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.

This article explores how healthcare leaders can deliberately integrate artificial intelligence (AI) into decision-making to enhance efficiency, equity, and impact. It examines traditional leadership frameworks alongside AI tools such as predictive analytics and natural language processing, highlighting their potential to improve data-driven choices. At the same time, it underscores challenges like algorithmic bias, ethical risks, and resource barriers. The proposed “ABC of AI-inclusive Decision-Making Process” offers leaders a structured way to balance human judgment with technological innovation for more effective and ethical leadership in a rapidly evolving healthcare landscape.