Nate Kaufman
This is Nate Kaufman with the Healthcare Bridge, our final podcast of the year, which is my Ten New Year’s Resolutions for Health System Leaders. I’ll try to do this in less than ten minutes.
Number One
Given the expected headwinds in 2026, the executives of our health system must be laser focused on appropriately allocating scarce resources to achieve best in class benchmarks that are being measured in real time. One cannot manage what they cannot measure in real time.
Number Two
In the new year, health system leaders must limit the use of the “mission” excuse for under performance. It’s not the mission of an organization to allocate capital to chronically money losing facilities and services when those funds could be used elsewhere to expand services, improve quality and reduce cost. Hope is not a strategy. Services and facilities that are chronically under-performing will be evaluated for immediate closure.
Number Three
A primary goal of every health system will be to attract and retain the best human capital. Our actions will demonstrate our commitment to recruiting and retaining the best physician and other clinical professionals. The health systems culture will be to treat physicians as professional partners and not as wRVU (work Relative Value Unit) piece workers.
Number Four
Leadership is a critical driver of success. To achieve their assigned goals, individual dyad leaders will be given the authority and accountability to work across organizational silos - like supply chain and HR and IT - so that those silos actually support the dyad goals, rather than derail them. Dyad leaders will be carefully selected for their emotional and clinical intelligence, since we recognize that poor leadership cannot be compensated for.
Number Five
We will promote an agile, cohesive, performance based culture. In 2026, strategy must be based on the best available facts and data and not on opinions, unproven theories, feelings or overly optimistic, heroic projections.
Number Six
Leaders will limit meetings and spend more time in the field. As Peter Drucker said, “Endless meetings aren’t a sign of collaboration, they’re a sign of low trust and unclear decisions.”
Number Seven
We will continue to demand commercial rates and terms that subsidize the underfunded government programs of Medicare and Medicaid, and we will take advantage of programs such as 340-B that close the gap between payments and the cost of providing care. We will avoid value-based payment schemes if they’re nothing more than a race to the bottom in disguise.
Number Eight
We will demand fair rates and terms from Medicare Advantage plans, or we will not contract with those plans. MA plans must yield at least 100% of Medicare after allocating the additional costs associated with their extreme administrative cost burden.
Number Nine
Recognizing that health care is unaffordable, we will be obsessed with taking significant cost out of the system by eliminating multiple administrative layers and standardizing clinical processes and protocols whenever possible.
Number Ten
We will focus on improving our core services. We will not be distracted by peddlers selling panaceas such as provider-based health plans or corporate funded academics producing research to support the viewpoints of their benefactors. I hope this will be helpful for you in 2026. Harry and I would like to hope that your families have a happy holiday season and a great New Year. Wave goodbye to everybody - don’t bite me.
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