Board proposes new governance structure

The Greenville Health System Board of Trustees approved a resolution today to explore changes to the organization’s current governance structure that would keep Prisma Health as a public, not-for-profit organization but as part of a larger multi-regional health system that provides the flexibility needed to survive in today’s changing healthcare environment.

Over the past 12 months, the board has undergone an extensive and thorough process of analyzing healthcare trends at a local, regional and national level. This process included meeting with governance experts and leaders from some of the most successful healthcare systems in the country to better understand the changes and pressures both Prisma Health and the industry are facing.

One of the most significant changes to health care is how it is funded. The current fee-for-service model is changing to one based on value. With this new model come bundled payments, shared savings and other programs that require providers to deliver better, more efficient care at an affordable price. In addition, businesses are asking Prisma Health to provide care to their employees regardless of location, which means the organization’s service area is quickly expanding beyond the Upstate.

After much scrutiny and careful review, the board determined that Prisma Health’ governance structure must change. Its current structure hinders Prisma Health’ ability to partner with other entities – both public and private – that share similar missions and visions. It also prevents Prisma Health from achieving the scale needed to remain viable in the new healthcare environment and continue meeting the needs of the communities it serves.

“As a public, not-for-profit health system, Prisma Health serves as the safety net hospital for the region, providing care to patients regardless of their ability to pay. It is our role as board members to ensure this important resource remains available to our community for years to come,” said Jim Morton, chair of the Prisma Health Board of Trustees. “Moving forward, our goal is to select a governance structure that allows healthcare decisions to remain local and ensures Prisma Health is able to thrive in today’s fast-changing, highly competitive world of health care.”

One example of what a new governance structure could look like involves creating a multi-regional health system in which Prisma Health and other healthcare entities could participate. In this scenario, the multi-regional health system would be governed by a newly created private, not-for-profit entity that would provide strategic oversight for the multi-regional health system with services and operations rendered through affiliated entities. For example, Prisma Health would lease its facilities to a Greenville-based Upstate affiliate organization that would then be responsible for day-to-day operation and management of Prisma Health. The Upstate affiliate organization, along with other regional affiliates, would receive its strategic direction from the private, not-for-profit entity that governs the multi-regional health system.

In this model, care in the Upstate community would continue to be delivered under the Prisma Health name, and over time, the role of the Prisma Health Board of Trustees would transition to one of oversight of the lease agreement, assessing community need and ensuring the healthcare needs of the Upstate community are met.

The board believes there are many benefits to changing the organization’s governance structure. In this particular example, one of the chief benefits is the ability to deliver care to more people across more communities while keeping healthcare decisions local. The ability to manage the health of populations is the future of health care, and this proposed structure allows Prisma Health to do that in partnership with others. These partnerships also bring value in terms of quality and cost-savings to our community.

“Changing Prisma Health’ governance structure is one of the most critical changes in the organization’s history, and while the proposed changes are complex and far-reaching, they are essentially administrative. Patients, for example, would not notice a change other than enhanced care,” said Morton.

“By taking these steps to position our community for the future, the board is ensuring Prisma Health is able to fulfill its mission and vision and continue providing care to all regardless of their ability pay,” he added.

A due diligence period is set to begin immediately and last for approximately three months, at which time the board will make its final decision regarding any and all proposed governance structures. If a specific structure is selected and approved, full implementation will take additional time.

About Greenville Health System

Greenville Health System (Prisma Health) — an academic health system that is the largest not-for-profit healthcare delivery system in South Carolina — is committed to medical excellence through research, patient care and education. Prisma Health offers patients an innovative network of clinical integration, expertise and technologies through its eight medical campuses, tertiary medical center, research and education facilities, community hospitals, physician practices and numerous specialty services throughout the Upstate. The 1,358-bed system is home to 15 medical residency and fellowship programs. Prisma Health is also home to the University of South Carolina School of Medicine Greenville, a joint effort of USC and Prisma Health. Visit for more information.

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