Hospital and health system CEO turnover is running hotter in 2026 than it did in 2025, with a bigger share of successors coming from the COO ranks, according to Becker’s tracking of hospital executive moves.
The turnover comes as systems and their CEOs are navigating a difficult industry environment, with delayed insurer payments and rising workforce and pharmacy costs, already squeezing hospital and health system margins. HR 1 is also expected to cut federal Medicaid spending by $90.9 billion in 2029 alone and by a projected $911 billion by 2034.
Here are seven trends to know about hospital and health system CEO turnover in 2026 and 2025:
1. Becker’s has tracked 219 new hospital and health system CEO appointments — permanent and interim combined — between Dec. 31, 2025, and Aug. 3, 2026. That compares to 241 for all of 2025, meaning 2026 has already logged about 91% of last year’s full-year total in roughly seven months.
2. Annualized, the pace of CEO change in 2026 is well above 2025. At the current rate, 2026 is on track to finish with well over 300 new CEO appointments, a marked acceleration from 2025.
3. COO-to-CEO promotions have become more common. COOs accounted for 68 of 219 new CEOs named in 2026, or roughly 31% of all appointments, up from 48 of 241 (about 20%) in 2025.
4. Lateral CEO-to-CEO moves remain the single largest single category, but their share has held relatively steady. CEOs moving directly from one organization to lead another accounted for 54 of 219 moves in 2026 (about 25%), compared to 63 of 241 in 2025 (about 26%). Nashville, Tenn.-based HCA Healthcare and Altamonte Springs, Fla.-based AdventHealth were especially active in shuffling sitting CEOs among their own facilities in 2026.
5. Promotions from other internal executive roles — chief strategy officers, administrators, vice presidents of operations, directors of pharmacy and similar titles made up 28 of 219 appointments so far in 2026 (about 13%), compared to 53 of 241 in all of 2025 (about 22%).
6. Interim-to-permanent promotions, in which an organization elevates its own interim or acting CEO to the permanent role, ticked up slightly: 18 of 219 in 2026 versus 15 of 241 in 2025.
7. Appointments from the CFO, chief nursing officer and chief medical officer ranks stayed roughly flat or dipped slightly year over year. CFOs accounted for 8 of 219 new CEOs in 2026, versus 15 of 241 in 2025; CNOs held steady at 7; and physician executives dipped to 5, versus 8.
Editor’s note: These figures reflect hospital and health system CEO appointments reported by Becker’s hospital executive moves coverage and are not a comprehensive census of every CEO change nationally. A small number of appointments (16 in 2026 and 10 in 2025) could not be matched to a specific prior title because the source article did not disclose one, and are counted separately as unverified. The 2026 data are current through Aug. 3, and will continue to grow as the year progresses.
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