Culture, communication, commitment: Insights from America’s most socially responsible hospitals
The Lown Institute recently released the 2026-27 rankings for the Lown Hospitals Index of Social Responsibility. At the launch event, we discussed the state of U.S. hospitals and facing new challenges with the leaders of some of America’s most socially responsible hospitals. Watch the video recording and read the recap below!
The panel discussion featured:
- Ed Banos, President and CEO of University Health in Texas
- Mike Belbeck, Executive Vice President of Operations for Covenant Health in Tennessee
- Vikas Saini, president of the Lown Institute
Covenant Health in Tennessee is ranked in the top ten most socially responsible hospital systems, and has four hospitals on the Honor Roll this year. University Health in San Antonio, Texas, is ranked #3 on social responsibility this year.
The state of the hospital landscape
Lown Institute president Dr. Vikas Saini set the stage by outlining key challenges facing U.S. hospitals. While hospitals overall have bounced back financially from COVID-19 and labor shortages, this recovery is not evenly distributed; the bottom quarter of hospitals are still in the red, while the top quarter have operating margins over 10%. At the same time, health care has become the biggest cost worry for American families and trust in health care institutions is declining.
How are socially responsible hospitals facing these obstacles? Mike Belbeck, Executive Vice President of Operations for Covenant Health, emphasized the importance of community partnership in taking on these challenges. “Your hospital can’t solve 100% of the the economic and financial challenges that are out there,” said Belbeck. “You have to look for opportunities to work with others to help meet those needs.”
Covenant Health has partnered with local clinics and nonprofits to expand their clinical capacity, coordinate care transitions for homeless patients, and provide job opportunities to community members with disabilities.
Ed Banos, President and CEO of University Health in Texas, noted that San Antonio’s population is increasing faster than the health system can grow, which leads to pressure on the demand side. Threats to supplemental funding from Medicaid and 340B are also a potential financial issue.
“As a hospital that is 25% uninsured, when those dollars go away…it has a real impact on the community of how we try and maintain our mission,” said Banos.
What’s the secret sauce?
It’s not easy for hospitals excel on equity, value, and outcomes— in fact, only 5% of hospitals ranked on the Lown Hospitals Index get “A” grades in all three. What’s different about the few hospitals that can do it all and do it well?
Panelists emphasized culture and communication as key for achieving all of these goals. “Our culture that we try to focus on every day is really at the heart of why we’ve been able to accomplish what we’ve been able to accomplish,” said Belbeck.
If hospital leaders need to change their culture, they should be “talking about it routinely with your leadership team and setting clear expectations of what you’re striving for and what you’re trying to accomplish,” said Belbeck.
“What other area of our society do you really need to strive for perfection that’s more important than healthcare?”
Mike Belbeck, Covenant Health
For University Health, their culture was built over the course of a decade, but they still rely on communication and accountability from leadership to maintain that culture of improvement, which creates a virtuous cycle for new hires. “The key to continually build and making that culturally ingrained from new employees coming into orientation to commitment to the medical staff of not giving up when it comes to quality,” said Banos.
“We spend a whole lot of time talking about culture in our organization and trying to continually improve the culture of our organization,” said Banos. “I think it is in large part why we’ve been able to achieve success and it’s not overnight. It’s literally taken years of focus and continually improving.”
See also:
2026/27 Hospital Social Responsibility Full Rankings
2026 Lown Hospitals Index: Acute Care Honor Roll
2026 Lown Hospitals Index: Critical Access Honor Roll