Growing Intentionally: The Challenge and Opportunity Facing Health Systems

By Pierre Monice

Health care leaders today face a difficult equation. Labor costs, expenses and economic pressures continue to climb, and many of the decisions shaping our industry happen outside our organizations entirely in policy, regulation and the broader economy. We’re being asked to do more with less. At the same time, the need in our communities keeps growing. In South Florida, too many people still lack consistent access to care.

We can’t control most of these pressures, but we still have to lead through them. That’s the challenge. The opportunity is what we do about it.

At Holy Cross Health, our answer is to grow with intention. We opened a new health center and emergency care facility in Deerfield Beach this year and recently broke ground on another in Fort Lauderdale. But when I stood at that groundbreaking, what struck me wasn’t the construction timeline. It was what’s actually being built: access to care, so people don’t put off treatment because it’s too far away or too difficult to reach.

Growth Doesn’t Mean Being Everything to Everyone

In a market with abundant health care options, we don’t have to be all things to all people. We know what we bring to the table as a faith-based institution, and our job is to double down on it: expanding where the community’s need is real and sequencing investments with discipline rather than growing for growth’s sake.

Philanthropy remains a cornerstone of that growth. This past fiscal year, the Holy Cross Health Foundation raised $15.2 million, funding key investments from a new Community Pharmacy launching later this summer to recent mammography equipment upgrades at the Dorothy Mangurian Comprehensive Women’s Center. As we expand into Deerfield and Downtown Fort Lauderdale, that same generosity continues to fuel both facility growth and patient care access.

As a not-for-profit system, we don’t do this alone. That kind of community partnership is what allows us to keep advancing care even as costs climb, and it’s a reminder that growth in this market isn’t just a hospital’s responsibility. It belongs to the whole community.

Culture Is the Hardest Thing to Scale

Stepping into a bigger challenge doesn’t change the fundamentals of leadership. It’s still about people: being present, having real conversations and staying connected to those closest to the work. As an organization grows, the impact of those behaviors only grows with it. Every new facility and every new team either reinforces what makes an organization work or dilutes it.

Trust isn’t built in big moments. It’s built over time, in how we show up with each other every day. It doesn’t automatically carry over to a new building. You have to be deliberate about it: in who you hire, how you develop leaders at each site, and whether people feel comfortable saying what’s working and what isn’t. Those conversations only happen when trust is already there, which is exactly why it can’t be an afterthought as an organization scales.

Listening Is the Discipline That Makes It Work

Some of my most valuable insights haven’t come from reports or strategy sessions. They’ve come from walking the halls, from new hires forming their first impressions, from patients and families experiencing our organization in real time. Sitting at the top shouldn’t give you all the answers. It should push you to get closer to them and to the people doing the work every day.

That discipline matters more, not less, as we grow. It’s easy for leadership to get pulled into capital plans and opening timelines and lose touch with what’s actually happening on the ground. The communities we serve and the colleagues delivering care every day will tell you what’s working if you’re present enough to hear it.

The systems that succeed in this market won’t simply be the ones that build the most. They’ll be the ones that grow with purpose: clear about who they are, honest about what their communities need, and disciplined about protecting quality and culture as they scale. That’s the standard we hold ourselves to at Holy Cross Health today and as we continue to grow.

Pierre Monice is President & CEO, Holy Cross Health.