If you are going to do the radical things you must do to actually drive measurable Contribution Margin into your hospitals, you will have to better understand health reform legislation.
1) You can only be credible talking to your senior leaders if you are informed
2) You must begin modeling what is and what is not going to be profitable and then who and what you should target
This post from Harvard Business Review will take about 10 minutes to read. It is a good start in your understanding of the current situation and your thinking about the future of building profitable clinical volumes in your health system.