Hospital Board Self-Assessments Are Declining, Report Finds

Fewer hospitals and health systems are formally evaluating their own boards, even as the stakes of governance climb. An August report from Spencer Stuart, drawing on the American Hospital Association's 2025 National Governance Report, found that only 51% of surveyed organizations conducted a full board evaluation in the past year, a notable drop from a decade ago.

The timing is awkward. Boards now shoulder heavier responsibility for cybersecurity, financial sustainability, care quality, and emerging oversight of artificial intelligence. Skipping regular self-assessments makes it harder to spot gaps in board composition, skills, and effectiveness before they become liabilities.

For health system leaders, the practical message is straightforward: routine board evaluations are a low-cost governance discipline that surfaces weaknesses early. As demands on directors grow more complex, letting assessment practices lapse leaves organizations flying blind on whether their governance can keep pace with the pressures they face.