A biennial survey of tax-exempt hospital governance found few gains in board performance and some areas where directors and trustees slid.
Few gains, some slips
Survey looks at performance of hospital boards
The survey, conducted every two years by the Governance Institute, found composite scores for performance on 95 measures of recommended governance practices did not change or slipped compared with 2009, with two exceptions.
Composite scores across nine categories show no change or a slight decline from 2009, including oversight of quality, strategy and management. Scores for financial oversight and the duty to disclose possible conflicts of interest showed improvement in the latest survey.
Results come at a time when hospitals are under increased financial pressure and scrutiny as states and federal policymakers grapple with budget distress and rising healthcare spending. In New York, efforts to reduce Medicaid costs through a task force to recommend that the state health commissioner get the power to remove hospital board members.
The survey results underscore the challenges hospital governing boards face toward making performance gains, said Don Seymour, a healthcare governance consultant and president of Don Seymour & Associates. Seymour was among the governance experts to comment on the results and recommendations for a Governance Institute report on the survey.
Many boards have already made significant gains in performance, making further gains more difficult to come by, he said. Directors and trustees also have increasingly difficult jobs as the industry struggles in a weak economy and healthcare providers must navigate healthcare reform and ongoing pressure to curb costs and improve quality, he continued. “The job has gotten harder.”
Boards performed slightly poorer on self-assessment measures in the latest survey compared with 2009. On a scale of one to five, boards on average scored themselves 3.71 this year compared with 3.74 two years ago.
Hospital and health systems largely do not have formal plans to manage board turnover, but respondents said such plans were under consideration or under way.
Roughly three out of four respondents disclosed whether the board included a committee on nominations and governance. Of those, 73% reported their board included such a committee. Seymour said volunteer hospital board members are often so overwhelmed by other board tasks, such as oversight of finances and quality, that plans to recruit and train new members slip through the cracks.
The Governance Institute conducted the survey by mail and e-mail last March; it had a response rate of 15.5%.
Send us a letter
Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.