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Mandy Eaton, PhD, did not set out to become a health system CEO.
She started in human resources, took on broader operational roles and said yes to opportunities that stretched her. About a year and a half in, she is running a nearly $2 billion system in Springfield, Ill. — and thinking less about how she got there than about where Memorial Health needs to go.
Dr. Eaton joined the “Becker’s Healthcare Podcast” to discuss how her people-first background shapes her approach to leadership, why she is watching operating EBITDA more closely than operating margin, and the strategic pressure she believes is not getting enough attention from health system CEOs.
Her path to CEO was guided more by openness than ambition. She studied public health and health policy in college, landed in HR because she was drawn to the people side of organizations, and spent years expanding into operational roles, strategy projects and leadership development. Healthcare’s mission is what drew her in.
“My journey was never to be a CEO or really to have any of the roles I found myself in,” Dr. Eaton said. “It was about saying yes to opportunities to learn and grow and lead in different ways. There were always people around me who saw something in me that I didn’t see in myself, and those people pushed me to take on bigger things.”
That background in people and culture runs through her work as CEO today. She said organizations in healthcare mostly work with the same infrastructure, technology and governmental constraints. What separates one from another is the people inside it.
“I tend to view decisions through both a business lens and a people lens, and I think you really need to do both,” Dr. Eaton said. “I care deeply about accountability and performance, but I also understand that engagement, and trust, and communication, and culture are really what makes sustained performance possible. One of my strongest beliefs is that colleague engagement is not a soft metric, it’s a business strategy. And when our colleagues are engaged, patients have a better experience, quality improves, turnover declines and financial results follow.”
Memorial Health reflects a similar philosophy in how it develops leaders. Several of the system’s hospital CEOs came up through nontraditional routes, including physical therapy and nursing.
“One of the things I appreciate most about Memorial Health is that we value leadership capability more than a specific career path,” Dr. Eaton said. “Healthcare is so complex, and we need leaders who understand operations and relationships and strategy, quality, patient care, workforce challenges and community needs. I don’t think there’s a single path that develops all of those capabilities.”
What the system’s nontraditional leaders tend to share, she said, has less to do with where they started than how they lead.
“What those leaders have in common isn’t their original profession,” Dr. Eaton said. “Maybe not even that they are clinically oriented. It’s that they have an ability to learn and adapt, and that they know how to build teams, and they know how to help people succeed.”
Watching EBITDA, not margin
Dr. Eaton is steering Memorial Health’s financial focus toward a metric that looks further out than the current year. Asked which number she watches most closely heading into 2027, she named operating EBITDA and offered a pointed critique of healthcare’s relationship to operating margins.
“Healthcare has become comfortable celebrating very small margins,” Dr. Eaton said. “The reality is that 1% to 2% operating margins really aren’t enough to fund the future, and if we’re going to replace aging facilities, invest in technology, expand access, recruit top talent and remain independent, we need to generate significantly more capital than many of us have become accustomed to.”
The shift from operating margin to EBITDA reflects a longer time horizon, she said. Memorial Health faces significant capital demands, from its Epic and Workday implementations to facility modernization and growth investments. The question she keeps returning to is not just whether the system is making money, but whether it is generating enough cash flow to reinvest in the future.
“The number I’m actually watching most closely is our operating EBITDA,” she said. “And that’s because I feel like our margin tells us how we’re performing today, which is important, but EBITDA tells us whether we can afford tomorrow.”
Her framing of the current moment as distinct from where she was a year ago captures how her priorities have shifted.
“Last year, I was focused on creating transparency and building trust as a new CEO,” Dr. Eaton said. “This year, I’m focused on driving performance to create enough financial strength and capability to make the investments our communities deserve. That’s a very different conversation.”
Memorial Health is targeting a Workday go-live at the end of September and an Epic go-live on Feb. 27. Dr. Eaton placed both at the top of her priority list for the remainder of the year, alongside continued improvement in operating performance and an accelerated push on access and growth.
“We want Memorial to be the easiest health system in every community that we serve to access, whether that’s through primary care or specialty care partnerships or new service models,” she said. “I would also say underneath all of those priorities is culture, because none of this works without engaged colleagues who understand where we’re going and why it matters.”
She framed the larger arc of where Memorial Health is headed as a shift from stabilization to something more expansive.
“Last year our focus was kind of on survival and stabilization, and as we look towards 2027, the focus is really creating the financial capacity to build the health system our communities are going to need 10 years from now,” Dr. Eaton said.
The challenge most leaders aren’t naming
When asked to name the industry-wide pressure health system CEOs are not discussing enough, Dr. Eaton did not point to reimbursement, workforce or technology, though she acknowledged all three as real.
“Most health system leaders understand the industry’s challenges,” she said. “We understand reimbursement pressures, workforce shortages and rising costs, technology investments and constraints, and increasing consumer expectations. But what’s less discussed is that health systems are trying to solve all those challenges simultaneously, while continuing to care for patients every day.”
The organizations that break through over the next decade, she said, will be defined less by the quality of their strategy than by their ability to carry it out.
“The organizations that succeed over the next decade won’t necessarily be the ones with the best strategy,” Dr. Eaton said. “They’ll be the ones that can consistently execute. They’ll know how to prioritize. They’ll know how to align resources. They’ll know how to manage change. They’ll be masters at managing change, and they’ll help people adopt new ways of working.”
That conviction, she said, is also the throughline of her own career.
“If there’s one thing I’ve learned throughout my career, it’s that healthcare is ultimately a people business,” Dr. Eaton said. “Technology matters, and strategy matters, finances matter. But when you invest in people and you build trust and you stay focused on your mission, amazing things can happen.”
The post Memorial Health CEO: ‘EBITDA tells us whether we can afford tomorrow’ appeared first on Becker’s Hospital Review | Healthcare News & Analysis.
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