The Commonwealth Center for Governance Studies released a report, "Governance in Large Non-Profit Health Systems," which analyzes governance and leadership trends in 14 of the country's largest hospital organizations.
Surveyed systems include Adventist Health System (Altamonte Springs, Fla.); Ascension Health (St. Louis); Banner Health (Phoenix); Carolinas HealthCare System (Charlotte, N.C.); Catholic Health East (Newton Square, Pa.); Catholic Health Initiatives (Englewood, Colo.); Catholic Health Partners (Cincinnati); Christus Health (Irving, Texas); Kaiser Foundation Hospitals and Health Plan (Oakland, Calif.); Mayo Clinic (Rochester, Minn.); Mercy (Chesterfield, Mo.); Providence Health & Services (Renton, Wash.); Sutter Health (Sacramento); and Trinity Health (Novi, Mich.).
Senior trustees and CEOs were surveyed in site visits conducted in the latter part of 2010 and during 2011. Independent interviews were conducted with all 14 CEOs and a total of 57 board members.
1. Size of system boards
Fewer than nine voting members: 0
Nine to 17 voting members: 10
18 to 28 voting members: 3
More than 28 voting members: 1
2. Substantial involvement of physicians in governance roles
Boards of systems that are part of parent organization: 25 percent
Boards of independent systems: 21 percent
3. CEO is a voting member of the board
Boards of systems that are part of parent organization: 90 percent
Boards of independent systems: 80 percent
4. Written performance expectations are provided for the CEO by the board:
Boards of systems that are part of parent organization: 98 percent
Boards of independent systems: 86 percent
Standing board committees have oversight responsibility for…
5. External audits
Boards of systems that are part of parent organization: 64 percent
Boards of independent systems: 95 percent
6. Internal audits
Boards of systems that are part of parent organization: 73 percent
Boards of independent systems: 89 percent
7. Executive compensation
Boards of systems that are part of parent organization: 59 percent
Boards of independent systems: 98 percent
8. Board education and development functions
Boards of systems that are part of parent organization: 43 percent
Boards of independent systems: 53 percent
9. Community benefit programs
Boards of systems that are part of parent organization: 52 percent
Boards of independent systems: 38 percent
10. Patient quality and safety
Boards of systems that are part of parent organization: 86 percent
Boards of independent systems: 89 percent
Board consistently demonstrates proactive culture of commitment and engagement, including:
11. Commitment to the system's mission
Boards of systems that are part of parent organization: 91 percent
Boards of independent systems: 89 percent
12. Reviewing and improving core governance processes
Boards of systems that are part of parent organization: 50 percent
Boards of independent systems: 39 percent
13. Tracking the system's clinical and financial performance and taking action when targets aren't met
Boards of systems that are part of parent organization: 80 percent
Boards of independent systems: 70 percent
14. Addressing long-term strategic issues
Boards of systems that are part of parent organization: 61 percent
Boards of independent systems: 67 percent
15. High enthusiasm at board meetings
Boards of systems that are part of parent organization: 52 percent
Boards of independent systems: 51 percent
16. Mutual trust among board members
Boards of systems that are part of parent organization: 73 percent
Boards of independent systems: 71 percent
17. Encouraging constructive deliberations at board meetings
Boards of systems that are part of parent organization: 64 percent
Boards of independent systems: 72 percent
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Surveyed systems include Adventist Health System (Altamonte Springs, Fla.); Ascension Health (St. Louis); Banner Health (Phoenix); Carolinas HealthCare System (Charlotte, N.C.); Catholic Health East (Newton Square, Pa.); Catholic Health Initiatives (Englewood, Colo.); Catholic Health Partners (Cincinnati); Christus Health (Irving, Texas); Kaiser Foundation Hospitals and Health Plan (Oakland, Calif.); Mayo Clinic (Rochester, Minn.); Mercy (Chesterfield, Mo.); Providence Health & Services (Renton, Wash.); Sutter Health (Sacramento); and Trinity Health (Novi, Mich.).
Senior trustees and CEOs were surveyed in site visits conducted in the latter part of 2010 and during 2011. Independent interviews were conducted with all 14 CEOs and a total of 57 board members.
1. Size of system boards
Fewer than nine voting members: 0
Nine to 17 voting members: 10
18 to 28 voting members: 3
More than 28 voting members: 1
2. Substantial involvement of physicians in governance roles
Boards of systems that are part of parent organization: 25 percent
Boards of independent systems: 21 percent
3. CEO is a voting member of the board
Boards of systems that are part of parent organization: 90 percent
Boards of independent systems: 80 percent
4. Written performance expectations are provided for the CEO by the board:
Boards of systems that are part of parent organization: 98 percent
Boards of independent systems: 86 percent
Standing board committees have oversight responsibility for…
5. External audits
Boards of systems that are part of parent organization: 64 percent
Boards of independent systems: 95 percent
6. Internal audits
Boards of systems that are part of parent organization: 73 percent
Boards of independent systems: 89 percent
7. Executive compensation
Boards of systems that are part of parent organization: 59 percent
Boards of independent systems: 98 percent
8. Board education and development functions
Boards of systems that are part of parent organization: 43 percent
Boards of independent systems: 53 percent
9. Community benefit programs
Boards of systems that are part of parent organization: 52 percent
Boards of independent systems: 38 percent
10. Patient quality and safety
Boards of systems that are part of parent organization: 86 percent
Boards of independent systems: 89 percent
Board consistently demonstrates proactive culture of commitment and engagement, including:
11. Commitment to the system's mission
Boards of systems that are part of parent organization: 91 percent
Boards of independent systems: 89 percent
12. Reviewing and improving core governance processes
Boards of systems that are part of parent organization: 50 percent
Boards of independent systems: 39 percent
13. Tracking the system's clinical and financial performance and taking action when targets aren't met
Boards of systems that are part of parent organization: 80 percent
Boards of independent systems: 70 percent
14. Addressing long-term strategic issues
Boards of systems that are part of parent organization: 61 percent
Boards of independent systems: 67 percent
15. High enthusiasm at board meetings
Boards of systems that are part of parent organization: 52 percent
Boards of independent systems: 51 percent
16. Mutual trust among board members
Boards of systems that are part of parent organization: 73 percent
Boards of independent systems: 71 percent
17. Encouraging constructive deliberations at board meetings
Boards of systems that are part of parent organization: 64 percent
Boards of independent systems: 72 percent
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