Why health systems need leadership competency models more than ever | Viewpoint

In a time of transformation, health systems need a clearer definition of leadership.

Health care leaders today face a storm of disruption: workforce shortages, financial pressure, accelerating health equity demands, care model redesigns, and regulatory shifts like the One Big Beautiful Bill Act (OBBBA).

These are not just operational challenges—they are leadership challenges. And far too many systems are navigating them without a clear definition of what effective leadership looks like.

Leadership competency models offer a powerful solution. When well designed and embedded into daily practice, they define what great leadership means in your unique context. They bring alignment to leadership expectations, consistency to development and promotion, and clarity to leaders at all levels.

Yet many health systems still hesitate. Are competency models too theoretical? Too HR-driven? Too time-intensive?

We get the skepticism. But in our experience, the absence of a clear, shared leadership model creates real risk: fragmented development, unclear expectations, subjective talent decisions, and misaligned leadership behavior. In contrast, a thoughtfully crafted model can serve as a strategic blueprint for who you want leading your organization—and how you expect them to lead.

What is a leadership competency model?

A leadership competency model is a structured framework that articulates the behaviors, mindsets, and capabilities required to lead effectively within a given organization. It’s not a list of personality traits or a generic leadership checklist. It’s a living tool that translates your health system’s values, strategy, and culture into observable leadership expectations.

When embedded into talent practices—like hiring, coaching, development, and succession planning—the model becomes more than a document. It becomes a consistent language for leadership and a driver of systemwide alignment.

What health systems are prioritizing

While every organization’s model is unique, several common themes are emerging across the sector:

• Leading change and fostering innovationLeaders must navigate complexity, embrace uncertainty, and drive transformation—proactively, not reactively.
• Strategic thinking and systemnessLeadership isn’t local anymore. Systems need leaders who can think and act enterprise-wide, balancing service lines, clinical, and financial perspectives.
• Collaboration and relationship buildingHealth care is a team sport. Effective leaders build trust across disciplines and functions and elevate diverse voices.
• Talent developmentStrong leaders build strong teams. Coaching, mentoring, and growing others are non-negotiables in today’s environment.
• Mission alignment and personal accountabilityIn health care, leadership is about more than performance—it’s about stewardship, integrity, and modeling the system’s values in action.

These competencies reflect not just what leaders need to do, but how they need to show up, especially in a field grounded in care, service, and community.

From expertise to empathy: How leadership expectations are shifting

Health care leadership is evolving. Once defined primarily by clinical expertise and operational execution, it now requires emotional intelligence, cross-system collaboration, and the ability to lead people through complexity. Today’s leaders must:

• Think beyond departments to the full enterprise
• Lead through influence, not just authority
• Create psychologically safe, inclusive environments
• Balance results with culture-building behaviors

The message is clear: soft skills are now core skills. And the leaders who thrive are those who can both perform and connect.

Making the model real

Competency models only drive impact when they’re used. The most effective health systems don’t let their models sit on a shelf. Instead, they embed them into how they:

• Hire and promote: Screening for aligned behaviors, not just experience
• Develop and coach: Grounding IDPs, feedback, and 360s in the model
• Evaluate performance: Including both “what” and “how” in performance reviews
• Plan succession: Assessing readiness based on demonstrated competencies

When a model is truly lived, it becomes the thread that connects leadership actions to organizational priorities.

What makes a model work

If you're considering building—or refreshing—a model, a few principles can help:

• Start with strategy: Anchor competencies in your system’s mission, vision, and future direction. Don’t copy someone else’s model—make it your own.
• Engage leaders early: Involve diverse voices across clinical, operational, and administrative roles. This builds buy-in and ensures relevance.
• Focus on behaviors: Define each competency in observable terms. What does this look like in practice? How do you know someone is demonstrating it?
• Embed it deeply: Integrate the model into talent processes you already use—performance reviews, hiring guides, coaching tools.
• Keep it dynamic: Revisit the model every few years to reflect evolving strategy and leadership needs.

And importantly, don’t try to do it all at once. Start with executives or a pilot group, refine, then scale.

The cost of not having one

Leadership will always be defined—either explicitly, or implicitly. When expectations aren’t clear, development is inconsistent, bias creeps into talent decisions, and culture drifts from intent. That’s the hidden cost of not having a model.

In contrast, health systems that define and operationalize leadership competencies are better positioned to:

• Build cohesive leadership cultures
• Accelerate succession planning
• Retain and develop top talent
• Advance health equity and inclusion

Competency models don’t guarantee perfect leadership, but they create the conditions for it to grow.

Now is the time

The leadership demands of tomorrow won’t wait. As care models shift, workforce expectations evolve, and transformation becomes the norm, health systems must be intentional about the kind of leaders they are shaping.

A leadership competency model isn’t a check-the-box exercise. It’s a strategic investment in clarity, culture, and long-term success.

If your system hasn’t defined what great leadership looks like—or hasn’t revisited it in years—now is the time.

Jackie Bassett is a principal at Lotis Blue Consulting. Alexandra Bullock is a consultant at Lotis Blue Consulting.