Resource Library

The U.S. health care system is quickly moving toward a care delivery model that encompasses entire populations, not just the patients who present themselves for care. This is because many at-risk individuals in the community seldom, if ever, seek treatment or health screenings—and they have a disproportionate impact on total health care spending.

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.

Information technology can be the catalyst in transforming the health care delivery system.

Is participation in a super clinically integrated network (CIN) in your organization’s future? Here are some questions for health care organization boards and leadership to consider.

Serving on the boards of a hospital system and its health plan offers a unique governance perspective. My journey as a student of governance began 10 years ago when I attended a course on board best practices. As president of the Health Plan Alliance in Irving, Texas, I thought this would be a good way to enhance my communication with my own board, which is made up of C-level health plan executives.

The emerging health care environment has changed the game for health care organizations and for physician leadership. The turbulence of that environment is going to require what could be called “agile organizations” adept at matching leadership and decision-making styles and setting and executing strategies appropriate to the nature and depth of environmental change.

Health care governing board members confront a complex and changing financial landscape in their role as stewards of health care organizations. Hospitals and health systems have faced slim bottom lines for an extended period that have reduced available dollars to invest in organizational advancement and forced many to change strategy, forego acquisition of new technology, delay physical plant improvements, reduce services and streamline staff.

Succeeding in the care coordination environment means leaving behind the hospital business model.

Great health care boards primarily focus on enabling their organizations to create innovative solutions that address community needs for improved health and well-being. They also address regulatory, competitive, resource and other challenges that sometimes may seem daunting, but these do not divert them from their primary purpose.

The complexity around physician compensation demands defined, layered board oversight.

Executives, trustees and physicians should be the leading advocates of philanthropy.

When someone walks into your hospital, his first impression is created by the physical architecture. But his lasting impression — and what he is most likely to talk about when he returns home — will be determined by what we call the “invisible architecture” of core values, organizational culture and behavioral expectations.

The traditional acute-care hospital is becoming just one of the entities within a larger system that probably includes primary and specialty care clinics, ambulatory care sites, behavioral health care and post-acute care. In addition, the systems may be employing physicians, developing robust philanthropic organizations, developing entrepreneurial businesses, conducting research and offering medical education.

A new business model is emerging to transform the care delivery and payment systems. The transition is underway in many communities — moving health care delivery from emphasizing sick care to addressing population health management.

Much has been written about the resources that hospitals should provide their board members to develop their governance expertise. Generally, a good orientation to the board’s work, educational sessions at board meetings, an annual retreat, periodic attendance at outside educational programs and frequent performance evaluation are some of the basics for any board.

Given the sweeping changes in health care, forward-thinking hospitals, systems and medical centers are carefully evaluating board member succession and recruitment. The challenging environment in which these organizations operate requires strong, knowledgeable boards whose members have deep insights into the field and a fundamental understanding of business, management practices and how to compete in a highly competitive market.

Steps CEOs and boards should take to understand and improve engagement.

Our understanding of effective governance in hospitals and health systems is growing. Several recent studies find that meeting certain benchmarks for board structure, composition, culture and evaluation practices has become a basic governance responsibility. These studies also call for heightened board engagement in governance oversight responsibilities.

With CEO support and opportunities for education, trustees can become better hospital leaders

Society and industries are always evolving; revolutionary change occurs sporadically when powerful forces align to disrupt the old order. The health care delivery system today is in the midst of an historic transformation to redesign how care is delivered. The quite immodest aim is to take 20 to 30 percent of costs out of the system while maintaining or improving clinical outcomes and patients’ health.