System Govrenance4 principles for effectively governing health systemsBy Jamie OrlikoffThe evolution of health care delivery organizations in the United States is generally marked by the transition from stand-alone hospitals to multihospital systems to integrated delivery systems that include different provider organizations such as skilled nursing facilities, rehabilitation facilities, physician organizations and insurance companies. As systems evolved, so has governance.Governing a health system is different than governing a stand-alone hospital. One clear example of this is that all health system boards oversee and attempt to integrate different businesses regardless of the type of system they govern. But many system boards also are charged with the unique responsibility of overseeing different, subsidiary governing boards and coordinating their work. The structure of system governance can be divided into two broad categories: centralized and decentralized. A pure centralized model...
