Health care is undergoing substantial transformation and board governance is transforming to embrace that reality. The American Hospital Association offers longitudinal data that paints a vivid picture of hospital governance covering crucial areas such as board composition, structure, selection, orientation, evaluation, performance oversight, culture and more.
AHA’s latest governance survey data covers:
- Board Composition and the Community: Insights into member demographics and diversity
- Board Structure: Examination of term limits, compensation and committee structures
- Board Selection: Understanding board member competencies and recruitment processes
- Board Orientation and Education: Best practices in onboarding and ongoing education
- Board Evaluation: Methods for assessing performance and utilizing evaluation results
- Performance Oversight: Strategies for executive oversight and accountability
- Board Culture: Examination of meeting dynamics and time commitments
Among the key findings from the most recent survey:
- 91% of respondents said they are interested in identifying and engaging board candidates who represent diverse characteristics.
- Nearly 70% of all responding boards have engaged in restructuring efforts to improve their governance.
- A third of respondents do not use term limits.
- The average board size is 13 members.
- The percentage of respondents reporting having outside board members increased from 26% in 2018 to 42% in 2022.
Governance dataset years available
Survey methodology
AHA’s latest Governance Survey, conducted between November 2021 and March 2022, gathered data from 933 hospital and health system CEOs. The report also explored aspects of diversity, equity, and inclusion, as well as board practices during the COVID-19 pandemic. Similar to the AHA’s 2018 and 2014 surveys, the 2022 survey examined findings across all respondents and by system, system subsidiary hospital, and freestanding hospital boards.
The 2022 survey, designed for completion by hospital and health system chief executive officers (CEOs), was sent via electronic mail to the CEOs of 5,232 non federal community hospitals and health systems in the U.S. Specialty hospitals, such as eye-and-ear and psychiatric hospitals, were not included. Survey responses were collected between November 2021 and March 2022. A total of 933 CEOs responded to the survey (a 17.8% response rate).
Figure 1.1 Survey Respondents Compared to All Hospitals
| System | ||
| Responders | Universe | |
| System | 61% | 67% |
| Non-System | 39% | 33% |
| Total | 100% | 100% |
| Location | ||
| Responders | Universe | |
| Urban | 60% | 66% |
| Rural | 40% | 34% |
| Total | 100% | 100% |
| Bed Size | ||
| Responders | Universe | |
| <100 | 54% | 57% |
| 100-299 | 35% | 34% |
| >299 | 11% | 9% |
| Total | 100% | 100% |
| Ownership | ||
| Responders | Universe | |
| Public | 26% | 20% |
| Not for Profit | 67% | 56% |
| Investor Owned | 10% | 24% |
| Total | 100% | 100% |
| Region | ||
| Responders | Universe | |
| Territories | 1% | 1% |
| Midwest | 31% | 28% |
| Northeast | 16% | 12% |
| South | 28% | 40% |
| West | 24% | 19% |
| Total | 100% | 100% |