November 17, 2022
O Nonprofit Governance, Wherefore Art Thou?
The “Keckley Report” from October 31, 2022 zeroed in on three blind spots that plague governance of nonprofit hospitals and health systems. First, boards are not paying enough attention to organizational culture. Second, they do not understand and are not monitoring their competition. Third, they have lost track of purchaser attitudes and beliefs.
Paul and I are featured columnists for HFM Magazine. His incisive opinions about good and bad organizational governance dovetail with my own. With this in mind, 4sight Health has compiled the following three articles on nonprofit governance of hospitals and health systems.
My 2017 article coauthored with former Providence CEO, Dr. John Koster. It’s titled “Dynamic Tension: Rethinking Health System Governance.” Read more.
These are dangerous times for healthcare providers. Inpatient volume is soft. Payer mixes have deteriorated. Labor and supply costs have skyrocketed. New competitors are stealing market share. Government and commercial insurers are not riding to the rescue. Asset-heavy platforms have become a liability. Negative media has proliferated. Indeed, we may be witnessing the beginning of the collapse of the nonprofit health system business model.
Given the stakes, this is a time for decisive leadership from boards with engaged and expert members who are fully vested in organizational positioning and risk-taking. This isn’t happening enough. The three articles above provide concrete suggestions for improving organizational governance at this time of critical need.
This compilation’s title riffs on the famous balcony scene from Shakespeare’s “Romeo and Juliet.” Juliet’s plaintive plea, “O Romeo, Romeo, Wherefore Art Thou Romeo” is among the most misunderstood lines in literature. She is not asking where Romeo is. She is asking why their current circumstances prevent their being together.
Nonprofit boards should also be asking why: why current circumstances prevent the hospitals and health systems they govern from providing the value-base services that Americans need, want and desire. Leadership begins at the top. Change is necessary. Let’s get it done.