The Evolving Hospital COO: Why Tech Savvy and Adaptability Will Define Success in 2026 and Beyond
The hospital COO role isn’t just changing – it’s undergoing a fundamental transformation. A surge in leadership transitions across U.S. hospitals and health systems in 2025, including appointments, retirements, and even role eliminations, signals a pivotal moment. This isn’t simply about personnel shifts; it’s a reflection of escalating complexity and evolving expectations. The future of the hospital COO hinges on a skillset far beyond traditional operational expertise, demanding leaders who can navigate technological disruption, foster collaboration, and maintain strategic clarity in an increasingly chaotic environment.
Beyond Operations: The Expanding Responsibilities of the Modern COO
Historically, the COO focused primarily on streamlining internal processes and ensuring efficient day-to-day operations. However, today’s COO is increasingly tasked with responsibilities that extend far beyond the four walls of the hospital. A recent report by WittKieffer highlights a growing emphasis on talent management, community engagement, and cross-departmental collaboration. This expansion is driven by several factors, including the ongoing nursing shortage, the rise of value-based care, and the need for greater responsiveness to community health needs.
Consider the recent moves at Corewell Health, where Chad Tuttle transitioned from interim to permanent COO, and Hackensack Meridian Health, where Mark Sparta succeeded retiring COO Mark Stauder. These appointments aren’t just replacements; they represent a continuation of the trend toward COOs as strategic partners, deeply involved in shaping the future direction of their organizations.
The Rise and Fall of the Traditional COO Model
Interestingly, not all transitions point to expansion. The decision by Oregon Health & Science University to eliminate the COO role altogether is a stark reminder that the traditional model isn’t universally applicable. As former COO Joe Ness noted, the organization determined that the role’s responsibilities could be absorbed by other members of the leadership team. This suggests a potential shift towards more flattened organizational structures, where operational oversight is distributed rather than concentrated in a single position.
This isn’t necessarily a negative development. It could indicate a move towards greater agility and responsiveness, allowing organizations to adapt more quickly to changing market conditions. However, it also raises questions about whether the critical strategic oversight traditionally provided by the COO will be adequately maintained. The success of this model will depend on clear lines of accountability and effective communication across the leadership team.
Key Skills for the Next Generation of Hospital COOs
Regardless of whether the COO role expands, shrinks, or evolves, certain skills will be essential for success. WittKieffer’s report identifies four key areas:
- Leveraging Technology: From implementing electronic health records to embracing telehealth and artificial intelligence, COOs must be comfortable with – and champions of – technological innovation.
- Maintaining Clarity Amid Chaos: The healthcare landscape is constantly changing. COOs need to be able to cut through the noise and provide clear direction.
- Identifying Cross-Industry Patterns: Healthcare isn’t operating in a vacuum. COOs should look to other industries for best practices and innovative solutions.
- Guiding Across Distributed Environments: With the growth of telehealth and remote care, COOs must be able to effectively manage teams and operations across geographically dispersed locations.
The Impact of Leadership Changes: A Look at Recent Transitions
The recent appointments and departures offer valuable insights into the evolving priorities of healthcare organizations. Lisa Foo’s appointment as the first COO at Tenet Healthcare, coming from a commercial operations background, suggests a greater emphasis on revenue cycle management and market share growth. Similarly, the co-leadership model adopted by Sutter Health, with Kevin Manemann partnering with the Chief Physician Executive, highlights the importance of clinical-operational alignment.
The transition at Temple Health, where Abhi Rastogi moved from COO to CEO, demonstrates the potential for the COO role to serve as a stepping stone to the top leadership position. This underscores the growing strategic importance of the COO and the value of operational experience in leading a healthcare organization. The situation at Gothenburg Health, with both the COO and CEO placed on leave, serves as a cautionary tale, highlighting the importance of strong governance and ethical leadership.
Looking Ahead: The Future of the Hospital COO
The changes observed in 2025 are likely to accelerate in the coming years. The hospital COO of the future will be less of a traditional operations manager and more of a strategic leader, a change agent, and a technology evangelist. They will need to be comfortable with ambiguity, adept at building relationships, and committed to continuous learning. Organizations that invest in developing these skills in their COO candidates will be best positioned to thrive in the increasingly complex healthcare landscape. The ability to anticipate and adapt to disruption, as highlighted in Deloitte’s 2024 Healthcare Outlook, will be paramount.
What are your predictions for the future of the hospital COO role? Share your thoughts in the comments below!
