Healthcare CEOs’ Agenda: Top Priorities for 2026
This year, healthcare CEOs are navigating a compounding level of complexity that has reached new heights, while building resilient organizations capable of thriving in an...
In my regular conversations with healthcare leaders, a consistent theme emerges: traditional leadership playbooks no longer suffice for today’s complexity. CEOs face simultaneous pressures unthinkable a decade ago: policy uncertainty reshaping planning horizons, workforce challenges necessitating cultural transformation, M&A reversing from “scale for scale’s sake” to strategic precision, and artificial intelligence moving from pilots to enterprise-wide implementation. Through extensive research involving interviews with dozens of health system CEOs, one clear reality has come to light: leaders now operate in an environment where the lifespan of strategic imperatives is shorter, and decision-making windows are compressed.
For 2026, the CEO agenda includes foundational imperatives, referred to as evergreen priorities, as well as priorities expected to intensify in 2026, reflecting what is genuinely different or acutely pressing this year.
Evergreen Priorities: Foundational Imperatives
1. Essentiality and Market Leadership
Essentiality, meaning being indispensable to the communities served, drives every major organizational decision, from portfolio optimization to resource allocation to partnership evaluation. This is not about market share alone; it is about concentrated regional presence, clinical excellence, and delivering value no other organization can replicate. The clarity of knowing where the organization can truly compete and win enables disciplined decision-making about where to invest, where to divest, and where to build deeper capabilities, preventing the trap of trying to be everything to everyone.
The CEO imperative: Continuously assess your organization’s essentiality across markets and service lines. Make the difficult decisions to exit areas where you cannot achieve market leadership, and double down on investments where you can build indispensable value. Use essentiality as the filter for every major long-term decision: M&A, capital allocation, and partnership evaluation.
2. Margin Stewardship and Portfolio Management
Financial sustainability remains the foundation upon which all other priorities rest. With operating margins under persistent pressure from labor costs, supply chain inflation, and reimbursement challenges, CEOs must maintain disciplined cost management. However, the financial imperative extends beyond traditional cost reduction to sophisticated portfolio management: identifying which service lines generate sustainable margins, which require targeted investment despite current losses, and which should be divested or restructured. Administrative efficiency is emerging as a critical lever, with organizations deploying automation and AI to reduce the burden on clinicians and eliminate non-value-added work.
The CEO imperative: Move beyond across-the-board cost reduction to intentional resource reallocation. Build sophisticated financial analytics and digital P&L twins that enable simulation on every decision regarding portfolio optimization. Invest in administrative automation that improves both margins and workforce experience, creating a dual benefit in today’s constrained labor market.
3. Workforce Sustainability and Talent Development
The workforce crisis has evolved into a chronic leadership challenge. Healthcare organizations can no longer rely on crisis staffing solutions or premium labor costs to maintain operations. Instead, CEOs must build long-term workforce resilience through comprehensive talent strategies addressing recruitment, engagement, retention, development, and succession planning. Workforce sustainability requires moving beyond compensation as the primary retention lever. Organizations are creating more flexible work arrangements, investing in professional development for nursing, medical, and administrative staff, and building working environments where multiple generations can thrive. Succession planning and leadership development are increasingly considered critical CEO responsibilities.
The CEO imperative: Transition from crisis staffing to forward-looking workforce planning. Invest in comprehensive talent assessment and succession planning processes. Create flexible work models and development opportunities that appeal to multi-generational workforces. Build culture as a retention strategy, not just a values statement.
4. Quality, Safety, and Clinical Excellence
Amid all pressures, the core mission remains unchanged: delivering high-quality, safe patient care. Quality and safety require “high rigor, high reliability” approaches that systematically eliminate variation and prevent harm. The definition of quality continues to expand beyond traditional clinical outcomes to encompass patient experience, health equity, and population health management, with organizations measuring and improving access to care, addressing social determinants of health, and ensuring high-quality care is available to all community members.
The CEO imperative: Maintain unwavering focus on quality and safety as the foundation of organizational mission. Implement high-reliability principles across all operations. Expand quality measurement to include patient experience, equity, and population health outcomes. Create cultures where safety concerns can be raised and addressed without fear of retribution, recognizing that psychological safety is essential to clinical safety.
5. Partnerships and Ecosystem Building
The era of healthcare organizations operating in isolation has definitively ended. As ecosystem architects, CEOs understand that no single organization can address the full spectrum of community health needs alone. This requires moving beyond healthcare provision to collaborate with local administrations, schools, business partners, payers, and competitors on holistic solutions: job creation, education, transportation, housing, and care coordination. This shift from competition to “coopetition” reflects the complex interdependencies within communities and aligns with next-generation workforce expectations for purpose-driven organizations engaged in meaningful social impact. Partnerships take many forms but share a common goal: community wellbeing, improved access, better coordination, and effective population health management across the care continuum.
The CEO imperative: Actively seek partnerships that expand organizational capabilities and community impact. Move beyond traditional competitive mindsets to embrace collaboration where it serves patient and community needs. Build local ecosystems that improve community wellbeing.
Intensified in 2026: High-Pressure Focus
6. State and Federal Advocacy
External engagement has moved from a peripheral CEO responsibility to a central leadership imperative. Policy decisions at state and federal levels increasingly determine organizational viability, making advocacy and policy influence essential CEO competencies. The policy environment in 2026 is characterized by volatility and uncertainty, with federal healthcare reforms, state-level regulatory changes, and evolving reimbursement policies creating both risks and opportunities that CEOs must actively navigate.
The CEO imperative: Elevate policy advocacy to a top priority. Build relationships with state and federal policymakers. Leverage state and national associations to amplify your organization’s voice and influence broader policy agendas. Participate actively in industry associations and advocacy coalitions. Develop the capability to translate policy changes into practical implications for your organization. Engage your board and leadership team in understanding the policy landscape.
7. M&A and Mission-Driven Growth
M&As have evolved from opportunistic growth strategies to organizational necessities driven by three distinct imperatives: building essentiality through selective market consolidation, acquiring capabilities required for future care delivery models, and facilitating survival partnerships for financially distressed organizations. Today, health systems demonstrate heightened selectivity, favoring laser-focused acquisitions that strengthen regional presence and competitive position. The era of pursuing small, fragmented deals to achieve scale for scale’s sake has ended. Organizations are also using M&A purposefully to build resilience beyond hospital-centric models by expanding into ambulatory care, behavioral health, health plans, and other service lines essential for capability-driven diversification.
The CEO imperative: Approach M&A with disciplined focus, not an opportunistic growth mindset. Develop clear criteria for evaluating potential transactions based on essentiality, capability building, and strategic fit. Build the organizational capacity to integrate acquisitions effectively, as many deals fail not in the transaction but in the integration.
8. Board Relationship and Governance Alignment
The relationship between CEOs and their boards has intensified, as boards transition from “wait-and-see” postures to demanding decisive action despite ongoing uncertainty. Boards in 2026 expect deeper conversations that go beyond financial metrics to encompass culture, performance rigor, market positioning, and long-term organizational sustainability. The governance agenda has expanded significantly, with boards demanding regular updates on culture and workforce engagement as leading indicators of organizational health, asking harder questions about strategic positioning and competitive threats, and expecting CEOs to articulate clear visions for the future while demonstrating agility to adjust as circumstances change.
The CEO imperative: Invest in board education and alignment as a key priority. Create governance structures that enable rapid decision-making while maintaining appropriate oversight. Expand board conversations beyond financial performance to include culture, future market positioning, and long-term sustainability. Build board capability to evaluate complex growth options like M&A, partnerships, and portfolio optimization.
9. Organizational Resilience and Culture
In an environment of constant disruption, organizational resilience is perhaps the most critical capability for healthcare organizations. It is the capacity to absorb shocks, adapt to change, and maintain performance under pressure. Building this muscle requires both operational agility and dynamic scenario planning as traditional five-year strategic plans become quickly obsolete. Resilience ultimately depends on culture: how people respond to adversity, embrace change, and maintain urgency under pressure. In a crowded market where many approaches look similar, how your people work and who you are as an organization becomes your most difficult-to-replicate competitive advantage.
The CEO imperative: Build organizational resilience as an enterprise-wide capability, not just a response to crisis. Abandon rigid long-term planning in favor of agile, horizon-scanning approaches that enable rapid pivots. Embrace your role as “chief culture officer” and create environments where psychological safety, innovation, and urgency coexist. Measure and monitor culture as rigorously as you measure financial performance.
10. AI Integration and Implementation at Scale
AI is reaching an inflection point, and 2026 is the year that shifts AI from a Petri dish to measurable operational impact and enterprise-wide adoption. Immediate applications include clinical documentation, revenue cycle management, clinical decision support, and predictive analytics. The challenge is making AI actionable, moving from pilots to scale with clear ROI and measurable outcomes. This transition will fundamentally reshape organizational design, requiring a human-AI partnership model where AI literacy becomes essential across all roles and new job families emerge to manage the synergy between human expertise and machine intelligence.
The CEO imperative: Move AI from innovation projects to enterprise-wide adoption. Prioritize applications with clear ROI and measurable impact on clinician experience. Build the data infrastructure and governance frameworks required for responsible deployment. Invest in AI literacy training across all levels and consider emerging job families dedicated to human-AI collaboration. Measure and communicate impact to justify continued investment and build organizational confidence.
This article was supported by research conducted by WittKieffer’s Commercial Strategy & Insights team.
