Health system boards have often looked quite different from the boards of other healthcare organizations. This is understandable; nonprofit systems are different than for-profits with different motivations (e.g., mission) and a deep connection to the communities they serve. However, in recent years, this divergence has been called into question. As health systems have grappled with the need to make transformative changes in how care is delivered, we’ve seen several significant changes to average health system board structure and approach to governance—generally reflecting a shift to greater convergence with S&P 500 companies’ standards and best practices.