Health care is undergoing a complex, uncertain and fast-paced transformation on many fronts. Hospitals and health systems are adapting to shifts in health care reimbursement that encourage greater provider coordination and integration (mergers, acquisitions, affiliations, joint ventures and other relationships) that will radically change the organizational landscape. In addition, evolving advances in information and medical technology, an emphasis on population health that requires organizations to reconsider how and with whom they can partner to best achieve their mission and vision, and a myriad of new laws and regulations are compounding the growing need for diligent, high-performance governance.
This 2014 National Health Care Governance Survey includes many questions from previous surveys that allow insightful comparisons of governance evolution over time. It also probes new areas to enable a better understanding about how hospital and health system boards are preparing for and responding to the transforming health care environment. For the first time, the survey examined the results of questions by types of boards, including independent hospital boards, subsidiary boards of health care systems and boards of health care systems. The survey results confirm the growing transition toward system boards holding greater fiscal and strategic responsibility than their subsidiary organizations; at the same time, however, local boards continue to offer a valuable purpose and essential connection and engagement link to local communities. Independent hospitals typically utilize more traditional board structures, including longer board member terms and term limits and more frequent meetings, while hospital systems and their subsidiary boards typically have shorter terms and term limits, and meet less frequently