Summary5 min read

Becker’s Healthcare Podcast: JPM Takeaways, AI Progress, and the Future of Hospitals with Molly Gamble

Date: January 23, 2026
Host: Scott Becker
Guest: Molly Gamble, Vice Chair/Vice President, Editorial Affairs & Former Editor-in-Chief at Becker’s Healthcare

Episode Overview

This episode features a discussion between Scott Becker and Molly Gamble focusing on fresh insights from the 44th JPM Healthcare Conference in San Francisco, shifting business models in healthcare, the evolving role and challenges of hospitals, the tangible impact of AI in health systems, and the status and semantics of value-based care. The conversation blends forward-looking trends with current operational realities and includes firsthand anecdotes and predictions from industry leaders.

Key Discussion Points and Insights

1. Takeaways from the JPM Healthcare Conference

Hospital Centrality is Fading
- Shift in Business Model:
  - “The hospital [is] no longer being the center of the health system business model.” – Molly Gamble [01:23]
  - For years this was speculative; now it’s materializing in “substantial but also quiet ways” as health systems reduce hospital footprints and ramp up outpatient and ambulatory strategies.
- Case Examples:
  - Ascension reducing from 139 hospitals to 95; acquisition of Amsurg to boost ambulatory services.
  - Sutter Health is set to invest nearly half a billion dollars in 50 new ambulatory surgery centers (ASCs). [01:46]
- Outpatient Focus:
  - Major systems are “planting the flag” with outpatient-centric strategies.

2. Reality Check: Hospitals Still Overburdened

Capacity Crisis vs. Business Model
- Hospitals are “at capacity,” especially due to flu season and virus surges. Some, like a hospital in Iowa, have suspended elective surgeries to handle admissions. [02:53]
- “You still are seeing the reality in the day to day. A lot of these hospitals are operating at the brink…” – Molly Gamble [02:39]
Juxtaposition Highlighted:
- Even as care migrates towards outpatient and ambulatory environments, “hospitals are totally full… having trouble getting people out of their ER into the hospital.” – Scott Becker [03:33]
- “At the end of the day, notwithstanding all the technology, we still need doctors and nurses.” – Scott Becker [04:15]
- “Maybe it’s not so much that hospitals aren’t needed, it’s just hard to make money in hospitals.” – Scott Becker [04:41]
Critical Functions Remain In-Hospital:
- "The hospital is less the core of the health system business model. But... it is very much the core of the care model." – Molly Gamble [05:03]
- Patient access and high-acuity care, particularly for uninsured and underinsured, still depend on the traditional hospital. [05:03]

3. Financial Pressures and Strategic Service Lines

Where Need and Money Align:
- Systems are heavily reinvesting in orthopedics, oncology, cardiovascular services—“because there’s both need and money.” [05:57]
- The challenge persists for high-need areas that lack sufficient funding or resource supply.

4. AI’s Ascendancy From Pilot to Proof

Real-World Outcomes Emerging:
- AI has moved out of the pilot phase; “more and more systems have results to show for it.” – Molly Gamble [06:23]
- Examples:
  - Hundreds of thousands of nursing clicks eliminated (“for our team, we really enjoy reporting… what’s actually changed with these tools.”)
  - Providence cut contract labor spend by 62%.
  - WellSpan aims to save 400,000 staff hours annually. [07:01]
Workforce Support, Not Solution:
- “Technology will not solve the workforce crisis, but you're seeing more systems at least have results to show for… these investments.” – Molly Gamble [06:43]
AI’s Differential Impact:
- Faster adoption and impact on admin tasks, some progress in “ambient listening,” and still in early stages for diagnostics or specialist work. [07:51]

5. The (Not So) Death of Value-Based Care

Mixed Perceptions About Momentum:
- While public pledges by health systems to shift to value-based care have declined, core risk-based contracts (especially in Medicare Advantage ACOs) are more important than ever. [08:18]
- “I would argue [value-based care is] not dead… for many systems, it’s not an option but a must.” – Molly Gamble [09:03]
Debate Over Terminology:
- “There are so many definitions of value-based care... I find value based care to be such a euphemism.” – Scott Becker [09:19]
- Subtext: Many providers see themselves as offering value, regardless of payment model (fee for service or risk-based). Framing often distorts reality.
- “Part of the issue is the framing of all this is so bastardized versus reality… it becomes almost consulting talking points that drive us one way or the other.” – Scott Becker [10:33]
Upcoming Reporting:
- 10-year anniversary of CMS’s Comprehensive Joint Replacement (CJR) Program; Becker’s will survey health systems on how participation has shaped their care and business models. [10:53]

Notable Quotes & Memorable Moments

On the evolving hospital role:
- “It is very much so the core of so much of the care model.” – Molly Gamble [05:05]
On AI progress:
- “Now you’re just seeing more and more systems have some results to show for it.” – Molly Gamble [06:28]
On value-based care terminology fatigue:
- “As much as I can get really tired of hearing that term, quite frankly, I think there’s probably a lot to be learned about what’s happening with value-based care right now among some of the largest systems especially.” – Molly Gamble [11:26]

Timestamps for Important Segments

01:08 – Molly’s JPM Conference takeaways: the diminishing centrality of hospitals
02:35 – Hospitals grappling with capacity and the flu season’s burden
03:33 – Scott on the “challenging juxtaposition” of full hospitals and the ambulatory shift
05:03 – Molly: business model vs. care model distinction for hospitals
06:23 – AI, from pilot to practical results in health systems
08:18 – Value-based care: status, semantics, and strategic necessity
10:53 – The CJR anniversary and the legacy of bundled payments

Summary

This candid, insight-rich episode delivers a snapshot of a sector in flux: health systems are building strategies around outpatient care, but the need for inpatient capacity persists due to high-acuity patient loads. AI is transitioning from hype to meaningful, measurable change—especially in admin/workforce relief. Meanwhile, value-based care, despite shifting rhetoric and market fatigue, remains central to financial planning and care delivery transformation. Becker and Gamble combine data points and lived industry experience to paint a clear, nuanced picture for healthcare decision-makers.

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Transcript13 lines

[00:02]
Announcer
Every year, Becker's annual meeting brings healthcare leaders together to unpack the most pressing issues facing the industry. And every year those conversations shift in profound and unexpected ways. This April, more than 3,500 healthcare executives will return to Chicago for Becker's 16th annual meeting. 795 elite speakers will offer new lessons, new case studies, and predictions about what comes next. Join us April 13th through the 16th. For the agenda and event details, visit BeckersHospitalReview.com and click on the Events tab in the upper right.
[00:38]
Scott Becker
This is Scott Becker with the Becker's Healthcare Podcast. I am thrilled to weekly get a chance to visit with Molly Gamble. Molly's the vice chair or vice president in charge of editorial affairs at Becker's Healthcare Longsome editor in chief, and we visit with Molly regularly to talk about what stories she's watching closely in health care. Molly, let me turn it to you and ask you, are there a couple stories that you're watching most closely currently?
[01:09]
Molly Gamble
Yeah. Thank you so much, Scott. It's good to be back with you. And to kick off 2026, I come with some observations and notes from the JPM Healthcare conference that took place last week in San Francisco. This was the 44th version of the event and I think it's been interesting to watch it evolve over time, but there were definitely some health system centric takeaways that I thought we could unpack together. I think one of the first, Scott, that really stood out to me is this has been discussed and anticipated so frequently. I feel like I've been writing about this for like 10 plus years, but the hospital no longer being the center of the health system business model. I think 10, 12, 15 years ago that was somewhat of a remark or anticipation you would hear from a lot of the futurists out there. It was kind of aspirational and now you're really seeing it happen and it's happening in some substantial but also quiet ways. So you're seeing systems like ascension go from 139 hospitals to 95. It obviously has its pending acquisition of Amsarg, which would increase its ambulatory footprint. It really major way you have Sutter Health in California. It's already the largest ambulatory system in the state, looking to spend nearly half a billion dollars on 50 more ASCs. And so you're having a lot more of these systems really plant the flag and make sure that their strategy moving forward is outpatient centric. I think, Scott, what didn't come up as much that maybe this is just something that hospital leaders are More close to versus the broad system leaders. But we're talking right now in virus season. I understand this flu season has been pretty hard for especially for certain pockets of the country. And our team is conducting interviews with leaders at hospitals that are at capacity. We had one in Iowa had to suspend elective surgeries for flu to make capacity for patients and the high volume of patients related to this virus season. So as much as the playbook is pushing health systems to think outside of the acute hospital model, you still are seeing the reality in the day to day. A lot of these hospitals are operating at the brink and we're going to see how this continues to evolve as more uninsured continue to add up under the obbba.
[03:34]
Scott Becker
Let's talk about that. Really this concept that there's this really challenging juxtaposition of hospitals are totally full, totally full and they having trouble getting people out of their ER into the hospital. And just there's really challenging spot many hospitals operating at total capacity and at the same time there's so much movement of care in so many different places to other spots. And maybe it's the hospitals becoming less the total center of health care, but it does seem that even so they're still quite, quite full and maybe it's and not or hospitals and everything else taking care of patients and doing so in a supply constrained environment. Because at the end of the day, notwithstanding all the technology, we still need doctors and nurses. So really challenging. And then you continue to get reminded of this stuff like you mentioned, the flu season being bad and all of a sudden the hospitals again being overwhelmed. And obviously we saw this so many times during COVID So as much as the country wants to get away from a hospital centric model, and certainly you're right, USPI went from being a hospital company to as much being a surgery and outpatient surgery company ascension trying the same transformation, other places are too. And maybe it's not so much that hospitals aren't needed, it's just hard to make money in hospitals. So these systems are trying to hit this balance of outpatient and inpatient, but the hospital still seem very sorely needed in terms of our nation.
[05:04]
Molly Gamble
I couldn't agree more. And I think that what you're hearing is the hospital is less the core of the health system business model. But I think to your point Scott, it is very much so the core of so much of the care model. So I think it's something to be careful about because as you see more and more systems look to another health system leader on the East Coast. He would always remind me that hospital revenue was about 46% compared to outpatient. You know, that makes sense that that clearly illustrates at a business model level, the hospital is not as important as it once was. But I think to your point, Scott, when it comes to access and acuity of care and uninsured, which will continue to be accepted and treated under EMTALA and ers, I think the hospital will continue need to hold a very, very important position when it comes to care and access.
[05:57]
Scott Becker
I think that's right on. No, thank you. It's this mix of business model versus patient need. And there are places where that business model and patient need lines up well. And why you see hospitals again reinvesting so much in orthopedics, oncology, cardiovascular, because there's both need and money. But it's challenging for all those places where there's a mismatch, where there's tremendous need but not enough money or not enough supply. Fascinating. Molly, tell us something else that you're watching closely.
[06:24]
Molly Gamble
Currently the other trend line I would point to from the conference was, you know, overall I heard that the presentations from the health systems were really relatively rosy. This is an event where they were pretty, pretty forward looking with bright dispositions amid some of the margin pressure they're facing. You have some big systems that were represented, Scott, but another big trend line you're starting to see. I don't think this is as much of a surprise, but we've talked in the past about AI and its evolution. It was in this pilot phase for a couple of years and now you're just seeing more and more systems have some results to show for it. This is exciting for our team. I know we really enjoy being able to report on what is actually has changed with these tools and technologies in place. So you've got, you know, health systems like talking about how many hundreds of thousands of nursing clicks they eliminated cutting contract labor spend. Providence cut theirs by about 62% WellSpan setting a goal of saving 400,000 staff hours annually. So this is becoming more and more when we I know you and I have talked about in the past, technology will not solve the workforce crisis, but you're seeing more systems at least have results to show for making some of these investments in these tools and how they are paying off for their people. So I think that's something we'll continue to stay curious about in the year ahead. Ideally more and more of these implementations and rollouts and pilots that we reported on. We'll just continue to have a through line for what that actually means today and what it's actually changed in those organizations.
[07:51]
Scott Becker
Thank you. No, I think that's fascinating. And you're seeing different spots where it's really taking off and having impact on the administrative side, the ambient listening side still sort of getting there in that diagnostic side and the specialist side. But helpful tools. But it does seem like cascading different places where AI and technology is having the most impact. And it seems like it's going to be a evolution over the next several years.
[08:19]
Molly Gamble
Really very much so. And then I think the other and final note is just value based care. This is something that I've read some commentary saying that like value based care is dead. Like it just does not have the momentum it once did. We used to see systems basically publicly make a pledge that they wanted X percent of their revenue under risk by this year. That doesn't seem to happen as much or as frequently or is with much visibility. But it's, I would argue it's not dead. I think you're seeing the Medicare Advantage ACO performance risk based contracts really showing up as central to so many financial discussions. So Scott, I just wanted to note that there's I'm sure plenty more reporting than our team will be doing on this. But when it comes to value based care, there might have been a slowdown, especially post Covid in those immediate years after the pandemic, but I think a lot of systems out there seem to be seeing value based care as not an option for them but a must.
[09:19]
Scott Becker
No, I think that's right. And there are so many different definitions of value based care. And part of it is it's probably almost better to talk in terms I find value based care to be such a euphemism. And I don't mean to offend people, but you've got taking risk on one side and you've got fee for service on the other side. And I would argue that most physicians and health systems, whether they're doing it in a fee for service environment or risk based environment, better believe that they're get that they're giving value for the care they're giving. That that the idea that value based care is just a risk based concept is sort of a, it's a prejudice or bastardization against one payment system which we may all agree as challenges. But I think if you talk to an obstetrician, gynecologist who's delivering a baby and getting paid, whether they're getting paid for it and they're certainly not cleaning up on it, they must believe they're giving value for the care they're giving just as well as an OB gyni that would be doing it under a risk based contract situation. So I think part of the issue is the framing of all this is so bastardized versus reality and it becomes almost consulting talking points that drive us one way or the other versus the reality of. I think most providers believe they're giving value for care. Now they might be getting paid for fee for service, they might be getting paid under risk, but, but either way they probably believe they're giving good value for the care they're giving.
[10:53]
Molly Gamble
I couldn't agree more. Like the lexicon of it and the language of it and know under the umbrella value based care of ebc, I mean you've got like bundles, you've got global payment. Like there's just so many flavors of that. So I know Scott, we've got someone on the team working on a story because we're coming up on the 10 year anniversary of CJR, the comprehensive joint replacement program that was implemented under CMS. And so we're just going to be asking some questions of health systems that participate in that. If it, you know, help sharpen their muscles, what are the after effects that still stay from that, that big pilot that really moved bundles from an option to a mandate 10 years ago. So more to come on that, but I think it's a, it's an interesting. As much as I can get really tired of hearing that term, quite frankly, I think there's probably a lot to be learned about what's happening with value based care right now among some of the largest systems especially.
[11:45]
Scott Becker
Could not agree more. Molly, as always, fantastic to visit with you. Thank you for joining us on the Becker's Healthcare podcast. And more importantly, thank you for your leadership every day. Thank you for joining us.
[11:56]
Molly Gamble
Thank you so much, Scott.