The next five years will test hospital and health system leadership in ways that go beyond traditional strategic planning. Financial pressure, workforce constraints and policy volatility are colliding with rapid technological change, forcing executive teams to rethink how decisions get made, how risk is managed and what effective leadership looks like at the top.
C-suite leaders are reassessing the skills, structures and mindsets they will need to navigate sustained uncertainty through 2030, from how teams respond to shifting reimbursement and regulation to how organizations build resilience, trust and speed in the face of constant change. The buzzword from top C-suite leaders for next year continues to be “agility.”
“Health system C-suites will continue to evolve rapidly through 2030 and the leaders who thrive will be those who can blend clarity of vision with adaptability in action,” said John Couris, president and CEO of Tampa General Hospital and Florida Health Sciences Center in Tampa. “Many C-suite leaders across the country, including members of my own team, are doing meaningful, innovative work, and the next several years will demand even more of that mindset.”
There are some legislative changes, including Medicaid cuts and ACA subsidy shifts, that healthcare leaders know are coming down the pipe. Additional guidance around AI and policy updates to strengthen cybersecurity are likely as well. But leaders are also preparing for the unknown to pivot as state and federal funding for healthcare institutions changes.
“In the years ahead, members of the C-suite will more than ever need to practice (in my team’s case, continue to practice) strategic improvisation: holding onto a strong strategic framework while staying agile enough to adjust in real time as circumstances shift,” said Mr. Couris. “The pace of change in healthcare won’t slow, and headwinds will only grow stronger, so leaders must become more comfortable with being uncomfortable.”
He advises his team to make decisions with 60% to 70% of the information needed and to lean into “uncertainty within reason.”
“They must be willing to fail fast, learn fast and move forward with intention,” he said. “Equally important, the C-suite of the future will require leaders with deep emotional intelligence. These are people who understand how their teams think, what motivates them and how to create an environment where everyone can do their best work. The ability to trust and bring out others’ strengths will be just as critical as operational expertise. By combining strategic agility, thoughtful risk-taking and people-centered leadership approach, health system executives will be well-positioned to guide their organizations through the complexities and opportunities that lie ahead.”
Wendy Horton, PharmD, who recently joined UCSF Health in San Francisco as senior vice president and president of adult services, has a similar outlook on building teams. Through 2030, she sees leaders of academic medical centers needing to amplify the skills that have made them successful to this point.
“Agility, business acumen, digital fluency, strategic thinking and systems-level problem solving must all rise to meet constant uncertainty,” she said. “We will need to communicate with honesty and empathy, guide teams through rapid change and advance new care models while keeping our mission front and center.”
She believes leaders with an edge will be the best listeners and intentionally build relationships with their teams and communities. Especially amid digital transformation, the leaders who are “boldly decisive and profoundly human” will be able to pivot their organizations and thrive.
Maria Ansari, MD, co-CEO of The Permanente Federation, CEO and executive director of The Permanente Medical Group and president and CEO of Mid-Atlantic Permanente Group and CEO of Northwest Permanente in Oakland, sees additional forces shaping her team’s leadership.
“Health systems will need to be agile and ready to adapt to significant demographic and operational shifts already underway,” she said. “One of the most pressing is an aging population, a trend driven by longer life expectancies, fewer births and the larger Baby Boomer generation all reaching age 65 or older by 2030. This demographic shift is increasing demand for care while simultaneously shrinking the workforce. C-suites will need to navigate reimbursement pressures, inpatient capacity constraints, and bottlenecks in post-acute care that can delay patient discharge. Care redesign will need to focus more on care at home and in the ambulatory space.”
The ambulatory care models and hospital-at-home are elevating C-suite priorities at systems across the country: urban and rural, academic and community, large and small. Many are also making strides with value-based care and integrating technology for better decision-making, EHRs and digital health.
“This approach enhances care delivery and supports patients having agency in their health, while also strengthening operational performance,” said Dr. Ansari.
Kaiser Permanente and the Permanente Medical Groups are proudly physician-led and have found the advantages of physician leadership. Clinicians are rising in the C-suite and poised to continue making an impact on the administrative level.
C.J. Marbley, BSN, RN, CNO of the University Medical Center New Orleans and CNO and COO of New Orleans East Hospital, part of LCMC Health, sees clinicians increasingly taking on CEO and COO roles at hospitals and health systems.
“As value-based reimbursement continues to prioritize clinical outcomes, throughput and care coordination, executive leadership will need deep clinical fluency alongside operational and financial expertise,” he said. “Clinicians tend to have a shorter learning curve when acquiring business and finance competencies than non-clinical leaders do in mastering the complexities of clinical operations, team-based care, and frontline decision-making. As a result, health systems will place greater value on leaders who can seamlessly bridge clinical care delivery with enterprise strategy.”
He also sees resource-constrained hospitals merging C-suite roles for dual executive positions such as CNO and COO or CFO and CAO.
“These hybrid positions will reflect the need for agile leadership models that integrate quality, operations and financial stewardship to sustain performance in an increasingly complex healthcare environment,” he said.
Beyond clinical acumen and having a high degree of flexibility, executive leaders are becoming more well-versed with technology and AI. The leadership team at Washington, D.C.-based Children’s National have been digging into the capabilities they’ll need most in the next few years, and Gina Cronin, executive vice president and chief people officer, said the word at the top of the list is “agility.”
“Each of our executives need to be agile and responsive to the impending shifts of workforce and technology, including AI enablement, and how that will impact their teams, functions,” she said. “We are encouraging agility to scan the environment and bring actionable solutions today to be ready tomorrow. Specifically, we are looking to redesign workflow and jobs in clinical and administrative areas that will bring not only efficiency but also improved outcomes and patient experience.”
