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December 2006 (Volume 84)
Quarterly Article
Jeffrey A. Alexander
Shoou-Yih D. Lee
September 2026
Sep 25, 2026
Sep 23, 2026
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As performance accountabilities, external oversight, and market competition among not-for-profit (NFP) hospitals have grown, governing boards have been given a more central leadership role. This article examines these boards’ effectiveness, particularly how their configuration influenced a range of performance outcomes in NFP community hospitals. Results indicate that hospitals governed by boards using a corporate governance model, versus hospitals governed by philanthropic-style boards, were likely to be more efficient and have more admissions and a larger share of the local market. Occupancy and cash flow were generally unrelated to hospitals’ governing board configuration. However, effects of governance configuration were more pronounced in freestanding and public NFP hospitals compared with system-affiliated and private NFP hospitals, respectively.
Author(s): Jeffrey A. Alexander; Shoou-Yih D. Lee
Keywords: governance; not-for-profit hospitals; performance
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Volume 84, Issue 4 (pages 733–758) DOI: 10.1111/j.1468-0009.2006.00466.x Published in 2006