Health systems have spent years arguing that growing leaders from within often beats importing them, for a few reasons: it is more cost-effective, more culturally aligned and more sustainable.
The logic underpins everything from executive-level succession conversations to the structured cohort programs now spreading across the industry. The harder question — whether those programs actually move people up, or whether they develop employees who eventually take those skills somewhere else — is the one most systems have not fully answered.
Becker’s connected with health system leaders who offered a direct response, and each one brought numbers.
At Aurora, Colo.-based UCHealth, Nicole Schell-Dreyer, vice president of total rewards, said 31 participants have advanced from staff-level positions into manager roles and an additional eight have moved into director-level roles since their leadership development program launched, displaying a concrete output in an industry where leadership development ROI has historically been difficult to quantify.
In California, Carole Bennett, vice president of talent management and development at Sacramento-based Sutter Health and head of Sutter Health University, said a recent evaluation covering more than 3,400 leadership development participants found promotion rates of approximately 10% to 11% across the system’s programs, with some cohorts tracking even higher. Sutter’s Leadership Academy, an executive readiness program, produced three promotions into critical leadership positions in just the final months of its most recent cohort.
The picture at Salt Lake City-based Intermountain Health is similarly encouraging. Chief Learning Officer Marguerite Samms said 35% to 55% of leaders move into broader roles across the organization after participating in its leadership and executive development programs. That range, she said, is a product of the system’s deliberate effort to connect development directly to succession planning, building readiness before a vacancy exists rather than scrambling after one opens.
At Houston-based University of Texas MD Anderson Cancer Center, the results are framed in comparative terms. Courtney Holladay, PhD, vice president and chief learning officer, said participants in the Leadership Institute’s Leading Self Accelerate program achieved an 80% higher promotion rate than non-participants, while those who completed the Leading Self Discover program saw a 133% higher promotion rate. Participants in coaching showed a 31% promotion rate compared to 22% among those who did not participate.
“Every member of the workforce is invited to participate in the institution’s Leadership Institute, which offers structured, evidence-based training to employees at all levels,” Dr. Holladay said. “This title and discipline-agnostic approach focuses on recognizing and developing leadership potential wherever it emerges.”
Tampa (Fla.) General Hospital’s Alice Pauquette, vice president of learning and development, said participants in LEAD TGH and Modern Advances in Leadership, the hospital’s development programs delivered in partnership with the University of Tampa, saw an overall promotion rate of 26.5% across fiscal years 2024 and 2025.
“At Tampa General Hospital, however, we view success through a broader lens than promotions alone,” Ms. Pauquette said. “Our goal is to build a sustainable leadership pipeline while strengthening the culture that shapes how leaders show up every day.”
Renton, Wash.-based Providence is tracking results across cohorts. Chief Learning Officer Sandi Murray, PhD, said the Providence Business Challenge — a program designed to prepare high-potential leaders for executive roles through strategic problem-solving and executive exposure — has seen 83% of retained participants from its first cohort promoted within three years of completion. Promotion rates across other cohorts have also risen over time, climbing from 23% two years after enrollment to 38% at the three-year mark.
At Rochester, Minn.-based Mayo Clinic, the measure is internal fill rate rather than a single program’s output. Chief Human Resources Officer Paula Menkosky said the majority of leadership positions across the enterprise are filled by internal candidates, a reflection of the system’s long-standing focus on developing leaders from within rather than relying on external searches.
Financial pressures of 2026
What makes the data more striking is the environment in which it was produced. Financial pressure has intensified across healthcare over the past year, compounded by the Medicaid cuts embedded in HR 1 legislation as health systems brace for more pressure in 2027. For many organizations, that kind of pressure has translated into scaled-back workforce development budgets or restructured programs. None of these systems went that direction.
At UCHealth, Ms. Schell-Dreyer said fiscal discipline has always been embedded in how the program operates, not added in response to external pressure.
“As workforce and business needs evolve, we regularly evaluate all funded programs to ensure they remain aligned with organizational priorities and provide meaningful value to both employees and the health system,” Ms. Schell-Dreyer said. “While our commitment to workforce development remains strong, we continuously assess funding levels, program design, and participation trends to ensure our investments are targeted, sustainable, and delivering the greatest impact.”
Sutter’s response to financial pressure was to refine focus rather than reduce investment — more learning pathways, stronger foundations at each leadership level and more rigorous use of data to evaluate whether the programs are working.
“If anything, the current environment has reinforced the importance of leadership development,” Ms. Bennett said. “Healthcare organizations are facing unprecedented operational complexity, workforce challenges and financial pressures. In that environment, developing internal talent is often more effective and sustainable than relying exclusively on external hiring.”
Intermountain took a similar position. Ms. Samms said the system has become more intentional about where it invests, aligning development directly to business priorities including workforce stability, change leadership, financial stewardship and AI readiness. The emphasis has shifted toward learning in real-world challenges supported by coaches and mentors.
Tampa General has taken the same approach. Ms. Pauquette said the hospital continues to invest in leadership development through its People Development Institute, a centralized hub that supports team members from frontline contributors to executives. The system views leadership development as an investment in organizational resilience rather than a discretionary expense.
Dr. Murray said Providence carefully evaluates investments in light of ongoing financial pressures, but remains committed to leadership development because of its direct effect on workforce stability, succession planning and organizational performance.
“In fact, over the past four years, we have incrementally increased our investment in leadership development resources, including the addition of dedicated team members to support these programs,” she said. “In 2027 we will continue that investment in assessment, simulation, and external learning opportunities to support accelerating development for our senior leaders.”
Mayo Clinic has not scaled back either. Ms. Menkosky said the system has continued to evolve its approach rather than reduce it, most recently through the launch of its LLIFE leadership model, which centers on five capabilities: leads self, leads others, inspires others, forward thinking and engages others. The model is designed to equip leaders to guide teams and advance the organization’s mission through ongoing change.
MD Anderson’s approach also reflects the same logic. The Leadership Institute’s reach across every level of the workforce is built on the premise that leadership potential is not tied to a formal title.
Beyond the promotions
Across systems, the metric that kept coming up alongside promotion rates was retention. As health systems have invested more deliberately in workforce strategy, retention has emerged as the most consistent downstream indicator that something is working, a signal that employees are choosing to stay rather than simply staying by default.
At UCHealth, employees who participate in education and career development programs leave at lower rates than those who do not. At Sutter, approximately 96.5% of leadership development participants remain with the organization. In a labor market where turnover has remained a defining challenge for health systems, Ms. Bennett called that number meaningful.
“We also look beyond retention and promotion,” Ms. Bennett said. “We measure participation, leadership capability development, engagement, internal mobility and readiness for future leadership roles. We are seeing growing demand for these programs, increased participation across leadership levels and strong participant feedback.”
Intermountain is tracking a different downstream variable entirely — what happens to the caregivers who work for leaders who have gone through development. Ms. Samms said the system sees stronger engagement, higher confidence, improved leadership skills and better caregiver experience outcomes in areas led by leaders who actively engage in development. Participants in the Nurse Leader Academy demonstrated measurable gains in leadership skills, while the hospitals they lead showed improvements in experience, well-being and inclusion. The argument, in other words, is not just that the investment produces better leaders. It is that it produces better environments for the people those leaders manage.
MD Anderson’s data makes a similar case at the individual level. Employees who engaged in coaching were significantly less likely to leave the organization: a 12% departure rate compared to 23% among those who did not participate. That gap, Dr. Holladay said, suggests that comprehensive training programs carry meaningful benefits for both employees and the institution.
At Tampa General, the clearest signal of impact is behavioral. Ms. Pauquette said the hospital measures success by how leaders influence their teams and shape culture, not just whether they earn a new title. The system’s programs are connected to its AKTiVe model, which emphasizes authenticity, kindness, transparency and vulnerability as core leadership behaviors.
“We know the investment is working when leaders apply what they learn, and their teams feel the difference,” Ms. Pauquette said. “That can look like more effective communication, stronger collaboration across departments, better support during change, increased engagement, and a workplace culture where people feel valued and connected to our mission.”
Providence’s retention data makes the financial case directly. Dr. Murray said leaders who completed the Providence Leadership Academy experienced a turnover rate of just 2.9%, compared to 14.4% among leaders who did not participate. Participants also scored higher on engagement surveys, reflecting stronger leadership effectiveness across the organization.
Ms. Menkosky said Mayo Clinic measures the program’s success by whether employees see a long-term future at the organization.
“We invest in leadership development because we want people to see a future here, whether that’s expanding their skills, taking on new responsibilities or pursuing new opportunities across the organization,” she said. “The ultimate measure of success is the impact on patients. Strong leaders create engaged teams, foster innovation and strengthen the culture that enables us to deliver exceptional care.”
The measure all the systems seem most focused on, in the end, is not any single statistic. It is whether the program is building something that holds: a deeper bench, a culture of development, a pipeline that does not need to be rebuilt every time leadership turns over. The promotions are evidence. The retention is evidence. But the real test, as each system frames it, is whether the organization is stronger when the next vacancy opens than it was when the last one did.
“Healthcare’s future, more than ever before, will be shaped by the quality of leadership people experience every day,” Ms. Samms said. “Our investment in leadership development is really an investment in caregivers, patients, and communities. When leaders grow, caregivers thrive, and patients benefit.”
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