Most healthcare organizations assume they’ll have time to plan when a CEO transition happens. The data suggests that assumption is getting more expensive by the month.
In the first seven months of 2025, 78 hospital CEOs left their positions, a 15% increase over the same period in 2024, according to Challenger, Gray & Christmas. Zooming out to the broader healthcare sector, 133 CEOs had already exited by July. The numbers are from 2025, but the dynamics driving them haven’t let up.
Leadership change is normal and expected in any industry. What the data around these exits reveals is something more concerning than the turnover itself: Most healthcare organizations aren’t ready for it.
Healthcare leadership pressures are stacking
It would be easy to look at the volume of healthcare CEO exits and draw the wrong conclusions. These aren’t leaders walking away from easy jobs. Potential Medicaid cuts tied to federal legislation, significant funding reductions, mounting financial pressure on academic medical centers, unresolved workforce shortages — the conditions are genuinely punishing. As researchers noted, boards are “demanding adaptability and fresh perspective at the very top” and recalibrating leadership faster than ever.
What it means for healthcare organizations is that someone needs to be thinking a step ahead. Most aren’t.
The succession readiness gap
Executive departures often happen without warning. As fellow MEDI coaches wrote previously, one Chief Nursing Officer with 30 years in healthcare told her coaches she was shrinking her retirement timeline from three years to a month. When asked about her succession, she answered: “None of my direct reports are ready, and there is no one in the system that can take on this big of a role. We will need to do a national search.”
It’s a common scenario. Research from the Governance Institute, which surveyed approximately 370 hospitals and health systems, found that hospital boards are least likely to maintain a written succession plan for CEO and senior executive leadership compared to other board oversight objectives. Least likely. For the most consequential leadership role in the organization.
What I’ve seen in my work with health systems is that most organizations understand succession in theory. They can describe what the next CEO should look like. What’s far less common is an organization that has actually been building toward that leader, deliberately, over time. Aaron Sorenson of Lotis Blue captured it well: “Health systems know how to define competencies for future leadership roles, but many don’t know how to build the leaders for those roles.”
That gap, between defining and building, is where organizations are most exposed.
One CEO exit rarely travels alone
CEO turnover doesn’t stay at the top. ACHE research found that within one year of a CEO’s departure, the chief medical officer changes 77% of the time and the chief operating officer changes 52% of the time. A single leadership transition has a way of becoming several.
This means succession planning can’t stop at the CEO role. Building a leadership bench requires looking across the senior team — identifying who’s ready, who’s developing, and where the vulnerabilities are.
How well your organization handles a leadership transition often comes down to how early you start preparing. In one engagement our coaches supported, a health system CEO notified his board of his intent to retire 24 months out — enough runway to plan rather than scramble. The board formed a transition committee, developed a competency-based job description with input from the medical staff and executive team, and identified a strong internal candidate. Rather than simply watching to see if he’d rise to the moment, they gave him a stretch role leading the development of a new strategic plan, assigned MEDI Leadership coaches to develop him against the job description, and kept the outgoing CEO actively involved as a mentor and evaluator. The internal candidate earned the role.
Three elements made it work: a structured process, a meaningful transition role for the candidate, and sustained executive coaching throughout. The full account is worth reading — not because the process was complicated, but because it was deliberate in ways most organizations aren’t.
Getting started
If your organization doesn’t have a formal succession plan, or has one that hasn’t been revisited in years, the current environment is a clear signal that it’s time. Not because your CEO is leaving, but because preparation built in calm is far more valuable than triage built in crisis.
For organizations ready to act, we’ve written previously about succession planning as a competitive advantage and what it looks like when organizations approach it as an ongoing priority rather than a reactive one. We’ve also explored the mechanics of building a leadership bench beyond the C-suite, because the pipeline that protects your organization runs deeper than the executive team. And for organizations thinking about how succession connects to broader growth strategy, this piece may be a useful starting point.
Leadership transitions are unavoidable. Organizations that aren’t ready before the need arises will find themselves starting from zero at the moment they can least afford to.
