Prisma Health board approves new governance plan

GREENVILLE, SC (Dec. 15, 2015) ― By a 12-2 majority, the Greenville Health System Board of Trustees today approved a measure that paves the way for Prisma Health to be part of a larger multi-regional health system. The new structure will provide Prisma Health and future partners the flexibility needed in today’s changing healthcare environment.

Under the approved model, the new multi-regional system will be comprised of new operating affiliates whose activities will be centrally coordinated through a private not-for-profit entity. Prisma Health will remain in existence as a public entity that will lease its facilities to a Greenville-based Upstate affiliate organization that will then be responsible for day-to-day operation and management of clinical care in the Upstate. The entity leasing the Prisma Health assets will be the first affiliate entity in the multi-regional system and will serve as the region’s safety-net provider, providing care to all regardless of their ability to pay.

The changeover to the new structure may take some time. Prisma Health has said it will not operationalize the new structure so long as a petition or case is pending with the state Supreme Court regarding whether Prisma Health has the legal authority to enter into this transaction. Three community leaders – who were also former Prisma Health board members – filed the lawsuit asking that question. Prisma Health has asked the state Supreme Court to accept the case so that the issue can be expeditiously resolved.

“The new structure will help us ensure that health care in the Upstate remains local, accessible and high quality in the years to come,” said Prisma Health President and CEO Mike Riordan. “At the end of the day, our vision has always been – and will always be – to improve the health of our communities. We do this not only through direct patient care but also through community outreach and our training of the next generation of physicians, nurses and allied health professionals.”

The multi-regional system will benefit residents by giving them increased access to integrated primary and specialty medical and surgical services, including some highly specialized services not readily available in most areas. Moreover, the multi-regional’s private status will pave the way for joint-venture partnerships with not-for-profit and for-profit entities, enabling access to additional sources of capital and expanded patient services.

“For Prisma Health to remain a leader in this healthcare environment – and continue meeting the needs of the communities it serves – we believe the organization must evolve into a multi-regional health system that harnesses the synergies of a larger system while preserving high-quality care locally,” said Riordan. “Our goal is to provide the best quality health care to this market, and we believe changing our governance structure will allow us to do that.”

The proposed change has drawn criticism from a handful of Greenville County Legislative Delegation members who want to expand the role of the delegation in overseeing the Prisma Health Board of Trustees.

“This discussion was not undertaken lightly,” said Prisma Health Board Chairman Jim Morton. “We carefully evaluated current and future trends of health care and listened to national healthcare experts and leaders of successful healthcare systems who provided insight into the cataclysmic changes at work in the healthcare industry. The overwhelming consensus is that this is the governance structure that will allow Prisma Health to meet its fiduciary obligations to the community and responsibilities under state law.

“We talked with members of the Legislative Delegation, numerous chambers of commerce, civic leaders, civic clubs and church groups throughout this process to get their feedback,” said Morton. “Their input has been extremely helpful, and we have incorporated many of their thoughts and ideas.” Morton said he was also pleased by the response from surveyed Prisma Health employees, the overwhelming majority of whom supported the new direction.

The new system will continue the charitable missions of all involved hospitals; develop services that will improve access to comprehensive, convenient high-quality inpatient and outpatient health care; promote community health and well-being through patient care, wellness, research, education and population-health efforts; build the medical community; enhance sound stewardship through more efficient delivery of services and quality of patient care and enhance community benefit and patient value.

Added Morton, “One of our cornerstone principles is that the new multi-regional system remains accountable to the communities we serve and operates in an open, transparent way.” To ensure that, the master affiliation agreement calls for publically available reports on the programs of the system, including audited financials, reports reflecting the quality, safety and patient satisfaction delivered, community needs assessment reports and community benefit reports. The lease document explicitly provides for the ongoing involvement of Prisma Health, which shall remain a governmental public body and oversee all requirements of the state law in shaping the future of healthcare services within the community.

Initially, board members of the strategic coordinating organization and the Upstate affiliate will be selected by Prisma Health. The master affiliation agreement calls for these boards initially to have six to 15 directors, and provisions are included to ensure many of these directors have strong ties to the community.

A specially-formed committee, made of members of the Prisma Health current governance committee and other board members, has been appointed to establish the specific criteria for future members of these groups.

“Changing the Prisma Health governance structure is about leadership and strategy alignment,” said Riordan. The day-to-day work of employees will continue as it is today, and patients will not notice a change other than enhanced care.

“Prisma Health has been a leader for more than 100 years in providing care and advancing medical education in the Upstate,” said Morton. “This structure will enable that tradition not only to continue, but improve, for years to come.”

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