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Introduction to SMART GovernanceAssociation of California Healthcare DistrictsLeadership AcademyFebruary 8, 2018
Jim RiceManaging DirectorGovernance and [email protected]
Best Practices in Governance
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Learn about how your Board can adapt SMART board work practices to ensure an effective delivery of services, collaborating with stakeholders and sharing resources amongst partners in the community to achieve the Board’s mission in a changing policy and political landscape.
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Good Governance Enables Stronger Health Systems and Greater Health Impact
The Brown Act Seeks to Protect the Public Interest as You Govern.
Governance is a structured process wherein a group of people (usually referred to as a governing body/board) make decisions about policy, plans and rules of collective action that wield power and resources intended to define, promote, protect and achieve the health mission of an organization, system, program, country or institution.
Implementing this definition requires a focus
on essential practices
These practices occur in many venues : Public and Private All Health Issues All levels
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SMART Governance for Health:
S…Stakeholder engagedM…Mission drivenA…Accountability expectedR…Resource mobilizedT…Transparency enabled
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Defined Populations with Diverse, Social Determinants of Health Risks
01
Behavior Change Protocols for Chronic Disease
02
Expanded Continuum of Care Technologies and Facilities
03
New Strategic Alliances and Co-Ventures
04
New Teams of Collaborative Health Workers
08Electronic Health
Records07
External Value Based
Bundled Payments
05
Internal Incentive Compensation,
Recognition and Reward Systems 06
Boards of Healthcare Districts Require New Capabilities & Investments
Re-inventing Care and Risk Management
These 8 imperatives call for new Strategic Partnerships and new Models of Governance withbolder and wiser governance practices
New Board Room Conversations
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System Board
Hospital Senior Living
Health Center
Home HealthPhysicians
FoundationAdvisory Council
Need Governance Authority Matrix Competency Mapping Themed Meeting Calendar Smart “Group” Charges and Work Plans Board Self-Assessment
Many Types of Governing Bodies in California
Community Health Partnerships
Housing Schools Food & Water
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Four Essential Practices of Good Governance
Group discussions about these practices.
What can leaders do to improve effectiveness in all areas?
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Continuous Governance Enhancement1. Cultivating governance competencies2. Building diversity in the governing body3. Organizing governance orientation and
continuous governance education4. Performing regular governance
assessments5. Running effective governing body
meetings6. Making governance policies7. Using governance technologies8. Working for continuous governance
enhancement
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Ongoing Assessment
and Refinement
Board Role
Board Composition KSA Matrix
Size & Structure of
Board
Excellent Committees
Board Information
System
Great Meetings: Calendars Agendas
Board Job Descriptions
Terrific Orientation
Process
Excellent Ongoing
Education Program
Market Needs & Strategic Plans for Health
Great Board Work Drives Good Organizational Results.Great Infrastructure Drives Great Board Work.
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Many Structures & Roles:
1. System or Corporate Board2. Regional Board3. Local Institution Board4. Subsidiary Boards5. Advisory Boards6. Foundation Board7. Co-Venture Board8. Community Partnership Board
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System Board
Hospital Senior Living
Health Center
Home HealthPhysicians
FoundationAdvisory Council
Need Governance Authority Matrix Competency Mapping Themed Meeting Calendar Smart “Group” Charges and Work Plans Board Self-Assessment
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Responsibility Continuum:
Decide Influence Advice
Community Needs AssessmentStrategic PlanningProgram Quality PlanningConsumer Experience MappingProgram Performance AssessmentFinancial Planning & BudgetingPhilanthropyCEO Hiring, Performance Review
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1.Mix of Roles and Contributions2.Need to Optimize Community Engagement3.Exploding Enterprises in Accountable Care4.Need for Many Competencies5.Work Load Needs to be Shared6.Moderate Numbers Making Decisions7.Tax-Exemption Pressure
Why have Mix of Board Types?
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Board Work Issues The Challenges Strategic Imperatives Implications for Your Strategic Actions & Investments
Social Determinants
Experience Mapping
Purchaser Value
Boundary Spanning
Transparent Results
For your realities, how might you best respond to ensure your success?
Chronic Care & Care ContinuumHealth Gain not just Health CareUnfunded MandatesNew PartnershipsUnderlying poverty
Impatient & Discerning SegmentsRetail Delight MetricsTotal Experience MapsCross Industry InsightsCRM Systems and Attitudes
Value MetricsPower Imbalance & Market PositionCompete on Costs & QualityCredit & Out-of-pocket SpendingRevenue Cycle Management
Boards and New Partners-StakeholdersGrowing Regulatory Oversight & RiskAddress Eroding Board TalentGovernance Best PracticesGovernance Portals
Published Quality ScoresPublished PricingActivist MediaGlass Door VisibilitySocial Media Advances
1. Enhance Joint CHNA Partnerships2. Strengthen Philanthropy Beyond
System3. Study Foster McGaw Lessons4. Study Collaborative Governance5. Energize Political Advocacy
1. Establish Consumer Advisory Councils2. Study Art of Experience Mapping3. Bring in Speakers on “Experience”4. Adjust EMR for CRM Features5. Quarterly Reward Team Performance
1. Convene Payer Purchaser Roundtable2. Invest in More Price Transparency3. Publish Performance Metrics4. Study Branded Visa Cards for Pockets5. Invest in Annual Payer Report on Value
1. Develop “Governance Enhancement Plan”
2. Enhance Board Portal Functions/Use
3. Conduct Mock OIG/RAC Audits
1. Conduct Results Oriented Annual Social Media Plan and Budget
2. Convene Media Advisory Council3. Re-invent Community
Roundtables
Navigating The Journey: A Trustees’ Roadmap
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Dare to Compare: a three-part series
Canadian Hospitals England Hospitals Credit Unions
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Case Study Learning. Study Tours. Strategic Retreats. Design Studios.
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Thank you for all your do for the people that live and work in your healthcare district!
Jim Rice, Managing Director Governance and [email protected]: 612-703-4687