The big picture: The report is based on interviews with executives at major health systems, including CommonSpirit, Northwell and Stanford Health Care, which represent a combined $150 billion in revenue.

It suggests that financial scale alone is not enough to ensure stability.
The core message is that without stronger, more agile board leadership, many systems will struggle to make the difficult strategic decisions needed to remain sustainable.
"In the face of declining federal support, strong governance is no longer optional - it is essential to sustainability,” said Chris George, a Managing Director at Alvarez & Marsal.

Zoom in: The report outlines several key recommendations for boards to evolve.

Modernize composition: Boards need to move beyond traditional recruitment to actively seek out expertise in areas like digital health, cybersecurity and population health.
Evolve practices: The report calls for regular board evaluations and a shift away from representational models toward integrated, system-wide oversight, which is especially important after mergers and acquisitions.
Streamline meetings: The firms advise reducing the frequency of meetings but extending their duration to allow for deeper dives into strategy, quality and patient experience.

Between the lines: The report places particular emphasis on the unique challenges facing academic medical centers and faith-based systems.

These organizations must balance their historical missions with new financial realities, requiring clear delegation of authority and adaptability from their boards.
The call to action pushes boards beyond a supervisory role into one of active strategic leadership, responsible for reallocating resources and steering innovation during a period of financial tightening.To download the report click here

SOURCE: Alvarez & Marsal

SURVEY: U.S. Health Systems Must Fortify Board Oversight

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