The health system CEO job description is getting longer, and increasingly filled with responsibilities that barely registered five years ago.
Today’s CEOs are expected to steer AI strategy, prepare for cyberattacks, shape culture, advocate in statehouses and on Capitol Hill, protect employees from workplace violence, address affordability and serve as trusted voices in their communities.
That shift is playing out at some of the nation’s largest and most prominent health systems. Leaders including Wright Lassiter III, president and CEO of CommonSpirit; Erik Wexler, president and CEO of Providence; Leslie Davis, president and CEO of UPMC; Warner Thomas, president and CEO of Sutter Health; and Joseph Cacchione, MD, CEO of Jefferson Health, described how the role is expanding far beyond its traditional boundaries.
Several leaders told Becker’s that the pace of change itself has become part of the job: CEOs must be prepared to pivot strategies quickly while bringing thousands of employees along with them.
Becker’s asked 23 health system CEOs across the country a simple question: If you rewrote your job description today, what’s the one bullet that wasn’t there five years ago and that most people still don’t realize is there? Their answers reveal a role stretching beyond the traditional boundaries of strategy, operations and financial performance, and offer a glimpse at what it takes to lead a health system in an era increasingly defined by rapid technological, political, financial and workforce change.
Editor’s note: Responses were lightly edited for length and style.
Erik Wexler. President and CEO of Providence (Renton, Wash.): One bullet would be IT and AI. Over the years that’s always been an important discipline for an executive within the organization. But I’m as much a partner in that work with our Chief Information and Digital Officer Cherodeep (Chero) Goswami. I spend a lot of time learning about how we can advance the use of technologies for positive good, which is part of our 2030 strategic direction. That’s one very important place.
The other important place: As CEOs, we’ve always known that we have to work on continued transformation of whatever business we’re in. Kodak probably needed to be thinking about that. Netflix certainly thought about that. General Electric thought about that. For us in the provider space, I think there needs to be a doubling down of how we’re going to transform to meet the imperative of healthcare in the future, which means bringing the total cost of healthcare down and bringing it closer to where people live and work. So, CEOs need to be relentless in helping that transformation occur before we fall behind as a country that leads the world in its ability to deliver healthcare.
Wright Lassiter III. President and CEO, CommonSpirit Health and CommonSpirit Health Foundation (Chicago): One responsibility has fundamentally changed the CEO role over the past five years: leading the organization through the AI transformation.
Five years ago, AI was still largely viewed as an emerging technology or innovation issue, often confined to pilots, analytics and specific use cases. Today, it is becoming embedded in some of the highest-stakes decisions a health system makes: how care is delivered, how clinical judgment is supported, how patient and enterprise data are protected, how work is redesigned, how resources are allocated and how leaders run their businesses. That shift has made AI an enterprise leadership responsibility, not simply a technology responsibility.
For CEOs, that means establishing the ambition and pace for AI adoption while ensuring the organization has the governance, accountability and safeguards necessary to scale it responsibly. The question is not simply where we can introduce another AI tool. It is where AI can meaningfully improve care, strengthen operations, reduce unnecessary administrative work and create value, where it needs further development and where it should not be used at all.
Strong governance is foundational to that work. At CommonSpirit, we have built it into our approach to AI so that proposed applications are evaluated for patient safety, cybersecurity, data privacy, ethics and value. Done well, governance does not slow innovation. It creates the discipline and trust necessary to adopt AI responsibly and at scale while protecting patient information and enterprise data.
Patient safety is an especially important part of that responsibility, particularly as AI becomes more deeply integrated into clinical care. Our fundamental principle is that the clinician remains the decision maker. AI can provide insights and support judgment, but it should not independently diagnose or treat a patient. Human accountability must remain clear.
There is also a significant workforce responsibility. AI will change how team members work. In some cases, it will automate tasks. In others, it will redesign jobs, change roles or create entirely new capabilities. Some work may no longer be necessary, while other roles will change significantly as AI enables us to work more efficiently, focus on higher-value work and develop new capabilities. CEOs have a responsibility to anticipate those implications, including how we reskill and retrain team members, prepare teams for new ways of working and manage the cultural impact of a transformation of this magnitude. That means creating a culture of learning, giving teams the tools and clarity they need to adapt and helping teams understand not only what is changing, but why. The success of AI adoption will depend as much on how we prepare for new ways of working as it does on the technology itself.
The expectations of leaders must evolve as well. I believe leaders should be able to demonstrate how they are meaningfully incorporating AI into the way they lead, evaluate performance, analyze their businesses and make decisions. Leaders need to understand where AI can improve their businesses, create clarity for their teams and be accountable for whether it is producing better outcomes, greater productivity, improved experiences or lower costs.
That expectation applies to the CEO, too. It is difficult to credibly lead an AI-enabled organization without changing how you work yourself. CEOs also need to become increasingly effective at incorporating these tools into their own daily and weekly work, whether that is synthesizing information, testing assumptions, preparing for conversations, evaluating scenarios or identifying questions that deserve deeper examination. The objective is not to outsource judgment to AI. It is to use AI to augment judgment and become a more effective leader.
Week to week, this means AI now shows up in conversations that historically would have been considered separate. In a given week, I may be reviewing the safety and performance of an AI-enabled clinical capability, discussing how automation will reshape a workflow or operating model, considering how we prepare team members whose work will change, challenging a leadership team on whether it is using AI to improve performance and evaluating how I can use the technology more effectively in my own preparation and decision-making.
The CEO does not need to become the organization’s chief technologist. But AI is becoming part of virtually every dimension of how an organization functions. The CEO’s responsibility is to ensure we adopt it thoughtfully, govern it rigorously, prepare our team members for what is changing and unlock its value responsibly.
Warner Thomas. President and CEO, Sutter Health (Sacramento, Calif.): I would add “culture-building” to the job description, but not simply as setting values or talking about culture. Today, CEOs have to connect culture, strategy and talent development, creating the operating conditions that help people grow and enable the organization to execute.
For me, that shows up every week: spending time with teams, listening and answering tough questions, setting clear priorities and reviewing progress with leaders. It also means creating a consistent operating rhythm so people understand what matters most, what is expected of them and how their work connects to the organization’s strategy and mission.
Culture is not what you say. It is what you consistently do. When leaders communicate transparently, follow through and create clarity, they build trust and develop people who can translate strategy into action — making good decisions, solving problems and moving the organization forward, even when the CEO is not in the room.
Joseph Cacchione, MD. CEO, Jefferson Health (Philadelphia): If I were rewriting the CEO job description today, I would add chief community and trust builder. While CEOs have always been responsible for strategy, operations and organizational performance, there is a growing expectation that they serve as visible leaders beyond the organization, building relationships and partnerships across the communities they serve. Increasingly, stakeholders look to CEOs not only to lead their institutions, but also to help address broader societal and economic challenges.
In practice, that means spending time each week with community leaders, employers, educators, nonprofit organizations, policymakers and other partners to advance shared goals. In healthcare, improving outcomes depends on more than delivering excellent care. It requires collaboration across the community to address workforce, access and population health challenges. Today’s CEO must often act as a convener and catalyst, bringing people together to create solutions that no single organization can achieve alone.
Leslie Davis. President and CEO, UPMC (Pittsburgh): Access is one of those issues that sounds operational but is deeply personal for patients and families. A growing part of my role is focused on opening more doors to care. This means recruiting physicians, nurses, advanced practice providers and techs; expanding imaging and specialty capacity; and using technology and AI to connect patients with experts and investing in services closer to home. At its best, access is about more than appointments. It’s about building more reliable pathways to the care and expertise patients need, closer to home and with fewer barriers.
Bob Riney. President and CEO, Henry Ford Health (Detroit): CEOs now are called upon to take political positions, and they are positions that are not only inappropriate to take because they alienate your workforce — which has divergent views — but the expectation sometimes comes with threats to the support of your operation if you’re not on one political side or the other. That is a very challenging environment for CEOs today and requires political acumen at a level that wouldn’t have been needed in the past.
An example of how that plays out: As health systems have become, in many cases, the largest employer even in large metropolitan areas or one of the largest employers in states, there’s an expectation that you’re going to use your voice as a CEO on very divisive issues: positions on international wars, positions on the U.S. role in things like tariffs. Those are very challenging arenas for a CEO of an industry that relies so heavily on governmental payment to venture into, because no good deed goes unpunished, and there is no unity in the country around these very issues.
Barclay Berdan. CEO, Texas Health Resources (Arlington): The responsibility I would add today would be a focus on AI. It would involve framing a plan for the organization around how to use and acquire technology in a way that benefits patient care and access while ensuring it is used safely.
Mitchell Rosner, MD. CEO, UVA Health; Executive Vice President for Health Affairs, University of Virginia (Charlottesville): The one bullet that wasn’t there, or wasn’t so prominent, is really managing culture. Organizational culture has increasingly become a strategic priority for health systems. And when I was growing up in healthcare, really supporting and retaining the workforce, developing that workforce capability, was largely thought of as kind of organic. It wasn’t really a very deliberate strategy. Occasionally you had HR people who were focused on that, but now I think CEOs spend much more time thinking about leadership development, employee engagement, staff and physician and nursing well-being, and creating an environment where people want to feel fulfilled by their careers, build their careers.
For example, I spent one morning with our HR team talking about how you build trust and what does trust mean. And, as a leadership team, how do we model behaviors that develop more trust, and how do we avoid losing trust? Then, on a broader scale, we just finished our engagement surveys. We did the standpoint survey from the [American Association of Medical Colleges], the Press Ganey engagement surveys, and we’re synthesizing that data to understand how we can really understand what our employees are feeling, so that we can improve the working environment and decrease the gap between leadership and those front-line employees. That cultural component has increasingly gotten to be a primary part of my job.
Laura Kaiser. President and CEO, SSM Health (St. Louis): The first is advocacy, working with elected officials and lawmakers. It’s not entirely new, but the degree of time I’m spending on it is higher. By virtue of so many patients coming to us through Medicare, Medicaid and other governmental means, partnership with lawmakers is really important in terms of helping to educate on what is going well in the healthcare system and what needs to be modified, and to brainstorm together. That’s gotten even more emphasized in the past five years. It’s always been important, but I’m spending more time there, and I’m glad to do so because it takes me all the way back to the person, the mission. We’re here to help people, so we need a system that works.
The other bullet that was not on my radar at all five years ago is agentic AI, and from the time we started this conversation to now, it’s already changed. I served on the board of Nuance before it was acquired by Microsoft, when they were developing ambient documentation for medical records. At the time, Nuance had voice recognition applications in automotive and banking, and they were working on what is now widely spread, DAX documentation in physician offices. The first time I saw a demo, I was breathless. It was so exciting, and I thought, “This is going to change everything.” It wasn’t perfect, but it felt real and possible.
Now, with it being so common across the system and the industry, even with that earlier experience, and that was now about eight years ago, I couldn’t imagine what is now forthcoming. I don’t think any of us could. We are all still learning about the potential. The power and the potential is very exciting, but there is also a need for us to be really thoughtful about how we as human beings help ensure that AI is used for good, and is used so that people who are called to be in healthcare continue to have their buckets full. We’re all better when we have joy in the workplace, and AI can help us be our very best for those who are counting on us to do so. That just wasn’t on my radar to the extent that I think it will influence our work going forward.
Elizabeth Concordia. President and CEO, UCHealth (Aurora, Colo.): We’ve now become the public health trusted source. We are putting up information, for example, with regard to measles and vaccine efficacy. We feel an obligation to share facts, so from an organizational perspective, we never before felt that one of our key roles was going to be to make sure we educated our community with regard to specific facts versus the falsities or fiction that was being placed out there.
From a public health perspective, our role has also been that we more aggressively have to be the advocate, in that healthcare is so expensive and Medicaid is such a large part of every state’s budget. Part of the role that we have to play, which wasn’t in a job description before, was the advocate for the patient, to make sure that legislators recognize the challenges that happen when you cut Medicaid funding from a patient’s perspective.
Cybersecurity also becomes a big deal that was not necessarily front and center. But lastly, we always talked about how we protect our workforce. When I first started out, protecting your workforce meant making sure you had enough PPE, masks and all the things that your employees needed to make sure that they were safe. Now when we talk about workplace safety, we’re talking about protecting them from violence. We’re talking about how we make sure that we give them training on how to defuse a situation, how we make sure that they actually know how to respond to avoid physical abuse, and what to do when they are physically abused. Five years ago, when you talked about workplace safety, you were talking about PPE. Now you’re talking about protecting them from shootings and stabbings and physical abuse.
Chris Van Gorder. President and CEO, Scripps Health (San Diego): If I rewrote my job description today, I would add one responsibility that consumes a remarkable amount of time but is largely invisible to the public: protecting the affordability and sustainability of healthcare before a patient ever walks through our doors.
Five years ago, I would have described my job primarily as leading a health system to deliver outstanding patient care, develop our people and culture, collaborate and co-lead with our physician leaders, and ensure our long-term financial strength. Those responsibilities have not changed. But the environment in which we fulfill them certainly has.
Most people assume hospitals control the cost of healthcare. In reality, hospitals sit at the end of a very long supply chain. Every week we are managing the financial impact of rapidly rising pharmaceutical prices, increasingly sophisticated and expensive medical technology, workforce shortages, inflation, cybersecurity investments, unfunded government mandates, new regulations and reimbursement policies established by Medicare, Medicaid and commercial insurers. We are expected to manage all those inputs while making healthcare more affordable and never compromising the quality of care we provide.
When I began my career, many health insurers operated as nonprofits. Today, many are publicly traded companies, which has changed the incentives and — in many cases — the relationship between payers and providers. Hospitals and physicians are increasingly held accountable for the affordability of healthcare while having limited control over many of the costs that ultimately determine what healthcare costs. At the same time, we are experiencing one of the most exciting periods of medical advancement in history. Gene therapies, biologics, advanced imaging, robotics, AI-enabled diagnostics, precision medicine and other innovations are saving and enhancing lives in ways we could only imagine earlier in my career. But many of these advances are extraordinarily expensive.
Society understandably expects access to these breakthroughs, often at little or no personal expense. Yet the payment system increasingly demands that hospitals and physicians improve outcomes, expand access, absorb rising costs and make healthcare more affordable, while reimbursement often does not keep pace with the actual cost of providing care. Reconciling those expectations has become an enormous leadership challenge.
Another responsibility that has become increasingly important is helping our communities understand how healthcare actually works. During COVID, hospitals, physicians, nurses and other healthcare workers were widely recognized as heroes. In a remarkably short period of time afterward, the narrative changed. Hospitals have increasingly been portrayed by some insurers, policymakers and others as a primary cause of rising healthcare costs.
The reality is much more complicated. Healthcare costs are the product of an enormous ecosystem that includes hospitals, physicians, pharmaceutical and medical technology companies, insurers, employers, government programs and ultimately, society’s expectations about the care that should be available. Hospitals are often at the end of that food chain, absorbing many of those costs while continuing to care for patients regardless of their ability to pay.
That means part of my job today is explaining those realities — to our employees, physicians, community leaders, elected officials and the public. Good healthcare policy depends upon an accurate understanding of how healthcare is financed and delivered. The result is that a growing part of my job is not simply running hospitals or a health system. It is helping preserve the healthcare infrastructure that our communities depend upon.
On any given week, I may spend as much time discussing reimbursement policy, legislative proposals, payer negotiations, cybersecurity, workforce strategy, pharmaceutical and technology costs and long-term capital planning as I do clinical operations. These issues may seem far from the bedside, but ultimately, they determine what we can provide at the bedside.
Every decision comes back to a fundamental question: Will this allow us to continue caring for patients not just for today, but 10 years from now? Today, I spend as much time protecting our ability to provide care tomorrow as I do managing the care we provide today. That may be the biggest change in the CEO role. We have become stewards not only of our organizations, but of the long-term sustainability of healthcare itself.
The hardest part of the job today isn’t choosing between good and bad options. It’s balancing competing goods — making healthcare more affordable today while ensuring the hospitals, physicians and caregivers our communities rely upon will still be there for the next generation.
Jonathan Curtright. President and CEO, OU Health (Oklahoma City): I don’t know that the job has changed that much, in a sense. Certainly technology has changed, but the job itself, I think it was true 50 years ago, and I think it’ll be true 50 years from now. There are a couple of things you cannot delegate.
No. 1 is strategy creation. What is your winning aspiration going to be, where you will play and how you will perform? You cannot delegate strategy. The second thing a CEO can’t delegate is talent recruitment, development and investing in that talent. Leadership talent and strategy are inextricably linked with the role of CEO. The third thing I would say you cannot delegate is resource allocation. Those are three things that are 100% in the wheelhouse of an executive leadership team and specifically a CEO.
My job is to really make the complex appear simple. When those are the three things I build my day around — What are you doing to improve your strategy? Are you executing on your strategy? Do you have good, solid leadership in place to execute on that strategy? And are you allocating resources to ensure that leadership has the resources they need so they can execute on the strategy that’s been developed? — it’s kind of back to the future, in a sense. I don’t think that has changed that much. Obviously things like technology will come up, and resources will continue to be constrained. There aren’t enough nurses and things have gotten more challenging. But those are a few things to keep in mind. Those are the things I can control and have some influence over.
Stephen Leffler, MD. CEO, University of Vermont Health (Burlington): A lot of people believe that when they become the CEO, they’re not going to need to be as operationally involved as they might have been in other roles to get there. And I can tell you that right now I’m very involved in operational decisions, because when you’re focused on affordability, the decisions you make really matter for downstream impact. While we have many people who are operationally responsible for what’s going on, I spend a lot of my time right now internally working alongside them and making sure they understand how important it is to drive efficiency. So I would say I am more operationally involved than I think you expect when you become CEO — in the fine detail of what’s going on across all the sites. That’s probably what stands out most.
Michelle Riley-Brown. President and CEO of Children’s National (Washington, D.C.): We all go into these roles and we think we know what the job is going to be and look like. But I’d probably add a bullet point that says serve as the organization’s chief change champion. I don’t think that would have appeared in the job description 10 or 20 years ago. But today, healthcare is evolving at an unprecedented pace. New technologies, changing consumer expectations, regulatory requirements and advances in care delivery are constantly reshaping how we operate. As the CEO, leading change has become just as important as making decisions on a daily basis. In any given week, that means listening to concerns, answering questions, reinforcing the why behind the strategic decisions we’re making, but also taking time to celebrate the progress and ensuring people feel supported through change. Because change can be tough.
Kristy Carrington. Chief Executive, Providence Swedish North Puget Sound; Incoming Chief Executive, Providence North Division: Recognition and mitigation of cybersecurity risks is a responsibility that has become more top of mind for CEOs over the past five years. We can no longer view cybersecurity as just an IT issue because it has such a significant impact on patient safety, operations, and can pose a major reputational risk for our hospitals. Today, healthcare leaders have to feel more and more confident about mitigating cyber risks, business continuity planning, and operational readiness for technology outages. While it wasn’t a malicious cyberattack, the CrowdStrike incident two years ago demonstrated how dependent healthcare organizations are on digital systems. At Providence, we rapidly activated our incident command structure, transitioned to downtime procedures, and had very strong coordination between clinical, operational and IT teams to maintain safe patient care.
While the disruption created significant challenges for us, our teams were able to continue caring for patients because of contingency planning and caregiver preparedness. Experiences like this really illustrate that cybersecurity preparedness requires the appropriate security systems and structures, as well as organizational familiarity with downtime and business continuity protocols. As a chief executive, it’s my responsibility to ensure we can continue clinical and operational functions when systems are unavailable. Cyberresilience is as essential to hospital operations as emergency preparedness for natural disasters, mass casualty events or other crises.
Gil Peri. President and CEO, Children’s Wisconsin (Milwaukee): The bullet I’d add is “chief value optimizer,” which is about making sure our organization stays relentlessly focused on what is truly of value to each of the stakeholders we serve. Five years ago, that focus was implicit at best. Since then, workforce expectations have been rewritten, families have come to expect the same convenience and transparency in healthcare that they get elsewhere, and the case for investment in pediatric and preventative care must be made more explicitly than ever.
Today, it looks very different for each of our audiences. For example:
- For our team members, what are we providing as an employer that is differentiated and appealing to retain and attract top talent aligned with our mission?
- For the kids and families we serve, how are we broadening the sphere of our thinking to include consumer needs that we didn’t previously perceive as critical, and then creating new opportunities to address these needs?
- For payers, how are we demonstrating pediatric expertise is a smart investment based on quality, efficiency and outcomes?
- For referring physicians, are we truly partnering in ways that bolster their ability to serve as a child’s medical home through effective communication and supporting their patients with timely access to specialists?
It is incumbent on me to ensure we’re keeping what’s most important to these audiences front and center in our discussions on a day-to-day basis, so that our decisions are advancing work that adds the most value for them. When we get this right, the payoff isn’t abstract: More kids get the right care, at the right time, in the right place. Chief value optimizer wasn’t in the job description five years ago, and it’s quickly becoming the most important role.
Sandra Scott, MD. CEO, One Brooklyn Health (New York City): I’m a new health system CEO. I was in charge of one hospital. I’ve been in charge of One Brooklyn Health as interim for a year, and then as the appointed CEO for one year. Now I’m into my second year as the appointed CEO. From my perspective, I’m also a doctor. I’m an emergency room physician, and I think the ability to translate from the bedside to the boardroom is more consequential now than ever. The fact that I understand what’s happening on the front line, and that I have to maintain good working relationships with leaders throughout my organization, whether it’s in facilities or the medical staff, matters because the decisions we’re making require it. A lot of health systems are transforming because we don’t have a choice. We have to, very quickly, because healthcare is not typically the fastest industry in the world. But now because of all of the pressures, we’re having to pivot and move and make changes and transform more efficiently and faster. And of course there’s the technology piece. The technology piece alone is driving a lot of innovation and change.
Those decisions at the top have to be carefully informed by the processes at the bedside, and you really have to make sure you’re getting information up from the front line to the CEO’s office and less top down from the CEO’s office to the front line. You don’t want to make a mistake at the top thinking that the numbers work out and you’re going to have a million dollars worth of savings, and then you break something at the front line. All of the technology is impacting the front line. All of the access challenges are impacting the front line. So it really requires a better translation of information from the bed to the boardroom instead of it going from the boardroom down to the bedside.
Patty Maysent. CEO, UC San Diego Health: I think, especially for public hospitals and public academic medical centers committed to serving the community, finding ways to stabilize community health systems was not in our job description. Now, I think it is essential in order to keep the systems running as a whole. Our patients are sicker and more complex, and our capacity is strained. Building more hospitals in California is also really hard to do. It is really expensive. But sustaining other health systems, creating partnerships and joint powers authorities — in our case — or making outright acquisitions has become a central part of what we do.
E.J. Kuiper. President and CEO, FMOL Health (Baton Rouge, La.): The health system CEO role has changed dramatically over the past five years. It is no longer primarily about leading a collection of facilities. Today, the CEO has to be the architect of a much broader system — designing mergers, affiliations, partnerships and regional models that allow care to be more connected, more sustainable and more responsive to the communities we serve. That requires thinking beyond individual markets and building the structures, teams and capabilities needed to deliver excellent care today while preparing for the health system of tomorrow.
What has also changed is the level of external leadership required. CEOs are increasingly called to engage policymakers, regulators, payers and national platforms, not simply as operators, but as advocates for patients, caregivers and communities. Policy decisions, reimbursement pressures and regulatory shifts now have a direct and immediate impact on access, affordability, workforce stability and the long-term sustainability of care. That means the CEO has to be a public voice for the system and for the people who depend on it.
Workforce and culture may be the most important part of all. The past few years have tested healthcare teams in profound ways — through staffing shortages, burnout, rising labor costs, unionization pressures and the ongoing challenge of sustaining culture through change. A CEO today has to be a talent developer, a culture builder and a steward of well-being. That means shaping strategies for retention, engagement, leadership development, belonging and resilience, because the strength of the workforce is directly tied to the strength of patient care.
That is why, in the age of AI, I believe the CEO’s responsibility to safeguard the people inside the organization is more important than ever. I spend a lot of time thinking about how AI should be used for the good of mankind. That goes well beyond gaining efficiencies, and it should never simply be about eliminating jobs. In healthcare, AI should be about unleashing the power of human interaction. If AI can reduce the time nurses and physicians spend typing notes, that is a good thing. But the efficiency gained should be reinvested in the caregiver-patient relationship. It should create more time for listening, compassion, presence and healing.
I have always considered myself a people-centric leader, but that philosophy has come under pressure in the current environment of substantial headwinds. The financial, operational and workforce challenges are real. But healthcare is still, at its core, a people business. It is people taking care of people. No matter what new technology, innovation or disruption comes along, you will not convince me otherwise. The CEO role may be more complex, more public and more digitally driven than ever before, but the calling remains the same: to protect the mission, support the people who deliver it and make sure the system is built to serve patients and communities well into the future.
Matt Fry. President and CEO, Freeman Health System (Joplin, Mo.): Health system CEOs today — perhaps more than ever — have to be comfortable making adjustments on the fly to strategies, to tactics, to some of our strategic objectives, because the environment is shifting so rapidly. Healthcare has always been an industry that has had fairly monumental shifts, but in the past, they’ve taken a little bit more time to develop and implement — a little bit more of a grace period to adjust your organization and your strategy to meet those new challenges or the new dynamics. I feel like that has hit a rapid supercharge recently, and health system CEOs are needing to pivot rather rapidly. And it’s really our job to make sure that our organizations are prepared for those pivots.
Dennis Johnson. President and CEO, Catawba Valley Health System (Hickory, N.C.): Today, you’re a community CEO. We serve five counties. You can’t just look at one site. You have to look at the global picture. You’re looking at this on a macro level. By macro, I mean whatever your service area is. For us, it’s five counties, 400,000 people in Central Western North Carolina. Strategy, in my mind, is more important than anything else. CEOs have to be strategic. This is kind of hearsay for folks that have lived in the inpatient world for years, but that’s only one small aspect anymore. We treat 13,000 inpatients every year. We treat 400,000 total outpatients every year. You have to be strategic. You have to always think like a competitor. What’s your competitor doing, and how does that impact the folks in your service area and your hospital or health system?
Tom Vasko. CEO, Newman Memorial Hospital (Shattuck, Okla.): Transformation is a big component that’s an absolute must; incoming CEOs and those up and coming must be able to endure and have that knowledge, and really have the tenacity and the mettle to engage in a high level of risk taking. If you’re not really driving and taking risks and transforming, you’re just managing the decline of the inevitable. That’s one big piece.
The other is culture. It’s so important nowadays; we talk more about it now than we did before, when everything was very operational. We looked at things like clinical effectiveness and RCM optimization, making sure providers were seeing a certain number of patients per day and really focusing on the financial components of how we operate. Now it’s more about how I drive culture and physician relationships to increase the effectiveness of both quality and excellence as well as patient experience. Looking at teaming with organizations like The Joint Commission — not in a punitive way but more as a collaboration of how do we work to achieve excellence and define excellence — to drive workforce interest, to gain population and patient trust of care so they utilize our services, and then you just kind of let those financial and operational components fall into place, because you’re really striving for excellence. Here at Newman we work very closely with The Joint Commission on multiple efforts, really as a partner, and not necessarily as, “Hey, we need to check this box of accreditation.”
[As an example], in rural areas, things like transportation and food insecurities are a lot larger than I expected when I got here. We launched women’s health services, and the volume was somewhat there but wasn’t what I expected. When we started really digging into the community, we saw that there were massive amounts of transportation barriers, and we realized that extended not just in women’s health but really across the entire enterprise and all specialties. So we went out and bought a van, in addition to the maternal health van, and we will go and pick our community members up hours away — two, three hours away — and bring them to the hospital. It could be for primary care, it could be for orthopedic surgery for total knees, it could be for labs. We’re not being reimbursed on that, so we just take the cut out of what reimbursement would be for the services, and sometimes it’s a loss. But I think that’s the transformation piece — we’re not just sitting still and expecting people to come to us. We’re really addressing some of the challenges in the underserved population that we see.
We have added 15 multi-specialty providers, both physicians and surgeons, that have come out here, and some of them drive two and a half hours out to Newman to practice on a weekly basis. We have tied in with a really integrated health perspective and created this rural integrated health system, per se. For example, we are in partnership with Oklahoma Heart Hospital, where they send cardiologists out here and we can conduct advanced imaging, which helps bring revenue into the hospital. We are doing telestroke with the University of Oklahoma where, live in the ER, our ER physician can launch telehealth and work with the OU Health neurological team to address stroke right there — so we’re not waiting an hour and a half for a life flight patient to get to the city. There’s a lot of transformative effort around integration of health systems and physicians in partnership, along with some of the basics of just food security and transportation barriers.
Deborah Visconi. President and CEO, Bergen New Bridge Medical Center (Paramus, N.J.): Building partnerships beyond the walls of the hospital to improve the health of the community. That’s something that has really evolved in the CEO job description — being responsible not just for running what’s within the walls of the hospital, but for improving the health of the entire community. If you wanted to put it in a sentence: creating value for the community, not just volume for our hospital. That’s what a modern CEO’s job description is really about today.
Building relationships and partnerships — looking into different types of partnerships, whether that’s with homeless shelters, food banks, payer strategy, or payer relationships. Looking at things like population health and addressing social determinants of health through some kind of partnership. More advocacy, too — advocating for policy, ensuring our organizations remain financially sustainable while fulfilling our mission, and really being in tune with the front line and the patient experience.
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.
