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A recent survey by executive search firm B.E. Smith shows that almost 2 in 3 healthcare leaders are contemplating leaving their current organizations, highlighting ongoing workforce instability in the sector. The survey, conducted via email between September 30 and October 23, 2025, collected responses from 703 executives across hospitals, health systems, clinics, and post acute care settings.

Key Findings from the B.E. Smith 2026 Healthcare Leadership Trends Survey

1. Executive retention is uncertain:
   • 37% of respondents have no intention of leaving, up 3 percentage points from 2024.
   • 7% plan an immediate exit, 11% within six months, 17% within one year, and 27% within three to five years.
2. Tenure and leadership level affect exit plans:
   • Leaders with 6–10 years of tenure are most likely to seek change immediately (17%) or within six months (35%).
   • Vice president-level respondents are 50% more likely than directors and 80% more likely than C-suite executives to pursue a near-term move.
3. Job satisfaction varies with exit timing:
   • Among those considering leaving, 73% reported satisfaction with their role, and 60% with their employer.
   • For those planning an immediate departure, satisfaction drops to 40% for their job and 32% for their organization.
4. Factors influencing retention:
   • Top motivators to stay include organizational culture, compensation, and colleagues.
   • Career advancement, flexible scheduling, and management support follow, while remote work ranked lowest.
5. Promotion and career growth concerns:
   • Only 21% feel they are on a promotion track.
   • 26% believe leaving their organization is necessary to advance their careers.
6. Outlook for organizations versus the industry:
   • Nearly 3 in 4 executives expect their own organization to perform the same or stronger in 2026.
   • 52% predict a decline for the healthcare industry overall.
7. Financial pressures dominate:
   • 84% cited financial pressures as the primary threat in the coming year.
   • Lowering operating costs is the top performance priority over the next five years (72%).
8. Growth strategies for stability:
   • Expanding existing service lines (50%) is the most common strategy for financial stability.
   • Other strategies include cost reductions (38%), new service lines (37%), partnerships with payers or health systems (33%), value-based reimbursement expansion (33%), telehealth (28%), and enhanced consumer marketing (27%).

The survey underscores the ongoing risk of losing strong healthcare leaders despite generally high job satisfaction, with organizational culture, career advancement, and compensation playing critical roles in retention.

Source: Becker’s Hospital Review Kristin Kuchno, 2 in 3 healthcare executives considering exit: Survey (2026).

Republican lawmakers are considering additional healthcare spending reductions as part of a broader federal budget package that could allocate up to $200 billion toward military operations involving Iran and expanded immigration enforcement, according to a recent Axios report.

The early stage discussions signal a potential return of major healthcare policy debates that could significantly affect insurance coverage, healthcare costs, and hospital financial stability across the United States.

ACA subsidy changes return to policy discussions

One proposal under consideration involves adjustments to subsidies connected to the Affordable Care Act (ACA). The plan would fund cost-sharing reductions while scaling back certain subsidies. Analysis from the Congressional Budget Office suggests the policy could lower benchmark premiums by about 11% but increase the number of uninsured Americans by roughly 300,000 annually through 2035. The changes are projected to save the federal government nearly $36 billion.

Meanwhile, the Centres for Medicare & Medicaid Services (CMS) has already proposed benefit and payment rule changes for 2027 that would allow higher cost-sharing in bronze marketplace plans and expand eligibility for catastrophic coverage options. Hospital groups warn these adjustments could reduce marketplace enrollment and increase patient financial burden.

Medicare and Medicaid reforms under review

Lawmakers are also evaluating Medicare and Medicaid policy changes, including expanding site-neutral payment policies and addressing Medicare Advantage upcoding practices. Site-neutral payment reforms, which align reimbursement rates regardless of care setting, are already affecting hospital revenues after CMS expanded such policies in its 2026 outpatient rule.

Industry analysts caution that health systems heavily reliant on outpatient hospital departments or Medicare Advantage reimbursement structures may face heightened financial pressure if Congress expands these policies further.

Existing legislation already impacting providers

Healthcare providers are still adjusting to the financial effects of the One Big Beautiful Bill Act, enacted in 2025. The law is projected to reduce federal Medicaid spending by $911 billion over a decade and could lower hospital revenues by as much as $25 billion annually.

Key provisions, including Medicaid work requirements set to begin in 2027, have raised concerns among hospital leaders, who warn they could increase coverage losses and uncompensated care, particularly for safety-net hospitals.

Fast legislative timeline expected

According to Axios, lawmakers aim to advance legislation within 60 to 90 days, setting up a rapid policy debate with potentially wide-ranging consequences for insurance coverage, reimbursement models, and healthcare system finances.

Source: Becker’s Hospital Review, Alan Condon, Republicans eye further healthcare cuts: Report (2026).

Billionaire entrepreneur Mark Cuban has publicly endorsed the proposed Break Up Big Medicine Act, legislation aimed at limiting vertical integration across the U.S. healthcare industry.

The bill, introduced in February by Sens. Elizabeth Warren and Josh Hawley, would prohibit companies from owning both a health insurer or pharmacy benefit manager (PBM) and healthcare providers or management services organizations. The legislation also seeks to prevent prescription drug or medical device wholesalers from owning provider organizations.

Cuban highlights employer cost pressures

In a March 24 post on X, the Cuban founder of Cost Plus Drugs argued that employers are struggling under rising healthcare costs driven largely by large vertically integrated insurance companies. He urged the public to contact lawmakers in support of the proposal.

According to Cuban, large insurers use extensive subsidiary networks to increase costs and exploit system inefficiencies, stating that breaking up major insurers would help reduce healthcare spending.

Push toward broader healthcare reform

In additional posts later in March, Cuban called on Sen. Bernie Sanders to support the bill, arguing that structural reform is necessary before broader healthcare models, including single-payer systems, can become viable.

Scrutiny of vertically integrated insurers

The legislation comes amid growing scrutiny of UnitedHealth Group, the nation’s largest healthcare company. Reports have indicated the organization operates nearly 2,700 subsidiaries, though many were not disclosed in certain 2025 SEC filings.

During congressional testimony in January, UnitedHealth CEO Stephen Hemsley defended the company’s structure, stating that integration improves care delivery and overall value within the healthcare system.

The proposal reflects ongoing bipartisan debate over consolidation in healthcare and whether separating insurers from provider operations could improve transparency, competition, and affordability.

Source: Becker’s Hospital Review Elizabeth Casolo and Mark Cuban back a bill to break up vertically integrated insurers (2026).

Oracle Corporation is reportedly laying off thousands of employees as part of a broader strategic shift toward artificial intelligence infrastructure investments, according to a March 31 report by CNBC.

The software company, which acquired electronic health record (EHR) firm Cerner Corporation in 2022 and rebranded the unit as Oracle Health, began notifying affected workers on March 31. Sources familiar with the matter confirmed the layoffs, although representatives from Oracle and Oracle Health declined to comment publicly.

Layoffs impact former Cerner workforce

The workforce reductions include 539 employees at the former Cerner campus in Kansas City, Missouri, according to a Worker Adjustment and Retraining Notification (WARN) Act filing submitted March 31. The layoffs are scheduled to take effect between May 26 and June 1.

Some impacted Oracle Health employees shared news of their job losses on platforms such as LinkedIn and Reddit following notification.

Ongoing restructuring after Cerner acquisition

Oracle currently employs approximately 162,000 people worldwide. Prior to its acquisition, Cerner had around 26,000 employees, and the healthcare technology division has experienced multiple rounds of layoffs since joining Oracle.

Leadership changes have also continued within Oracle Health, with several executives departing the organization earlier this year, according to reports published in March.

The restructuring reflects Oracle’s broader pivot toward expanding artificial intelligence capabilities and infrastructure as competition intensifies across the technology and healthcare IT sectors.

Source: Becker’s Hospital Review, Giles Bruce, Oracle cuts thousands of jobs: Report (March 2026).

More than 130 hospitals have filed a lawsuit against the U.S. Department of Health and Human Services (HHS), challenging how the agency calculates disproportionate share hospital (DSH) payments and alleging the methodology unlawfully reduces reimbursement for hospitals serving low-income patients.

The complaint, filed March 30 in the U.S. District Court for the District of Columbia, names HHS Secretary Robert F. Kennedy Jr. and focuses on how the agency treats Medicare Advantage (Part C) patient days in DSH payment calculations.

Here are five key points:

1. Hospitals challenge CMS’ 2023 final rule

The hospitals argue that a 2023 final rule issued by the Centres for Medicare & Medicaid Services improperly reduces DSH payments. The rule retroactively applies a policy that includes certain Medicare Advantage days in the Medicare fraction while excluding them from the Medicaid fraction a move hospitals say skews the formula.

2. What DSH payments are designed to do

DSH payments are intended to financially support hospitals that treat a high proportion of low-income patients. Payment amounts are calculated using a “disproportionate patient percentage,” which combines:

• A Medicaid fraction
• A Medicare Supplemental Security Income (SSI) fraction

Hospitals argue that changes to how these fractions are calculated directly impact reimbursement levels.

3. Allegations of improper methodology and retroactivity

The complaint claims CMS’ methodology:

• Revives a policy first introduced in 2004 that courts have previously rejected or narrowed.
• Applies the revised calculation retroactively to earlier cost-reporting periods, which hospitals contend exceeds HHS’ statutory authority.
• Undercounts low income patient days, thereby reducing DSH payments owed to safety-net hospitals.

4. What the hospitals are seeking

The plaintiffs are asking the court to:

• Vacate the 2023 rule
• Require HHS to recalculate DSH payments using the pre-2004 methodology
• Award additional reimbursement and applicable interest

5. Ongoing legal battles over DSH funding

The lawsuit adds to years of litigation over DSH payment formulas. In April 2025, the Supreme Court of the United States ruled in favour of HHS in a separate dispute regarding how SSI-related patient days are counted, a decision hospital groups estimated could impact at least $1 billion annually.

Hospitals have also opposed broader CMS policies projected to reduce billions in DSH payments to safety-net providers nationwide.

HHS has not yet publicly responded to the latest complaint.

Source: Becker’s Hospital Review Alan Condon, 131 hospitals sue HHS over DSH cuts: 5 notes (March 2026).

Donny Booth, MSN, RN, former CEO of Permian Regional Medical Centre, has been terminated for cause after a 4–2 decision by the Andrews County Hospital District Board during a March 26 meeting, according to reports.

Reasons behind the termination

Board members stated that the decision was made to protect the hospital’s financial stability. The board cited an alleged 18-month breakdown in communication and a $1 million withdrawal from a line of credit that they claimed was executed without proper board authorization.

The matter was discussed during a closed executive session focused on deliberating the CEO’s contract before the final vote took place.

Conflicting perspectives on leadership performance

Despite the board’s concerns, some stakeholders highlighted positive financial outcomes during Mr. Booth’s leadership. Turnaround specialist Chantelle Venter noted that the hospital experienced a $5 million revenue increase between March and September 2025, attributing the improvement largely to organizational culture changes introduced under Booth’s administration.

One board member reportedly proposed alternatives such as probation or a formal public reprimand rather than immediate termination.

Staff members also expressed worries about potential impacts on morale and employee turnover following the decision.

Leadership background

Mr. Booth had served as CEO since 2019 after previously joining the organization as chief nursing officer in 2014, according to his professional profile. Media outlet KWES-TV first reported details of the board’s action.

Industry context

The leadership change comes amid broader discussions across the healthcare sector about financial governance, transparency, and executive accountability. These themes are expected to be key topics at the upcoming Becker’s 11th Annual Health IT + Digital Health + RCM Conference, where healthcare executives and digital leaders will examine how AI, interoperability, cybersecurity, and revenue cycle innovation are reshaping healthcare delivery and financial performance.

Source: Becker’s Hospital Review  Kristin Kuchno, March 2026.

Amazon has expanded access to its AI-powered healthcare assistant, Health AI, making the tool available directly through Amazon.com and the Amazon mobile app as part of its broader push into digital health services.

The assistant was initially launched earlier this year for members of Amazon One Medical within the One Medical app. The new rollout allows a wider group of users to access the platform’s health guidance and care navigation features.

What Health AI does

Health AI is designed to help users better understand and manage their healthcare by:

• Answering general health questions
  
• Explaining medical records and lab results
  
• Providing symptom context
  
• Booking appointments and connecting patients with clinicians
  
• Managing prescription renewals
  

When users grant permission, the system can access medical data, including history, medications, and lab results, through health information exchanges to deliver more personalized insights.

Patients can also connect with providers via messaging, video consultations, or in-person visits through One Medical. Prescription services can be fulfilled through Amazon Pharmacy or another pharmacy of the patient’s choice.

Designed to support clinicians

Amazon emphasized that Health AI is intended to support, not replace, healthcare professionals. The tool does not diagnose or treat patients independently and requires provider involvement for clinical decision-making.

Pricing and availability

As part of the expansion, eligible Amazon Prime members will receive an introductory offer that includes up to five free direct-message consultations with a One Medical provider covering more than 30 common health conditions.

After the promotional period, telehealth visits through One Medical will cost $29 per visit on a pay-per-visit basis.

Privacy and security measures

Amazon stated that Health AI operates within a HIPAA-compliant environment, using encrypted conversations and strict access controls. The company also confirmed that protected health information from One Medical and Amazon Pharmacy will not be used for advertising or retail marketing purposes.

The company plans to expand Health AI access to more U.S. customers in the coming weeks as adoption grows.

Source: Becker’s Hospital Review Naomi Diaz, Amazon expands Health AI assistant (March 2026).

Hospital leaders across Colorado are urging lawmakers to reconsider a proposal that would cut approximately $50 million from a state program supporting physician training at teaching hospitals.

The proposal targets funding for Colorado’s Medicaid indirect medical education (IME) program, which helps hospitals offset the additional costs of training medical residents. Because the funding also qualifies for federal matching dollars, the reduction would trigger further losses in federal support.

The measure was included in a broader state budget package approved by the Colorado Senate in late February, as lawmakers work to address an estimated $850 million state budget shortfall.

Why the funding matters

IME funding helps hospitals cover the hidden costs of physician training, including maintaining teaching infrastructure, equipment, and reduced patient volume when attending physicians supervise residents instead of seeing additional patients.

Hospital leaders say eliminating the funding could significantly weaken Colorado’s physician workforce pipeline and worsen existing healthcare staffing shortages.

Dr. Ben Hughes, a pediatric pulmonologist at Children’s Hospital Colorado, warned that cuts could directly reduce pediatric physician training capacity.

“If the number of trainees decreases, access to pediatric care across the state will suffer,” he said in comments reported by regional media.

Potential impact on training programs

Teaching hospitals across Colorado train about 1,800 medical residents each year, according to state data.

Two of the largest training institutions expected to be most affected are

• UCHealth, which trains around 1,200 residents annually
  
• Children’s Hospital Colorado, which trains about 350 residents each year
  

State estimates suggest the funding reductions could result in:

• Approximately $18.1 million in cuts to UCHealth’s University of Colorado Hospital
  
• Around $12.4 million in cuts for Children’s Hospital Colorado
  

UCHealth leaders say the proposal could force the system to eliminate about 208 resident full-time equivalent positions, which would translate to roughly 441 fewer physicians in training each year.

Dr. Richard Zane, chief medical officer at UCHealth, criticized the proposal, describing it as a decision with long-term consequences for the healthcare workforce.

State officials defend the proposal

The Colorado Department of Health Care Policy and Financing said the funding reduction is intended to help close the state’s projected budget gap while focusing cuts on hospitals with stronger financial resources.

Officials said the approach aims to minimize the impact on smaller hospitals with weaker financial positions while still achieving necessary budget savings.

The broader concern

Hospital leaders warn that reducing funding for medical education could have long-term consequences for the state’s healthcare system. Fewer residency positions mean fewer physicians entering the workforce, particularly in high need specialties and rural communities.

As Colorado’s population continues to grow, healthcare organizations say protecting physician training programs will be critical to maintaining patient access to care.

Source: Becker’s Hospital Review  Erica Cerutti, ‘No rational explanation’: Hospitals warn Colorado budget cuts will shrink physician pipeline (March 2026).

Medical device manufacturer Stryker is investigating a cyberattack that disrupted its internal systems and caused a global network outage affecting parts of its Microsoft environment.

In a March 12 update, the company said the incident appears to be contained within its internal Microsoft environment. Stryker added that there is currently no evidence of malware or ransomware, though investigations into the scope of the attack are ongoing.

Despite the disruption, the company confirmed that several key products, including Mako, Vocera, and LIFEPAK 35, remain safe for clinical use.

The company also stated that orders placed before the outage are visible within its systems and will be shipped once communications are restored. Orders entered after the incident are currently being reviewed as Stryker works to bring its electronic ordering platform back online.

According to a March 11 report from The Wall Street Journal, the cyberattack may be linked to an Iran-affiliated hacking group. The report also indicated that some employee devices running Microsoft Windows were remotely wiped during the attack.

Health systems take precautionary measures

Healthcare organizations that rely on Stryker products and services are closely monitoring the situation while implementing precautionary cybersecurity measures.

Mass General Brigham said it is reviewing the disruption while maintaining clinical operations and ensuring patient care continues without interruption.

Similarly, Providence reported that its cybersecurity team temporarily restricted connectivity with Stryker systems and devices as a precaution. The health system emphasized that there is currently no evidence its internal systems were compromised and that care delivery remains unaffected.

Providence also noted that staff are trained in downtime procedures designed to maintain continuity of care during technology disruptions.

Stryker said it continues to investigate the incident and restore affected systems while maintaining business continuity operations.

Source: Becker’s Hospital Review, Naomi Diaz, Stryker hit by cyberattack reportedly tied to Iran-linked hackers (March 12, 2026).