Governance Studies
Healthcare boards today are challenged by increasingly complex, rigorous, and time-consuming responsibilities, and they are seeking ways to maximize efficiency and effectiveness to better accomplish their evolving governance role. Once-efficient processes may have become cumbersome or outdated, or role-related conflict may have arisen between administration and the board. In many dynamic healthcare organizations, the provider portfolio has evolved over time, yet board models may no longer reflect the complexity across the enterprise.
As a leader, you might think your board could benefit from an infusion of best practices to remove inefficiencies. Perhaps you are facing a potential merger that will require a retooling of your governance model. Or maybe you recognize that a new board model could revitalize the board’s vision and help them find a better balance between operational oversight and strategic issues. In any case, revamping your governance efforts can result in boards which are better informed, industry-aware, and more competent in their leadership roles for the organizations they serve.
ECG understands how defining the right governance infrastructure can help you leverage the valuable talent and business acumen that your board brings to the organization. Working in partnership with your senior leadership and board members, we can assist you with:
- Redesigning the board model and infrastructure.
- Delineating system and subsidiary board roles and responsibilities.
- Defining the nature, scope, and composition of board committees .
- Retooling board processes.
- Assessing board performance.
ECG’s depth of experience in governance design and extensive research into best practices of high-performing boards can help you achieve your board’s – and your organization’s – priorities.
Selected Projects
Restructuring the governance and management models at a large physician group. Expand Minimize
ECG was engaged to evaluate the current management and board structures for a regional, multi-specialty group of over 90 physicians and to make recommendations for models to best accomplish management, clinical and strategic objectives. After thorough analysis, ECG created management and governance models to help clarify roles, streamline clinical and administrative structures and workflow, and enhance physician involvement, while freeing the board to focus more time on strategy and policy issues. ECG’s comprehensive plans included formulating a detailed, revised authority matrix that clearly indicated span of control and oversight between the shareholders, the board and the board chair, the CEO, and the Medical Director, as well as suggestions for implementation to assure a smooth transition period to the new models. The physician group adopted the recommendations and successfully implemented the structural and organizational changes.
Determining best practices in governance structure at multi-hospital systems. Expand Minimize
Identifying an industry need for objective information about best practices, strategies, and structures in healthcare governance, ECG performed in-depth interviews with eleven major health systems across the country and compiled the results in the ECG Health System Governance Structure and Practices Survey. Survey topics include governance philosophy, the decision-making process between system and subsidiary governing boards, balance of power and division of labor, board structure, composition and duties of committees, and board evaluation methods. The compiled results and analysis provide valuable insights and benchmarking to assist today’s complex multi-institutional healthcare organizations achieve optimal board efficiency and effectiveness.
Assessing a health system’s corporate governance structure. Expand Minimize
ECG was engaged to assess the system-wide corporate governance structure of a 30-hospital health system prior to a merger with another health system, and to develop recommendations for an efficient, effective governance framework for the merged entity. ECG interviewed key administrative leaders and board members, analyzed the current structure, and performed extensive market research to identify alternatives for system-level and local governance. Specific areas of focus included size and composition of the board; agenda planning, frequency of board meetings; the nature, size and composition of board committees; and best practices for communicating subsidiary status reports and for sequencing approval processes. The health system successfully implemented ECG’s recommendations for a new governance structure resulting in streamlined reporting relationships, a more integrated board, and tighter decision-making processes to make best use of board members’ time.
