bParati Fiduciary Agent Icon

fiduciary agents handle the business end

 
third-party fiscal agent handle healthcare coalition business services Image

Healthcare coalitions that choose not to establish independent nonprofit corporations, must use a third-party fiduciary agent to apply for grants and handle business services, such as banking, insurance, legal and accounting. Letting someone else handle the business end sounds good, right? Not always.

different flavors of fiduciary agents

not all third-party fiduciary agents are equal; what's best is in the eye of the beholder

Types of Third Party Fiduciary Agents for Healthcare Coalitions

the hospital as fiduciary

hospitals come in different shapes, sizes and flavors

bParati Nonprofit Hospital Icon

hospital: fiduciary agent

The nonprofit hospital is a common fiduciary agent for healthcare coalitions; sometimes it works, sometimes not. No two hospitals are identical in size, competitive position in the market and willingness to play in the sandbox with others.

And there are scenarios to consider whereby public and even private for-proft hospitals may have an organizational stucture that makes them a fiduciary candidate.

Considerations:

  • Is the hospital the dominant provider in the region? Would it be perceived by other healthcare providers as a conflict of interest?
  • Is the hospital a smaller community provider with a local Board of Directors and limited internal bureaucracy or a corporate behemoth with coalition choking policies and procedures?
  • Can the hospital hire staff that serve at the will of the coalition's Executive Council?
  • Is the hospital private for-profit, nonprofit or public?
  • Does the hospital have a charitable foundation with a 501(c)(3) designation from the IRS?

A hospital is not a hospital is not a hospital

Hospital Fiduciary Graphic

Conventional wisdom is out the door when it comes to hospitals. Nonprofit and public hospitals seem like they'd be a natural fit as fiduciary agents, but that's not always the case. And for-profit hospitals are off the table right? Maybe not.

the ems provider as fiduciary

ems providers come in different shapes, sizes and flavors

bParati Third Service EMS FiduciaryIcon

EMS: fiduciary agent

EMS providers may serve as fiduciary agents for healthcare coalitions, provided they are operating as a governmental entity or under a nonprofit corporation. No two EMS services are identical, so discretion is in order.

In many areas of the country, EMS is operated under a private for-profit model, while others are a shared responsibility of government and the private sector. Still others are exclusively volunteer and likely operate under a nonprofit model.

Considerations:

  • Is the EMS provider public, private or nonprofit?
  • Does the EMS provider operate with a local Board of Directors and limited internal bureaucracy or a corporate behemoth with coalition choking policies and procedures?
  • Can the EMS provider hire staff that serve at the will of the coalition's Executive Council?





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healthcare coalition governance under a fiduciary

coalition governance changes little when transitioning to independent nonprofit status

Healthcare Coalition Governing Documents

Healthcare coalitions that establish independent nonprofit corporations must concern themselves with living by the requirements of their corporate charter. For coalitions using third-party fiduciary agents, governance starts with their bylaws.

Learn more about healthcare coalition governance


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About bParati

We are laser focused on ASPR Healthcare Capability 1, the Foundation for Healthcare & Medical Readiness. We help healthcare coalition leaders lay the foundation for effective, sustainable organizations that deliver value to their members ... learn more