This article analyzes profitability patterns across major DRGs to uncover how academic medical centers rely on high-margin elective procedures to subsidize unprofitable emergency and critical care. Using Medicare cost data, it quantifies cross-subsidization ratios and outlines strategic implications for hospital leaders navigating financial pressures. The findings highlight fundamental tensions between mission and margin in today’s healthcare environment.

I saw it all—tears, spontaneous hugs, high-fives, frowns, and even genuine relief. I saw what happens on stage and off stage, and the magic of the carefully curated sense of serendipity in between.