To say the health care climate is in flux is to put things very mildly. Otherwise, how else do you explain putting the state’s most influential power broker at the top of the list?

But who do you consider for a health care list? Last year, we took all comers, and were told in no uncertain terms that you can’t have the CEO of a hospital with a razor-thin profit margin outranking a big gun in pharma who makes billion-dollar decisions every day. It’s a fair point, so this year, the list is all about hospitals and the big stories as it relates to hospitals — be it takeovers, mergers or Gov. Chris Christie’s plans for higher education and health care. With that in mind, here is this year’s list of the most powerful people in health care.

For more on what these leaders are doing, read the full list.