Health systems are navigating a moment that resists the old playbooks — with federal budget pressure, AI adoption, workforce strain and shifting reimbursement all intensifying at once. For many executive teams, the response has reached beyond strategy into something more fundamental: how leaders work together, make decisions and hold each other accountable has become as consequential as the decisions themselves.
In this Becker’s Healthcare Leadership Council column, health system CEOs reflect on how their executive teams have evolved and what that shift looks like in practice.
How is your executive team functioning differently today? What’s made it a necessity to evolve, and what does that dynamic look like day to day?
Andrew Mueller, MD, CEO, MaineHealth (Portland)
Five years ago, as a new executive team navigating the COVID-19 pandemic, we had to lead with speed and decisiveness to protect both patient care and the financial stability of the system. Today, the challenges are different and more complex — federal budget pressures, an aging population, advances in genomics and biomarkers, and the rapid emergence of AI. The pace and interconnectedness of change mean past experience alone is no longer sufficient.
As a result, our team is relying less on historical playbooks and more on disciplined inquiry: asking better questions and seeking broader perspectives from front-line caregivers, community partners and experts both inside and outside healthcare.
Brad Haws, CEO, Clinical Enterprise, University of Iowa Health Care (Iowa City)
Our executive leadership team works within a highly matrixed environment, and today it is more important than ever that we are functioning with greater collaboration and shared accountability. Evolving reimbursement pressures combined with broader shifts toward value-based care have made it necessary to move beyond siloed decision-making and leverage the collective expertise of leaders and their teams across the organization.
Day to day, this looks like tighter alignment between clinical, operational, academic and financial leaders, with more rapid collaboration around access, workforce planning, service line priorities and sustainability while continuing to advance our mission and patient outcomes.
Kevin B. Mahoney, CEO, University of Pennsylvania Health System (Philadelphia)
Healthcare is facing a convergence of pressures — shifting reimbursement, rising costs, workforce shortages and more. At the same time, the pace of discovery, along with digital and AI capabilities, holds promise for accelerating knowledge and improving efficiency.
At Penn Medicine, we’ve created a framework to help the organization stay financially strong while advancing our mission for the long term. It centers on three priorities: repairing broken processes, refocusing on what matters most for patients and reimagining how medicine is delivered and experienced. With this approach, we’re building operational discipline, recognizing that lasting strength comes from many improvements, not one fix.
Pete November, President and CEO, Ochsner Health (New Orleans)
Our executive team functions more as a true partnership today than ever before. What changed is the recognition that every result — operational, financial, clinical — comes back to people.
We made a deliberate choice to build trust and psychological safety, not just as values, but as how we operate. We’re in constant dialogue, working through decisions together and staying closely aligned on culture and strategy. We can openly discuss what’s not working, which allows us to solve problems faster and more collaboratively. When we’re grounded in purpose and connected as a team, we make better decisions and move with greater clarity.
Robert Garrett, CEO, Hackensack Meridian Health (Edison, N.J.)
One major way we are functioning differently is by identifying a leader when we are working on a project that requires cross-functional team participation. If there’s HR, finance and IT involvement, we want the leaders in those areas participating, but only one leader can own the project. This prevents breakdowns in communication that can lead to delays or potential roadblocks not being identified.
I am also a proponent of having our entire executive team regularly visit our care locations. It helps us keep better connected to our mission. In fact, our new corporate offices are located in the same building as a new health and wellness center.
Robert Stone, CEO, City of Hope (Duarte, Calif.)
The role of an executive team has evolved because the challenges facing healthcare are interconnected, from access and affordability to scientific innovation, workforce expectations, AI and technology. Leaders today must bring these areas together in a coordinated and deeply collaborative way to meet the changing needs of cancer patients while preserving the human relationships at the center of care.
At City of Hope, it means our executive leadership agenda is increasingly focused on shaping the external environment that affects us, systemic integration, prioritization of strategic initiatives and strengthening organizational relationships. As healthcare becomes more digital, the importance of trust, communication and shared purpose only grows.
Technology, in particular, has evolved from discussions about “what is the right system to implement” to broader questions about how we best prepare our clinicians, scientists and staff to thrive in an AI-driven world, while ensuring that innovation enhances, rather than replaces, the human connection essential to healing and discovery.
Moving with the requisite organizational agility requires trust, candor, discipline and alignment. It also requires the courage to look beyond immediate pressures and make decisions that strengthen the organization — and the people within it — for the long term.
Wendy Horton, PharmD, Senior Vice President and President of Adult Services, UCSF Health (San Francisco)
Our executive team has had to evolve in almost every dimension. The pace of change demands far greater alignment and intentionality than ever before. One habit that defines how we operate today at UCSF is every day at 4 p.m., our leadership team gathers to review a portion of the business; we get crystal clear on data and goals, create rapid cycles of improvement and bring in leaders from across the organization.
It is not a status meeting. It is the best minds coming together to move the work forward on behalf of our patients. The fundamentals matter, time together as a team matters and keeping the mission close has never been more important.
William Morice, MD, PhD, President and CEO, Mayo Clinic Laboratories (Rochester, Minn.)
Our executive team is functioning differently today, fueled by our growth, expanding network of collaborations, advances in technology and shifting market dynamics. All of these factors have required our leadership to evolve to manage new levels of complexity and seize new opportunities.
We’ve always had a strong executive team, but it has now expanded to include a chief digital innovation officer, a chief growth officer and a chief scientific officer. These individuals bring unique knowledge and experience in these domains, better equipping the team to drive business growth and differentiation. One thing that hasn’t changed, however, is our relentless focus on maintaining a healthy, open and supportive executive team culture because this is the most important factor in our ability to serve our employees and meet the needs of our clients and their patients.
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
