At the outset of each year, the Health Care Advisory Board research team conducts the Advisory Board Research Annual Health Care CEO Survey to identify what issues are currently of greatest strategic importance to our hospital and health system members. Given the political uncertainties of the past year, the intensifying margin pressures sweeping across the industry, a new wave of mega-mergers, and the looming threat of disruptive innovation from outside entities—especially Amazon—we were curious to see which topics rose to the top in 2018.