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Matrix service lines in healthcare… Is your organization ready?

Updated: Jun 13, 2022

By Marcia Messer, DCCS Consultant

As the pace of healthcare mergers and acquisitions continue at a steady clip, with concomitant complexity of managing across expanded geographic footprints, many large health systems have adopted matrix organizational management structures.

As a past service line administrator for large health systems, I can attest to both the value and complexity. The deployment of an effective matrix service line structure requires a delicate balance transcending across multiple business vertical, physician groups and organizational cultures.

While there are no “one-size, fits all” models or playbooks for designing a matrix structure, here are a few key points for consideration:

Communication is critical and requires a succinct communication plan that targets the top of organization and every juncture to ensure stakeholders have a common understanding of the strategic decision and goals for a centralized matrix structure. A natural response is anxiety related to loss of control, personal value or corporate trying to seize authority, therefore, executive leadership should be mindful of alleviating these unspoken fears.

Role Clarity and alignment is essential to mitigate confusion and ambiguity. This is especially true between the facility based and corporate service line leadership team. Admittedly, dotted-line reporting structures and multiple bosses can seem confusing and if not managed proactively can create delays in decision making, redundancy, and gaps in accountability. It is important, in partnership with local leadership, to develop an explicit authority matrix with specific and unambiguous roles and responsibilities.

Governance Structure, a corporate governance structure will need to be convened to monitor operational, quality and financial performance. The governance committee should have veto power related to strategy and growth initiatives to avoid market cannibalization and ensure goals are aligned with strategy.

Physician Leadership, the importance cannot be over emphasized and is key to success, whether through a dyad leadership model or governance structure. Physician leadership is imperative in adopting evidence-based care, eliminating non-value added test and standardizing care across multiple site where culture and bylaws vary.

Operational Committee Structure should be thoughtfully considered and customized to fit your organization. This is where the work gets done, knowledge is transferred, standardization is adopted, relationships and trust are cultivated, expertise and talents are leveraged, and is the taproot for a culture of “system-ness”.

Key Take-Away: Although complex, research supports the value and necessity of matrix systems, especially in large integrated organizations that strive to function as an operating company versus a holding company. Careful consideration should be given to customizing the matrix structure to fit your organization to support broad scale efficiencies in standardized care, products, services and to leverage talent and create a culture of systemness.

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