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2015 Biennial Survey Shows Favorable Goverance Diligence Towards Population Health Models

Tuesday, November 10, 2015  
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November 10, 2015 (San Diego, CA) –The Governance Institute, a service of National Research Corporation, has published the results of its 2015 biennial survey of governance structure and practices in the nation’s non-profit hospitals and health systems. This is the only survey of its kind focusing on how four different types of healthcare boards—health systems, independent hospitals, subsidiary hospitals, and government-sponsored hospitals—conduct business and view their performance.


This year’s data from 355 respondents continues to show governance evolution in several areas, indicating that boards are slowly shifting their structures and activities to enable them to move forward into the 21st-century healthcare delivery system. Almost half (47%) of the respondents are participating in an ACO model of some type; 60% of respondents have added population health goals such as IT infrastructure and physician integration to the strategic plan; and 57% of respondents have added value-based payment goals to strategic and financial plans. Other major findings include:


Governance Structure & Culture:

·         Across all organization types there was an increase in the number of independent board members. As a result, independent board members make up a significant majority of the total board for all organization types (ranging from 67% to 88%).

·         A high percentage of respondents (48%) have an owned or affiliated medical group or physician enterprise (compared with 33% in 2013), and of these, 18% have a representative from this group as a voting member of the board.

·         The use of a board portal or similar online tool continues to climb and it can now be considered a commonplace board practice (65% of respondents already using one and an additional 10% are in the process of implementing one now).

·         System boards are more likely than in 2013 to retain authority on certain issues that could be considered “system-level,” such as quality, executive compensation, and compliance, and subsidiary boards continue (as in 2013) to retain authority on approving medical staff appointments and establishing board education and orienta­tion programs, which are usually considered to be “local” issues.


Governance Practices:

·         Government-sponsored hospitals have in­creased their adoption of most recom­mended practices in all fiduciary duty and core responsibility areas—the first report­ing year we have seen significant move­ment among this group of hospitals.

·         There was an increase in the adoption of several duty of obedience practices related to compli­ance, which reflects increasing legal/regulatory attention being paid by boards.

·         Performance and adoption in quality oversight practices showed significant improvement this year (87% of boards rated as “excellent” and “very good,” up from 85% in 2013), although reporting quality to the public has decreased.

·         Community benefit continues to improve in both performance and adoption of practices; up from 59% of boards indicating performance is “excellent” and “very good” in 2009 to 68% in 2015.


“Our survey two years ago showed promising signs of movement towards value-based payments and population health models,” said Zach Griffin, General Manager of The Governance Institute. “Now, two years later, results prove that boards and healthcare leaders are putting the right strategies in place to see a healthcare delivery model that keeps people healthy and businesses booming.”


To access the complete biennial survey, click here.


About The Governance Institute  

The Governance Institute provides trusted, independent information and resources to board members, healthcare executives, and physician leaders in support of their efforts to lead and govern their organizations.


The Governance Institute is a membership organization serving not-for-profit hospital and health system boards of directors, executives, and physician leadership. Membership services are provided through research and publications, conferences, and advisory services. In addition to its membership services, The Governance Institute conducts research studies, tracks healthcare industry trends, and showcases governance practices of leading healthcare boards across the country.


For more information, call 877-712-8778, write to, or visit


The Governance Institute is a service of National Research Corporation.


About National Research Corporation

For more than 30 years, National Research Corporation (NASDAQ: NRCIA and NRCIB) has been at the forefront of patient-centered care. Today, the company’s focus on empowering customer-centric healthcare across the continuum extends patient-centered care to incorporate families, communities, employees, senior housing residents, and other stakeholders.


For more information, call 800-388-4264, write to, or visit