No ‘magic wand’ for Jackson Health System


As a former public policy official, I am deeply aware of the positive role that Jackson Health System plays in the economic development and quality of life in Miami-Dade County.The Washington Economics Group, where I serve as principal advisor, recently completed an in-depth analysis on governance options for JHS. Based on case studies that we analyzed from comparable hospitals around the nation with similar characteristics and challenges to those of JHS, our study found that there is no governance structure that directly determines the financial viability of a comprehensive health system.

Our research found that the effectiveness of board governance and management in providing strategic direction and oversight is the key factor in ensuring the financial viability and quality care of hospitals.

JHS plays a vital role in meeting the healthcare needs of county residents, and is an important asset of our community. JHS is a critical component of economic development through the life sciences cluster. It is also one of the largest employers of our local economy. Therefore, stakeholders should proceed with careful study and deliberation concerning Jackson’s future governance structure and the relationship between board governance and organizational effectiveness.

Our study, which was commissioned more than six months ago by the employees and caregivers of Jackson — SEIU Local 1991, the union that represents 5,000 doctors, nurses and healthcare professionals at Jackson Health System — found that there is no “magic wand” to improve the financial health of the institution. In fact, any moves toward rapid changes in structure before improving the effectiveness of board governance and management oversight are unlikely to alleviate the current problems facing the JHS.

The current efforts at Jackson with the new governance structure and CEO appear to be steps in the right direction. Once Jackson’s financial and operational issues improve, a vigorous discussion involving all stakeholders could take place on whether different models of legal structures may be appropriate as long-term solutions. This conclusion was supported by the comprehensive research and case studies that were analyzed as part of the study.

Our analysis concluded that the legal structure of a hospital has less to do with the viability and quality care of an institution than it does with efficient board governance, effective strategic planning and top management qualities. Based on the experiences of the hospitals that we examined in the study, robust financial performance and top quality care are the results of effective board direction and management, not necessarily the results of the legal structure of a hospital.

Determinants of a quality and efficient hospital system depend on important policies being in place and a tool to measure the operating results of such policies. An effective governing body adheres to guidelines that are in place to ensure the seamless function of its mission. For example, an effective governing body will have a strategic plan in place which incorporates measures for clinical quality and patient safety, financial approaches and top patient care and employee satisfaction practices.

Additionally, any specific structural change to JHS alone will have negligible impact on its own, but it is the management, strategic planning and implementation that are most critical to the system’s sustainability and operational excellence.

Decisions concerning the future of the Jackson Health System should be met with careful, objective and non-political consideration in the evaluation of the governance procedures and practices, as well as the future of the entire system. Such a path is in the best interest of the thousands of residents who rely on Jackson to make their living and the thousands of patients who receive top-quality medical care from the system.

Tony Villamil is the dean of the St. Thomas University School of Business and principal economic advisor of The Washington Economics Group. He is also a former U.S. undersecretary of commerce for economic affairs.

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