By: John Erwin, Chief Executive Officer, Carenet Health
*Article originally published on Forbes: Business Council
America spends more on healthcare than any other OECD country of similar size and wealth. In 2023, $4.9 trillion flowed into our health system. A 2022 study found we spent about $13,500 for every person in the country. By 2032, the total expenditure is expected to reach $7.7 trillion, or almost one in every five dollars we generate as a nation.
On paper, this should mean we’re leading the world in health outcomes. We have world-class hospitals, groundbreaking research institutions and a history of medical innovation. Yet the reality is different: By many measures of health, from life expectancy to maternal health, we lag behind our global peers.
Healthcare leaders face unprecedented pressure. You must cut costs, transform care delivery and deliver measurable improvements—simultaneously. Nearly every C-suite leader I meet is judged not only on long-term outcomes but also on their ability to achieve results quickly. Speed to value and cost management have become the defining challenges for healthcare executives. Boards and stakeholders demand progress in months, not years.
Leaders are simultaneously urged to adopt AI and other technologies at a breakneck pace, often without a clear strategy or defined outcomes. This rush adds complexity and distraction rather than reducing it. Without a focused approach to impact drivers, even well-intentioned innovations can stall evidence-based outcomes instead of accelerating them.
The Hidden Costs Holding Us Back
When we discuss healthcare costs, we often focus on the obvious: rising premiums, labor shortages, claims spend and administrative overhead. But I’ve found the most damaging costs don’t appear on financial statements.
• Spending and waste: The U.S. loses nearly $1 trillion annually to administrative complexity, duplicative services and low-value care.
• Workforce strain and burnout: A pre-Covid-19 study reported around 30% of nurses experienced burnout, with the number rising to 91% in June 2023. And the country could face a shortage between 37,800 and 124,000 physicians by 2034. Exhaustion and turnover can directly impact access and quality.
• Poor experience and eroded trust: Only 11% of U.S. adults in a Gallup survey describe their healthcare experiences as “excellent.” Low satisfaction can erode loyalty and contribute to missed opportunities for preventive care.
• Underused and misaligned technology: Healthcare organizations have invested billions in digital tools and AI, yet these investments often fail to improve workflows or outcomes. Without intentional alignment, technology becomes another cost center instead of a value driver.
These hidden costs are as dangerous as financial losses. They drain energy from teams, frustrate patients and slow the transformation we urgently need.
From Cost-Cutting To Purpose-Driven Investment
The standard response to financial pressure is cost reduction. Cutting alone cannot build the best healthcare system in the world. I’ve learned true sustainability requires orchestration expertise that supports strategic investments in areas that drive innovation, economics and the humanity of care.
This means approaching change readiness strategically. Instead of layering on tools or processes and hoping for results, executives must first ask: Are we prepared to use these investments to their fullest potential? Do our people, systems and strategies align to deliver faster value without sacrificing quality or care?
Healthcare leaders should begin by assessing alignment across people, systems and strategies. Engage stakeholders to map current processes, identify gaps and encourage regular interdisciplinary collaboration. Transparent communication and a culture that welcomes feedback are essential.
When issues arise, act quickly, bringing together cross-functional teams to address disconnects and invest in change management support. Use new metrics that reflect both operational and human outcomes, including time-to-value for technology, clinician retention, patient trust and preventive care effectiveness.
To reduce workforce strain, streamline workflows and support clinicians with efficient technology. Build patient trust through consistent feedback channels and transparency. These actions enable organizations to drive measurable transformation without sacrificing care quality. Streamline workflows to reduce administrative burdens on clinicians, deploy well-supported technology that enhances—rather than complicates—daily practice and invest in staff well-being programs.
On the patient side, create feedback channels and transparency initiatives that invite engagement, demonstrate empathy and foster lasting loyalty. These steps, taken together, can help healthcare organizations drive meaningful transformation in a complex, rapidly evolving environment.
I think healthcare must move beyond incremental efficiency gains and focus on generating measurable improvements that address both financial pressures and human needs.
Leading With Purpose
Healthcare centers on people. Patients deserve care experiences that are accessible, supportive and humane. Clinicians deserve the time and space to practice at the top of their license, not drown in administrative burden. Organizations must demonstrate value in ways that protect both margins and mission.
The opportunity exists. The question is whether we as leaders are ready to seize it. By recognizing hidden costs, addressing workforce strain and aligning technology with strategy, we can move healthcare from a cycle of reaction to a future defined by prevention, performance and partnership.
Healthcare leaders must power the change that will secure the health of tomorrow.
