In recent years, you've heard a lot about health care moving from the first curve of payment based on the volume of services provided to the second curve of payment based on value rendered. The American Hospital Association's Hospitals in Pursuit of Excellence initiative has produced several guides outlining the potential paths an organization can take as it navigates this change. Its latest report focuses on the leadership competencies needed to manage the transition, and priorities such as improving the quality and efficiency of care delivery and aligning with partners to share risk and provide services along the continuum.

"Building a Leadership Team for the Health Care Organization of the Future," produced in conjunction with SpencerStuart, is based on the results of a survey of more than 1,100 senior hospital and system executives and additional interviews with leaders in the field. It explores the talent, leadership and organizational implications of the move toward a value-based system to answer such questions as:

• What leadership capabilities will become more important for organizations that are making the transition to new care delivery, financial risk and population health management models?

• How are traditional roles, such as the chief financial officer, chief medical officer and chief nursing officer, evolving in response to changing business needs?

• How might physician and nurse leaders be tapped to play a larger role in the future?

• How is the structure of the executive team evolving?

• What new capabilities will organizations need to develop or acquire?

• From where will executives with newly required leadership skills and competencies come?

• Do boards have the expertise needed to provide guidance and perspective to management teams?

These are important questions for boards to ask themselves, and to discuss with their hospital's leadership team. I encourage you to share this guide, available at, with your board and discuss it at an upcoming meeting.

Bina Eggensperger ( is COG chair and a trustee of Clark Fork Valley Hospital in Plains, Mont.