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Practice Benchmarks on Non-profit Health System Governing Boards

A study of the governance structure of the 14 of the largest nonprofit health systems in the US is detailed in this new report. With an eye toward ongoing improvement, the report provides benchmarking data on governance practices in the following areas:

  • Board structure, including consecutive term limits, voting board member limits, board size, board composition, board committees and executive committees, and perceived effectiveness of committees
  • Board processes, covering board accountability, board chair-CEO relationships, board and CEO evaluation processes, succession planning, boards role in patient care quality and in community benefit, and allocation of board time and effort
  • Board culture, such as  approach to decision-making, board development, senior staff support for the board, and executive sessions

Emerging governance patterns are identified. The study collectively scores systems [not by name] on effective governance practices and correlates that with overall system patient care performance, based on Thomson Reuters [now Truven] 100 Top Hospitals methodology. While not the primary focus of the study, the researchers found a correlation between effective  governance scores and some patient care measures, but not with the overall aggregate patient care performance measures used. An appendix to the report highlights a selected governance feature each participating system provided.

The systems that participated in the study were:

  1. Adventist Health System Sunbelt Healthcare
  2. Ascension Health
  3. Banner Health
  4. Carolinas HealthCare System
  5. Catholic Health East
  6. Catholic Health Initiatives
  7. Catholic Health Partners
  8. Christus Health
  9. Kaiser Foundation Hospitals and Health Plan
  10. Mayo Clinic
  11. Mercy Health
  12. Providence Health & Services
  13. Sutter Health
  14. Trinity Health

Source: Prybil L and others. Governance in large nonprofit health systems: current profile and emerging patterns. Commonwealth Center for Governance Studies, 2012. http://www.mc.uky.edu/publichealth/documents/Governance_booklet_FINAL.pdf

Related sources:

Foster D. Hospital system membership and performance; top 100 hospitals research. Truven Health Analytics, May 2012. http://www.100tophospitals.com/assets/health_system_hospitals_perform_better.pdf

Prybil L and others. Governance in high-performing community health systems; a report on trustee and CEO views. Grant Thornton, 2009. http://www.nonprofithealthcare.org/resources/GovernanceInHigh-PerformingCommunityHealthSystems.pdf

2011 AHA health care governance survey report. AHA Center for Healthcare Governance, 2012. Available for sale at http://ams.aha.org/eweb/?ahabu=AMERICANGOVERNANCE

Dynamic governance: an analysis of board structure and practices in a shifting Industry.  2011 biennial survey of hospitals and healthcare systems.  Governance Institute, Fall 2011. Available for sale at http://www.governanceinstitute.com/ResearchPublications/ResourceLibrary/tabid/185/ProductID/1199/CategoryID/3/List/1/Level/a/Default.aspx?

Posted by AHA Resource Center, (312) 422.2050, rc@aha.org

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