Fifteen years ago, I made a conscious decision to enter the healthcare sector. At 34, I had options, but I wanted a career that would challenge me intellectually—so much so that I once told people I wanted my “brain to hurt.” I wasn’t naïve about the industry’s complexities, but I didn’t anticipate how much it would also hurt my heart.
A decade and a half later, after working across multiple roles in healthcare, I can confidently say the industry met my wish for intellectual challenge. What I didn’t expect was how deeply frustrating it would be—watching an industry fully aware of its failures yet unwilling to change. It’s like watching someone recognize the harm their choices cause, acknowledge a better path, and then refuse to take it. We name the challenges, but we lack the courage to truly address them.
The Symptoms of a Failing System
As part of my role, I navigate the complexities of the healthcare landscape daily—analyzing reports on hospital closures, health system mergers, shifting insurance strategies, and the growing workforce crisis fueled by burnout, layoffs, and financial instability. What I deduce from that is that these are the logical symptoms of a failing organism, and our industry is content to keep treating the symptoms rather than transforming the system.
Transformation—not mere tweaks, adjustments, or repositioning—is the only path forward. After years of incremental changes, the past several years have made one truth painfully clear: trying is not enough. As Yoda wisely put it, “Do or do not. There is no try.”
Patients are demanding full commitment. A recent Gallup and West Health survey found that 35% of Americans cannot access quality, affordable healthcare, and only half are considered “cost secure.” Another survey revealed that 38% of insured individuals, including 80% with employer-sponsored plans, have delayed or skipped necessary care due to cost.
Trust in healthcare is eroding, and rightfully so. Trust is built on reliability, goodwill, and effectiveness—and many of us working in healthcare know, deep down, that we have not fully earned it. When patients endure month-long waits for a basic appointment, get bounced around from specialist-to-specialist, or encounter confusing prior authorizations, how can we expect them to trust the system?
To be clear, I’ve never met anyone in healthcare who lacks good intent or disregards patients. But if we continue down this path, we’ll only deepen the crisis. Instead, we must rethink the fundamental structures that underpin care delivery.
Building the Foundation for Real Change
There are countless structural flaws in the system that must be addressed. But transformation begins with a shift in mindset. Human nature clings to familiarity—even when it’s failing us. We have been “trying” while still investing in outdated structures. Retreating into the misaligned incentives of fee-for-service (FFS) and abandoning programs designed for accountability is not the answer. It might buy some time, but it will never be sustainable.
The future must center on access, outcomes, experience, and affordability. We must acknowledge cost as the single biggest driver of healthcare challenges, affecting individuals, health systems, insurers, employers, and the broader economy.
We also need to move beyond decades-old tactics that only treat symptoms rather than strengthening the system itself. While initiatives like care management, prior authorizations, remote monitoring, and patient outreach serve essential roles, they remain insufficient. True transformation requires systemic, structural shifts that empower healthcare providers, insurers, and health systems to deliver higher accountability care.
For example, adding a care management program for one subset of patients while simultaneously allowing high-cost sites of care and extreme variations in treatment elsewhere is like trying to paddle against a relentless current. Without structural realignment, we’ll always be swimming upstream.
The Path to Systemic Change
A truly systemic approach must recognize the intricate interdependencies at play, ensuring that success isn’t just about sustainability, but about meaningful, forward-moving growth. This begins with a holistic payer-provider contracting strategy, not just a vague understanding of a hybrid model, but the ability to leverage fee-for-service (FFS) and value-based care (VBC) in tandem. From there, it is about smart deployment of resources through a relentless focus on meaningful insights—the ability to remove the noise from the volumes of data—for analysis that derives information not just numbers. The goal is to know what actions to take that have the highest impact and the metrics that provide an honest assessment of performance. And ultimately, it demands an honest reckoning with how to activate the physicians and clinicians who directly impact care—giving them the right financial incentives, actionable data, and autonomy to drive meaningful outcomes.
Those may be simple steps, but they are far from easy. But the reality is that we are not just at an inflection point—it’s a moment of reckoning. Transformation is no longer optional; it’s the only path forward.
About Anna Youngerman
As Chief Transformation Officer, Anna oversees the company’s strategic direction, growth initiatives, corporate positioning, and cultural enhancements that facilitate performance. She also serves as Market President for the Minnesota region. During her tenure with Navvis, Anna led the development of the company’s five-year strategic plan that provides a design for performance commitment and growth trajectory. She successfully oversaw the market-based launch of Navvis’ patient capacity and throughput program in Minnesota, which delivered exponential length of stay improvement for a $5 billion health system, as well as a comprehensive rollout of Surround Care Academy.
