- Nearly half (49%) of hospital and health system boards do not have a CEO succession plan in place, according to the American Hospital Association's most recent hospital governance survey. Health system boards were most prepared, with 24% not having a plan in place. Half (50%) of free-standing hospital boards and 59% of subsidiary boards lack a succession plan.
- Of the 1,316 CEOs surveyed, 75% indicated low levels of board member turnover. Respondents also revealed slow or no progress in recruiting younger board members, while 31% have not undertaken board, board member or board chair assessments in the past three years.
- Racial and ethnic diversity is "growing, albeit slowly," according to the report. Health system boards were 83% Caucasian, while free-standing boards were 91%. In 2014, those figures were 86% and 90%, respectively. All boards are still very much majority male, as gender diversity "seems to have stalled."
Hospitals and health systems, especially nonprofits, are struggling to overcome a number of challenges. Chief among them are sharp declines in inpatient admissions as patients shift toward the convenience of outpatient settings. In response, players such as Ascension, Intermountain and Community Health Systems have undergone restructuring processes.
AHA President Rick Pollack said in a statement he believes this year's governance survey shows how boards are "rising to meet tomorrow's challenges" by restructuring.
“These changes are not surprising, given the continued transformation in where, how, when and from whom patients receive care," Pollack said.
Restructuring has occurred at all levels of health systems, but primarily at executive and governance levels. About two-thirds of all boards underwent "conscious efforts to implement governance restructuring," according to the report.
Boards are growing: The average board size is 14 members compared to 13 in 2014 and 12 in 2011. However, boards are also reporting a decline in clinician members while also reporting a higher percentage of older members. Respondents failed to indicate "specific efforts to attract Millennials to board service."
AHA said inclusion of board members outside of the organization's service area is growing, even more so for health systems. Nearly half (49%) of system boards reported the inclusion of these members, compared to 27% for subsidiary boards and 17% for freestanding boards.
Consultant Mary Totten, whose commentary on the results was included in the published survey, wrote that the findings suggest that, in some areas, "boards may be changing their practices more slowly than is optimal for a sector facing rapid, transformational change."