Healthcare boards: Value-based payments, population health goals on tap for 2014

Healthcare organizations are moving forward with plans for value-based payments and population health management for the upcoming year, according to the Governance Institute's 2013 biennial survey of governance structure and practices in the nation's non-profit hospitals and health systems.

The biennial survey, Governing the Value Journey: A Profile of Structure, Culture, and Practices of Boards in Transition, looked at how four different types of healthcare boards--health systems, independent hospitals, subsidiary hospitals and government-sponsored hospitals--conduct business and view their performance.

The survey asked healthcare leaders about how their board structures and practices may change to prepare for a new healthcare business model. According to the 541 responses, organizations are planning for value-based payments and population health management.

Key findings from the survey indicate that:

  • Fifty-eight percent of respondents have added population health goals, such as IT infrastructure and physician integration, to their strategic plans.

  • Fifty-two percent have added value-based payment goals to strategic and financial plans.

  • Forty-five percent are now affiliated with a system, an increase of 10 percent since 2011.

  • Only 29 percent of respondents were from independent hospitals, a 12 percent decrease since 2009.

  • Although 35 percent of government-sponsored hospitals compensate board members--a seven percent increase from 2011-- compensation rates have decreased from 2011 levels for systems, subsidiaries and independent hospitals.

  • A majority--59 percent--of hospitals provide board members with tablets or laptops to access online board materials, up from 30 percent in 2011.

  • Forty-four percent of systems have a system board and local or subsidiary boards with fiduciary responsibilities. And 70 percent of system boards approve a document or policy specifying allocation of responsibility and authority between system and local boards.

  • Ninety-one percent rated the performance of boards as excellent or very good for recommended practices for financial oversight. The percentage dropped three percent since 2009, a potential indication of increasing pressure on reimbursement levels and boards' anticipation of new reimbursement models and metrics, according to the survey announcement

  • Performance in quality oversight practices continues to improve (85 percent of boards rated as excellent or very good compared to  83 percent in 2011), with health systems showing the largest difference (95 percent of system boards rated as excellent or very good compared with 89 percent in 2011).

"As the boards continue to move their organizations forward, we consider this survey to be an important indicator of how boards are spending their time, and thus what issues are important to these hospitals and health systems," said Jona Raasch, CEO of the Governance Institute, in the announcement. "The signs of movement towards value-based payments and population health models are promising for what lies ahead."

To learn more:
- here's the announcement
- download the survey (membership required or fee)

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