Hospital and health system CEOs often enter their roles with strategic assumptions about what drives success. In practice, those assumptions are tested — and sometimes, leaders say, need to be reconsidered.
Becker’s asked three leaders — Justin Harris, CEO of Daviess Community Hospital in Washington, Ind.; Jason Mouzakes, MD, president and CEO of Albany (N.Y.) Medical Center Hospital; and Debra Sukin, PhD, president and CEO of Texas Children’s in Houston — the same question: What is the biggest strategic assumption you held coming into your current role that you’ve since had to let go of — and what finally convinced you it was wrong?
Their responses point to different areas — growth, culture and data — but share a common thread: even a sound strategy can fall short without the right conditions and execution behind it.
Editor’s note: Responses have been lightly edited for length and clarity.
Justin Harris. CEO of Daviess Community Hospital (Washington, Ind.): Coming into my role, I assumed that all health systems prioritize sustaining growth in rural hospitals. I believed it was a given that maintaining and expanding core services — such as primary care, women’s health and general surgery — is essential to keeping these hospitals viable.
Over time, I realized that assumption does not always hold true. Not every system’s strategy aligns with preserving or growing local access to care. That shift reinforced the importance of due diligence when selecting a health system partner, including seeking independent evaluation to support board decision-making.
Daviess Community Hospital became affiliated with Deaconess Health System in Evansville, Ind., in 2025 through a partnership structure that allows the hospital to remain locally governed while aligning with a larger system for resources and support.
If the strategic direction of a larger health system’s affiliations or management and partnership agreements diverts resources away from a rural facility to support a tertiary center, it is not a fiscally responsible model. We need to keep and build high-quality care locally while partnering with other health systems to ensure patients have access to higher levels of care when needed.
Jason Mouzakes, MD. President and CEO of Albany (N.Y.) Medical Center Hospital: One strategic assumption I had to let go of early in my tenure was the belief that clear strategy and disciplined execution were, on their own, the main drivers of organizational success. I came into the role confident that if we set the right priorities, made evidence-based decisions, and held ourselves accountable to execution, the organization would naturally move forward together.
What experience ultimately taught me during instances of incredible pressures on healthcare, and those who provide it, is that culture matters just as much, if not more. The moment that assumption truly shifted was watching how differently teams responded to challenges like the COVID pandemic and the ensuing strain on the workforce. Units facing the same issues performed very differently depending on whether people felt supported and trusted, and that leadership understood the reality of their day-to-day work.
Burnout, fatigue and constant change made it clear that even the best strategies rest on a fragile foundation if people don’t feel connected to the mission or respected in the process. I saw firsthand that teams become far more resilient when they believe leadership is listening, communicating transparently, and sharing accountability during difficult periods.
Letting go of that assumption reshaped how I lead. Today, I invest as much time in building trust, clear communication, and sustaining culture as I do in strategy. I’ve learned that culture isn’t a “soft” concept — it’s the infrastructure that allows organizations to endure uncertainty and continue to serve their communities with stability and purpose.
Debra Sukin, PhD. President and CEO of Texas Children’s (Houston): Throughout more than 30 years in healthcare, I have been a data-driven leader. I have subscribed to the old management principle that you cannot fix what you do not measure. While I still stand by that rule, I acknowledge that it is no longer quite that simple. Given the absolute deluge of information flooding health systems today, I have realized that success does not come from measurement alone. Rather, it comes from understanding it and implementing strategies to influence outcomes.
In other words, it is not about tracking more metrics, building more dashboards, or generating more reports. It is about giving leaders the right information and the right context to drive the insights that fuel success.
At Texas Children’s, we have spent the past year uniting and restructuring our data to drive change. We began the process by ensuring that every team owns the metrics that map to its responsibilities. This structure creates accountability and a clear path when we need to drill down to understand the “why” behind a number.
Next, we simplified our systems so that leaders across the system can easily access and digest the information. Centralizing data is key, because the truth is that any given metric only tells part of the story — and if information is siloed, each team will continue to view it from its own angle, with a different interpretation of what is happening.
By reorganizing and centralizing our data, our leaders can more easily identify patterns and bottlenecks, creating solutions to course correct when and if necessary. We can zero in on specific opportunities for improvement, while also seeing the bigger picture.
I am proud to say this work resulted in more than $600 million in year-over-year improvements in operating income in 2025. More importantly, it has helped us develop a clear strategic roadmap for how we can continue to create healthier futures for more children and women in the years to come.
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