Health system CEO pay has climbed across a range of measures over the past year, according to several reports Becker’s has covered in recent months — from academic research on nonprofit hospital pay gaps, to industrywide compensation surveys, to the SEC-mandated pay-ratio disclosures filed annually by the largest publicly traded systems.
Taken together, these separate data sources point to the same broad pattern: CEO pay is rising steadily, and at many systems it is rising faster than pay for the rest of the workforce.
Here are six trends to know about health system CEO pay in 2026:
1. The pay gap between CEOs and direct patient care workers at nonprofit hospitals was concentrated almost entirely in the largest 10% of hospitals by bed size between 2015 and 2022, according to a July 22 research brief from Rice University’s Baker Institute for Public Policy in Houston. At the largest hospitals, the CEO-to-direct-patient-care-worker pay ratio climbed from about 36 to 1 in 2015 to more than 51 to 1 in 2022, as CEO pay rose 62% (to $6.31 million from $3.9 million) while direct patient care worker pay grew just 11% (to $121,000 from $108,000). Mid-size and small hospitals saw a narrower gap, with CEO pay growing roughly 22% versus about 12% for front-line workers over the same period.
2. Median projected salary-increase budgets at healthcare organizations have held flat at 3% for three straight years, but actual pay increases have consistently run higher, according to Gallagher’s National Healthcare Leadership Compensation Survey, published July 7. Real compensation increases have outpaced budgeted projections by 1.5 to 1.8 percentage points annually. Year-over-year salary growth at health systems averaged 4.8% in 2024, 4.6% in 2025 and 4.8% in 2026.
3. The median base salary for healthcare executives increased 4.7% in 2025, up slightly from 4.6% in 2024, according to an Oct. 2 survey from SullivanCotter. Pay grew faster at the health system level, with a 5.2% median increase, than at subsidiary hospitals, which saw 4.7% increases.
4. Becker’s has also tracked CEO-to-worker pay ratios annually at some of the nation’s largest publicly traded systems as they file the SEC-required disclosure. A look at disclosures covering 2024 pay, filed in early-to-mid 2025, against disclosures covering 2025 pay, filed in early-to-mid 2026, shows the gap widening at most, though not all, of the systems that report the figure. At systems with no CEO turnover, CEO compensation rose by high single digits to as much as 75% between 2024 and 2025, while median employee pay ranged from flat to high single digits. Averaged across those systems, CEO pay rose roughly 30% year over year, compared with roughly 3% for the typical employee.
5. The pay ratio at the publicly traded systems analyzed widened by an average of about 28%. The gap between what the CEO earns and what the typical employee earns ranged from 2 points wider to more than 300 points wider year over year, depending on the system.
6. Stock awards and incentive payouts, not base salary, are driving the swings at the publicly traded systems. The system with the largest year-over-year jump saw its CEO’s stock award roughly double alongside a higher incentive payout, pushing its ratio up about 75% from the prior year’s level — the widest gap among the systems reviewed.
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