Becker’s Healthcare Podcast: David Rahija, President of Northwest Community Hospital at Endeavor Health

Episode Date: February 13, 2026
Host: Mackenzie Bean (Becker's Hospital Review)
Guest: David Rahija, PT, MBA, FACHE (President, Northwest Community Hospital, Endeavor Health)

Episode Overview

This episode features an in-depth conversation with David Rahija, President of Northwest Community Hospital at Endeavor Health, focusing on Endeavor Health’s ongoing integration journey. David shares how the newly formed system is uniting hospitals and teams for more seamless, patient-centered care, discusses major strategic projects—especially clinical and tech integration—and explores the balance of growth, systemness, and headwinds in US healthcare.

Key Discussion Points & Insights

1. Introduction to Endeavor Health and David Rahija

[01:26–03:20]

• Background: Endeavor Health is a relatively new, nonprofit, community-based system serving Chicagoland with 9 hospitals and 300+ ambulatory sites, formed from the unification of four legacy health systems over the past five years.
• Scope: Serves 1.4 million patients annually with 27,000 team members.
• Rahija’s Journey: 17 years with the system, various leadership roles, now President of the largest hospital in the network (500 beds).
• Quote:

  "Really like-minded, non-for-profit, community-based health system dedicated to excellence and serving our communities and it's been a great ride." – David Rahija [02:24]

2. Major Integration Initiative (Systemness & Best Practices)

[03:20–05:52]

• Strategic Focus: Moving beyond being a “collection of hospitals,” pushing for a truly integrated, seamless continuum of care across all providers and sites.
• Leadership Model: Each hospital president also oversees clinical service lines across all of Endeavor; David’s lines include surgical services, neurosciences, and rehab.
• Outcomes Sought:
  • Reduce unnecessary clinical variation
  • Create a “singular Endeavor Health way” by sharing and adopting best practices
  • Keep patients at the center of care redesign
  • Seamlessness from office to hospital, to post-acute, and back
• Quote:

  “How do we reduce unnecessary clinical variation and really settle on a singular Endeavor health way best practice across all of our service lines?” – David Rahija [04:32]

3. Single-Instance EPIC EMR Implementation

[06:15–07:20, revisited at 10:34–13:18]

• Major Project: Bringing three different EPIC instances (EHR systems) into one for all 9 hospitals and ambulatory sites.
  • Half of hospitals go live: August 2026
  • Remaining half: November 2026
• Why It Matters:
  • Enables true integration and differentiation
  • Empowers singular workflows, easier access, and coordinated care across the system
  • Supports operational improvements and clinical excellence (evidence-based order sets, real-time collaboration)
• Opportunities:
  • Seamless access for both patients and providers; expanded choice and subspecialty access
  • Improved care coordination “from an outpatient site in Plainfield or hospital in Evanston or a surgery in Arlington Heights.”
• Quote:

  “This is a giant step forward within our health system to make it more seamless. And it's exciting work. Obviously EMRs don't treat patients, but it's a huge enabling step to allow us to deploy evidence based pathways... in a big swoop.” – David Rahija [12:37]

4. Strategic Response to Financial and Access Headwinds

[06:15–08:15]

• Current Challenges: National healthcare financial turbulence, patient coverage losses (Medicaid, ACA exchanges).
• System Goals:
  • Remain committed to community service as a nonprofit
  • Leverage all assets and partnerships for continued service and growth
  • Make “difficult but necessary decisions” to survive and thrive

5. Surgical Services Strategy: Meeting New Demands & Cost Pressures

[08:15–10:34]

• Trends:
  • More surgical procedures moving off inpatient-only list
  • Physicians possibly shifting cases to ambulatory surgery centers (ASCs)
• Endeavor’s Response:
  • Adjust cost structures in anticipation of "site neutrality" payment changes
  • Emphasize technology, including AI, to reduce costs while safeguarding care quality
  • Optimize the entire perioperative system, not just ORs (SPD, pre/post PACU)
  • Focus on safe discharge and patient transitions to home where feasible
• Quote:

  "Using technology, using AI, [to] reduce our cost structure knowing that we're just going to get paid less for the work that we do." – David Rahija [09:15]

6. Redefining and Driving Growth Across the System

[13:18–15:45]

• Growth Lens:
  • Defined at the system and service line level, not hospital-by-hospital
  • Move to “singular clinical service lines, singular institutes” across the system
  • Strategy: Grow “front doors” (primary, urgent, virtual care); expand subspecialty access
  • Aligned for both fee-for-service and value-based care models
  • Aim for differentiation in a competitive Chicago market
• Quote:

  “We are setting ourselves up to be differentiated in the Chicago end market and offer a higher level, more coordinated, seamless, coordinated care across our clinical service lines…” – David Rahija [15:32]

7. Real-World Examples of System-Level Strategic Decisions

[15:45–18:09]

• Orthopedics: Consolidated from multiple hospitals into a specialty hospital in Skokie
• Cardiac Care: Centralized high-complexity, low-volume cardiac procedures into two main pavilions
• Rationale:
  • Facilitates subspecialization and technology investment
  • “P&L accountability” aligned at service line—not hospital—level to enable the move
• Quote:

  “No hospital president would want orthopedics pulled out of their hospital. It's a higher margin service line. So that enabling step of aligning where the accountability is from a P and L allowed us to then make more strategic decisions…” – David Rahija [16:39]

Notable Quotes & Memorable Moments

• On Integration:

  “Really challenging ourselves to be a truly integrated system of care across the continuum.”—David Rahija [03:54]

• On Systemness:

  “That has been a lot of the work…challenging everyone to put your best practices on the table.”—David Rahija [04:22]

• On Technology Enablement:

  “EMRs don’t treat patients, but it’s a huge enabling step…”—David Rahija [12:41]

• On Making Tough Choices:

  “Difficult decisions. But… it allows our teams to get more subspecialized, we can bring in the latest and greatest technology and really double down on doing those procedures... better than anyone else.” – David Rahija [17:22]

Timestamps for Key Segments

• [01:26] – David Rahija introduces himself & Endeavor Health’s background
• [03:20] – Defining integration & systemness as a strategic goal
• [06:15] – Discussion on EPIC EMR integration and financial headwinds
• [08:46] – Detailed surgical services strategy in response to industry pressures
• [10:57] – Deep dive into EPIC integration benefits
• [13:42] – Growth strategy & system-wide service line planning
• [16:03] – Concrete examples: orthopedic and cardiac care centralization

Conclusion

David Rahija offers a transparent look at Endeavor Health’s ambitious journey as a unified, integrated system. Major themes include technology-enabled systemness, embracing tough decisions for greater community impact, and the ongoing effort to align financial, operational, and patient-centered goals. The episode is a valuable playbook for healthcare leaders navigating consolidation, digital transformation, and the tough tradeoffs required for next-generation health system leadership.