McKinsey’s latest outlook on the US healthcare market is more than a financial projection – it is a guide to the kind of leadership the sector will need to navigate the next era. It reframes the central question boards must ask: not “Who can run what we have?” but “Who can build what comes next?”
Healthcare organisations are operating in an environment where the ground is shifting beneath their feet – structurally, economically, and technologically. These changes don’t just demand new strategies; they demand new leaders who can execute them.
Below, we break down the four forces reshaping the sector and the leadership mandates they trigger.
Four Forces, Four Leadership Mandates
1.Policy & Margin Pressure
→ Leaders who can redesign the economic model
Policy and reimbursement pressures are no longer episodic – they are constant. Across the industry, organisations are experiencing an uncomfortable reality: the old economic model simply doesn’t work the way it used to.
Margins are tightening, reimbursement is increasingly unpredictable, and the pace of regulatory change is accelerating. Boards can no longer rely on leaders who “know operations.” They now need executives who understand the full architecture of healthcare economics – how payment reform, government programs, site neutrality, and capital constraints intersect to shape what is viable.
In practice, this means leaders who can look across the portfolio – hospitals, ambulatory assets, virtual care, post-acute settings – and redesign it for financial sustainability. The organisations that move early are already reallocating capital, reshaping service lines, and future-proofing their cost structures. Those that do not risk sliding into permanent margin erosion.
This moment requires leaders who can see the big picture, not just reduce expenses.
2. Rising Input Costs & Tariffs
→ Leaders who think in systems, not departments
What used to be predictable – supplies, medication costs, equipment, labour inputs – has become volatile. Tariffs, inflation, and global supply-chain disruption have made the cost of doing business unpredictable and, in some cases, unsustainable.
This is where a subtle but critical leadership distinction emerges: departmental operators vs system thinkers.
Traditional operators optimise individual units. System thinkers orchestrate across regions. They understand shared services, scaled procurement, operating platforms, and the role that integrated data plays in making entire networks more efficient – not just single hospitals.
For example, two health systems facing identical cost pressures can experience dramatically different financial outcomes simply because one has a leader who knows how to centralise pharmacy, supply chain, and revenue cycle under a unified operating model – while the other does not.
The next decade belongs to leaders who can bring cohesion to complexity.
3. Workforce Shortages & Demographic Strain
→ Leaders who can rebuild the care model
Workforce shortages are no longer a temporary crisis – they are a structural reality. With an aging population and fewer clinicians entering the pipeline, the workforce problem will not be solved by recruitment alone.
The organisations that are pulling ahead recognise this. They are not just filling vacancies; they are redesigning the workforce.
This means moving care into environments that scale – ambulatory, home, virtual – and rethinking roles entirely. The most effective leaders today are asking:
- What tasks truly require a clinician?
- Where can technology augment teams?
- How do we design roles around capability, not convention?
It is no longer enough to manage staffing levels. Leaders must reshape how care is delivered, who delivers it, and where it happens. This is a mandate for creativity, courage, and an entirely new operating rhythm.
4. Innovation & AI Acceleration
→ Leaders who see technology as a new operating model
AI is moving faster than most organisations’ ability to adopt it – and certainly faster than their ability to staff for it.
What distinguishes future-ready leaders is not a fascination with technology, but a deep understanding of how it changes cost structures, workflows, patient engagement, and strategic advantage.
These executives think in terms of:
- end-to-end digital care journeys
- automation that removes friction, not people
- AI-driven capacity and productivity gains
- new business models enabled by new tools
They don’t treat digital as a bolt-on solution. They treat it as the backbone of the next generation of healthcare delivery.
In the same way electronic medical records once separated leaders who could modernise from those who lagged, AI will now separate those who can reimagine operations from those who maintain the status quo.
Why This Matters for Boards and Executive Search
McKinsey’s message is direct: the organisations that outperform will be the ones that elevate leadership capability, not just their strategy documents.
Profit pools are shifting – rapidly – toward non-acute care, specialty pharmacy, healthcare services, and technology-enabled care. Boards that cling to familiar executive archetypes will struggle to compete. Those that refresh their leadership lens will be positioned for growth.
Here’s what this means for executive search:
1. Role Design Must Catch Up to Reality
Modern leadership roles require more breadth and depth. The CEO, COO, CFO, CHRO, and CDO must explicitly own:
- policy adaptation
- service-line transformation
- workforce redesign
- AI and digital integration
When these responsibilities are treated as “projects,” organisations stall. When they are embedded in role accountability, transformation accelerates.
2. Assessment Must Prioritise Experience in Disruption
The next era will reward leaders who have:
- navigated reimbursement volatility
- transformed portfolios under pressure
- implemented technology at scale
- led teams through ambiguity and change
Boards must look beyond résumé headlines and prioritise evidence of resilience, judgement, and adaptability – the qualities that determine performance during disruption.
3. Talent Pools Must Expand
The expertise healthcare needs increasingly sits outside traditional provider environments. Boards must be open to leaders coming from:
- payers
- scaled healthcare services
- advanced pharmacy and distribution
- healthtech and digital-first organisations
The strongest organisations will be those that cast a wider net and recruit capability that matches where the market is going – not where it has been.
Leadership Teams, Not Hero Leaders
No single individual embodies the full range of capabilities needed. The leaders who thrive will be those surrounded by balanced, complementary teams.
A strong executive bench might include:
- a CEO with policy fluency
- a COO who can architect networks and operating models
- a CFO steeped in value-based care economics
- a CDO or CAIO who accelerates digital and AI adoption
Executive search must shift from “Who is the perfect candidate?” to “What combination of leaders gives this organisation a competitive advantage?”
Succession planning, leadership development, and external hiring all play a part in building that portfolio.
Why Acting Now Matters
The window for proactive leadership transformation is shrinking.
McKinsey projects margin recovery and profit pool expansion through 2028 – but only for organisations prepared to pivot early. Those who wait until financial pressure forces the issue will find themselves hiring reactively, often under scrutiny, and with limited room for innovation.
The takeaway is clear:
Use this analysis as a blueprint for the leadership capabilities you need over the next five years.
Reshape your leadership architecture before economic pressure dictates your choices.
A Global Signal, Not a US-Only Story
Although the analysis focuses on the United States, its effects extend far beyond it.
US policy shifts and cost structures influence:
- global pricing benchmarks
- investment priorities in pharma, biotech, and medtech
- supply chain and specialty drug economics
- expectations for AI, digital health, and workforce redesign
What succeeds in the US quickly becomes a template for what is funded, scaled, and adopted across Europe, Asia-Pacific, and emerging markets.
For global boards, this report is not just context – it is an early signal.
Organisations that begin recruiting for policy-savvy, tech-literate, globally connected leaders today will be positioned to navigate tomorrow’s disruptions with confidence.
McKinsey & Company. (2025, January 9). What to expect in US healthcare in 2025 and beyond. McKinsey & Company. https://www.mckinsey.com/industries/healthcare/our-insights/what-to-expect-in-us-healthcare-in-2025-and-beyondmckinsey
McKinsey & Company. (2025, November 17). Future of US healthcare: Gathering storm 2.0 or a golden age. McKinsey & Company. https://www.mckinsey.com/industries/healthcare/our-insights/future-of-us-healthcare-gathering-storm-2-point-0-or-a-golden-agemckinsey
About Hunton Executive
Hunton Executive specialises in Global Executive and Board Search for Healthcare and Life Sciences, partnering with organisations to appoint the next generation of leadership. With trusted expertise across Board, C-suite, functional, and enterprise roles in domestic, regional, and international markets, we connect you with exceptional leaders. Reach out for a confidential chat.