As other hospitals have closed, we've cared for more Medicaid patients while improving quality. Swedish is now a three-star CMS hospital, something it wasn't before joining Endeavor Health. We intend to remain deeply committed to underserved communities, but sustaining that mission requires hospitals to remain financially viable.
With financial pressures increasing, how do you decide where innovation investment matters most?
We've always taken a disciplined approach. Whether we're investing in technology, facilities or people, we begin with one question: what problem are we trying to solve, and what outcome are we trying to achieve? For us, that means improving patient quality and experience, improving how our team members experience working with us, strengthening community health, and increasingly, making healthcare more affordable.
What excites me most is combining that philosophy with our single Epic platform and our institute model. Whether someone enters our cardiovascular, cancer, neuroscience or orthopedic institute with a simple concern like high cholesterol or a much more complex condition, we want to give them greater control over the care they receive, the outcomes they want and the price they're prepared to pay. That's been an intractable problem throughout my career, and I think we're finally in a position to solve it.
