Building a Leadership Team for the Health Care Organization of the Future

This guide provides a detailed look at how health care organizations are responding to changes within the field and building the teams needed to achieve their strategic priorities.

Executive Summary

As a follow-up to the American Hospital Association’s reports “Hospitals and Care Systems of the Future” and “Metrics for the Second Curve of Health Care,” Spencer Stuart and the AHA examined how the shift toward health care’s “second curve” is impacting the leadership, talent and organizational models of hospitals and care systems. A survey of senior hospital and care system executives and additional interviews with more than two dozen leaders in the field reveal the ways health care organizations are responding to changes within the field and building the teams needed to achieve their strategic priorities.

Identifying capability gaps and evolving the executive team to address them

  • Nearly 70 percent of hospital and care system leaders surveyed expressed confidence that their current senior management team has the experience and skill sets to help the organization achieve its strategic priorities.
  • Experience in leading nontraditional health partnerships and population health management was seen as the most common capability gap, followed by change management experience, advanced financial expertise and data analytics.
  • Sixty percent of health care leadership teams are larger than they were three years ago.
  • Physicians and nurses are being tapped more often for leadership roles, including many of the new senior executive positions that organizations are creating to address specific strategic areas, or to participate in management dyads or triads and co-lead with administrators newly established or existing service lines.
  • Traditional hospital roles are changing and becoming more strategic and larger in scope, to respond to the changing demands of the field. CMOs, CNOs, CFOs and COOs are being asked to develop a broader set of leadership and technical skills and increase their understanding of health care delivery beyond the hospital setting.

Experimenting with different organizational approaches

  • Hospitals and care systems are experimenting with different organizational models, with the goal of identifying best practices, promoting innovation and collaboration, improving patient outcomes, increasing operational efficiency and standardization, and ensuring that care is coordinated across the continuum of services.
  • Management dyads and triads, in which clinical leaders are paired with administrators to jointly oversee service lines or clinical areas, are intended to encourage systems thinking and align clinical and operational resources to improve outcomes and efficiency.
  • Matrix organizations and multiple reporting relationships also are becoming more common, as are system-level leadership roles charged with standardizing practices and purchasing across the entire organization.
  • Some health care organizations are creating physician strategy groups, executive strategy committees or councils on clinical innovation to encourage broader clinician participation in strategic initiatives.

Building teams through selective hiring and training

  • Executives with experience in community and population health management and experts in change management will be hardest to find within the health care sector, according to survey respondents.
  • As they seek leaders in new disciplines, some health care organizations today are more willing to consider candidates from outside the sector for certain capabilities; these capabilities include retail and customer insight experience, analytics, enterprise risk management and insurance expertise.
  • Organizations can improve their success hiring executives from outside health care or promoting internal candidates into first-time leadership roles by carefully defining the technical knowledge and leadership skills that are required and consistently assessing candidates against those capabilities.
  • Cultural fit is an important consideration; ideally, organizations will define the cultural traits that need to be developed in the organization and select leaders with traits that match the direction in which the culture needs to move.
  • Seventy-nine percent of survey respondents said their organization has established in-house customized training programs for senior management during the past three years, and nearly 80 percent said training programs are focused on developing leadership skills.

Evaluating the composition of the board and whether it includes representatives with the most relevant experience

  • Many boards, especially those of regional health care systems and corporate health care entities, are adding expertise in new areas.
  • Board members with expertise in consumer businesses, marketing, social media, change management and the payer side of the business all are in demand.
  • Boards of national and larger regional health care organizations with sophisticated governance practices and procedures are best positioned to attract members with these profiles. However, all boards can benefit from adopting best-in-class governance processes and practices that allow members to contribute at a higher level.