Remaking the Hospital Board
With important strategic decisions increasing in frequency, boards need specific skills and experience to help evaluate their options and avoid mistakes.
This article first appeared in the December 2015 issue of HealthLeaders magazine.
Hospitals are evolving. Indeed, where many of them used to be focused exclusively on high-acuity care and strategies to improve volume, today's metrics that matter are shifting under the feet of both leadership and boards. Even as the leadership team seeks to remake the hospital into something far more important—an organization essential to improving health for the local population—boards must also adapt.
Whether the health system is large or small, board oversight is critical to ensuring that local healthcare isn't lost in the effort to transform, or that the organization doesn't financially implode as a result of the wrong strategic decision. As financial incentives morph into a framework more oriented toward improving and maintaining health rather than just treating the acutely ill, it's the board's responsibility to help the organization get back to the basics of the mission to improve the health of its home.
North Shore-LIJ Health System, headquartered in Great Neck, New York, and covering the New York metro area, is typical of a large health system that's worked hard on growth and transformation of the business in recent years. A relatively sleepy hospital system as recently as the 1990s, North Shore-LIJ has moved into the insurance business and has grown through mergers or acquisition into a 19-hospital system with a robust variety of joint ventures to help cover care outside the hospital's walls. The effort, broadly, reflects the vision of leadership and the board that scale and vertical integration would be essential to compete in a healthcare environment where value is king.
"Boards clearly are lagging behind because they might not have the necessary expertise that's now needed with some of these new ventures."
New business, new experts
That vision requires expertise that the health system's board didn't always have, says Mark Claster, the chairman of the board at North Shore-LIJ, which will officially change its name to Northwell Health beginning in 2016.
"Boards clearly are lagging behind because they might not have the necessary expertise that's now needed with some of these new ventures," he says.