Hoag Memorial Hospital Presbyterian is six months away from opening its long-awaited $1.2 billion Sun Family Campus in Irvine, marking a major milestone for the second-largest hospital in Orange County.
Before the expanded campus opens in September, Hoag’s Chief Financial Officer Andrew Guarni says he’s focused on checking off key tasks.
Current priorities include hitting budget and cutting costs amid high gas prices.
“Everything that comes in a truck just got significantly more expensive,” Guarni told the Business Journal.
Guarni won the Business Journal’s CFO of the Year Award in the not-for-profit category last May for guiding the hospital through the transformative period.
He said that they’re figuring out ways to buy in advance, in bulk or cut better deals to save money and use that to reinvest in the hospital.
Additionally, officials are thinking of how to backfill volume at the Newport Beach hospital as more patients are expected to shift to Irvine.
“Those are the things that are really on my mind right now,” Guarni said.
Hoag Responds to Coverage Gaps
“2026 is going to be an interesting year,” Guarni said.
“Not only because we’re expanding and opening up a new hospital but because some of the regulations from the federal government are causing more to not have insurance.”
Federal subsidies for the Affordable Care Act expired at the end of 2025 amid the government shutdown, causing premiums to more than double on average for enrollees this year, according to health policy nonprofit KFF.
An estimated 4.8 million people, as a result, are expected to go uninsured without the enhanced subsidies.
Guarni said that Hoag is working with organizations such as Orange-based insurer CalOptima Health to ensure that patients “get the care that they deserve.”
He expects to see more patients at the Melinda Hoag Smith Center for Healthy Living located across Hoag Hospital Newport Beach. The nonprofit hub houses more than 35 agencies that provide services ranging from health education to legal aid for underserved communities.
“We’ll be delivering more care and getting less reimbursement for it, so from a CFO perspective, that’s something I have to consider as we build budgets and figure out other ways to make that up,” Guarni said.
Surgical Pavilion Opening in May
The expanded campus has progressively been taking shape on Sand Canyon and Alton Parkway since breaking ground in 2023.
Soon to be the largest structure in the new six-building campus is the 130,000-square-foot Surgical Pavilion, which will open in May, according to Guarni.
The facility, intended to meet rising demand for complex inpatient surgeries, will feature eight operating rooms with advanced robotic technology and a new critical care unit.
In total, there will be six new buildings within the expanded campus, including two hospitals dedicated to women’s health and cancer and digestive health.
