In 2025, hospital and health system CEOs navigated regulatory changes, workforce shortages and financial strain.
Many reported increased burnout, and others noted the role has evolved in several ways, including a more public-facing nature and a greater focus on workforce engagement.
As 2026 approaches, six health system CEOs shared the industry shifts they believe other leaders are underestimating heading into the new year.
Several CEOs highlighted artificial intelligence, including Johnese Spisso, president of Los Angeles-based UCLA Health, CEO of UCLA Hospital System and associate vice chancellor of UCLA Health Sciences.
“A major industry shift that we are rapidly coming to recognize and prioritize is the ability of artificial intelligence and large language models to enhance our business and operating systems and advance the quality, safety and effectiveness of our patient care,” Ms. Spisso told Becker’s. “We are excited about the future of these tools to support physicians, healthcare professionals and staff in their work.”
Dipen Parekh, MD, CEO of University of Miami Health System, said many leaders are underestimating how quickly AI will move from special initiative to essential infrastructure — “much like electricity or the internet.”
“By 2026, the differentiator won’t be who is piloting AI, but who has fully embedded it across care delivery, operations and access in ways that measurably improve outcomes and reduce clinician burden,” Dr. Parekh told Becker’s. “At the University of Miami Health System, we view AI as a means to an end: better patient care, safer clinical decisions and a more sustainable workforce.”
Dr. Parekh said successful AI adoption depends as much on culture as technology. Organizations that succeed will align physicians, administrators and leadership around AI as a tool to remove — not add — friction from care delivery.
“That alignment at our institution allows us to move quickly, from using AI and computer vision to enhance surgical precision and diagnostic accuracy, to automating revenue cycle and patient access so clinicians can spend more time practicing medicine,” Dr. Parekh said. “Health systems that treat AI as optional or siloed risk falling behind; those that integrate it thoughtfully and at scale will define the next era of academic medicine.”
David Verinder, president and CEO of Sarasota (Fla.) Memorial Health Care System, said while AI-assisted imaging is becoming common, providers can do more to tap into its larger potential.
“One of the most meaningful opportunities lies in our ability to establish ‘incidental’ cancer screenings, using AI tools to find and flag possible cancers while patients are being scanned for other reasons,” Mr. Verinder told Becker’s.
He cited Sarasota Memorial’s use of AI to look for suspicious nodules during chest X-rays or CT scans ordered for other reasons, such as cardiac issues.
Since implementing the incidental screening component, the system has increased the number of patients screened for lung cancer each year and identified more than 50% of cancerous nodules in stage 1 or 2 — double the national average, Mr. Verinder said.
“With structured pathways and follow-up in place, we believe healthcare providers can better harness the power of AI-assisted imaging and establish new benchmarks for cancer care in their communities and across the nation,” he said.
Generational shifts in the workforce
Leaders also noted the underestimated impact of an aging U.S. population — presenting both increased patient acuity and more healthcare retirements.
“Regardless of how completely consumed we are by AI, I think we’re underestimating it,” according to Richard Lofgren, MD, president and CEO of Oklahoma City-based OU Health. “But more importantly, I don’t think we’re paying enough attention to the generational shift in the workforce. That shift is more profound than previous ones we’ve seen. If you approach workforce management monolithically, without understanding these generational differences, you simply aren’t going to optimize your talent.”
Dr. Lofgren told Becker’s OU Health is building a future-ready workforce through pipeline programs designed for each generation’s unique needs.
“Ultimately, healthcare remains a uniquely human endeavor and, above all, a team sport,” he said. “Underestimating how these varying expectations change the way our people interact is a significant risk, but managing them effectively is our greatest opportunity.”
Terry Murphy, president and CEO of Dover, Del.-based Bayhealth, told Becker’s the industry is underestimating the implications of an aging baby boomer population.
“The baby boomer generation at 65 is a lot different than they will be at 85 and older,” Mr. Murphy said. “It’s a very large cohort of the national population, and it’s going to require a different type and intensity of care delivery in the communities across the country. There’s a lot more that needs to be done to ensure our communities are prepared from a geriatric or senior care perspective.”
State legislation and policy
Mr. Murphy also said leaders are underestimating the role of state governments in 2026.
“A lot of people have their eyes on the ball of what’s happening at the federal level, which will take many, many years and will certainly have an impact on the industry,” Mr. Murphy said. “But I think what’s happening in certain states is actually much more aggressive against the hospital industry, and there’s a lot of underestimation on the amount of dialogue and work before different states about attacking hospitals as a way to state fiscal issues.”
This outlook is shaping Bayhealth’s strategy by prompting increased engagement with legislators and deeper conversations around healthcare costs, which the public tends to underestimate, Mr. Murphy said.
“They underestimate what the insurance industry and pharmaceuticals contribute to overall costs,” he said. “We’re upping communication with legislators, as well as sharing more data, being more transparent on costs and what we’re doing in our community.”
Operating discipline
One fundamental shift emerging at health systems in 2026 is a renewed focus on operating discipline, according to Colin McHugh, president and CEO of Nashua-based Southern New Hampshire Health.
“As resources become more and more constrained, we have to manage them much more effectively,” Mr. McHugh told Becker’s. “It requires taking a regular look at how your overall system is performing on an operating basis and managing volumes and productivity to ensure the highest quality of patient care.”
Southern New Hampshire Health has developed a monthly operating review to track metrics across departments, including utilization, productivity and quality indicators. The effort has engaged frontline staff by sharing data transparently and collaborating on ways to improve efficiency, Mr. McHugh said.
The monthly review also addresses another underestimated challenge: high levels of healthcare workforce burnout.
“We spend a lot of time having management working with frontline staff to ensure they’re seen and heard, and to address day-to-day challenges they face,” he said. “It’s about doing the hard work consistently, being visible and staying transparent about what you’re seeing, hearing and encountering — not just the challenges, but also the opportunities.”
