August 28, 2020

Envisioning a new role for the board in health system strategy

Between the two of us, we’ve spent nearly 40 years working with CEOs and health system boards, and have attended hundreds of health system board meetings. In the past, board meetings used to be predictable and, sometimes a little sleepy: boards would dine well, discuss the bond rating, review the quality report, and ensure leaders were smoothly executing the fee-for-service playbook. But this is no longer the case. Not only have board meetings moved online, raising the bar on structure to encourage deep dialogue, the focus and tenor of these meetings has also evolved. Systems have grown in scale, and face new disruptive competitors, and the chaos and uncertainties brought by COVID-19. The graphic below reflects the goals progressive CEOs and board chairs are trying to achieve—and why many CEOs tell us that working with the board is taking more time and bandwidth than ever before. Boards’ strategic involvement needs to evolve to match the market’s evolution. As the market becomes more challenging, the board has to not only increase the magnitude—but change the method—of its involvement in health system strategy.

Elevated board role