With 35 years of healthcare experience, Jeanette Wojtalewicz knows the CFO role and how it has evolved in recent decades.
Ms. Wojtalewicz spent the first five years of her healthcare career in public accounting and the last 30 working in hospitals and health systems.
She has served as CFO of CHI Health St. Elizabeth in Lincoln Neb., as well as CFO of Omaha-based CHI Nebraska. For the past five years, she has served as CFO of Omaha-based CHI Health, part of Englewood, Colo.-based Catholic Health Initiatives.
Ms. Wojtalewicz recently spoke with Becker's about the evolving CFO role and her proudest moments in the position.
Editor's Note: Responses have been lightly edited for length and clarity.
Question: What is the greatest challenge hospital and health system CFOs faced in 2018? Do you expect this to be their biggest challenge in 2019 as well?
Jeanette Wojtalewicz: The most specific thing is the flat and declining revenues that we have, while [also] seeing inflationary costs increasing quite dramatically — the cost to retain high-qualified clinical staff. It's difficult sometimes to manage that dynamic. I think some of that is due to things like the increase in observation patients, the two-midnight rule, [and] the changing dynamic of how we get paid by third-party payers. I think that's going to continue into 2019.
Q: What are your top cost containment strategies?
JW: I look at cost containment in two different ways. Certainly, [there is] the traditional cost containment — reducing costs in the healthcare system. But we're also working, at least in our health system, with cost containment strategies for our patients, so lower cost of care opportunities, keeping them well. [These two views of cost containment] must go hand in hand because if we're going to keep people out of the hospital and our revenues go down then we must also find ways to re-do our overall hospital and health system cost structure. We've been focusing year over year on a lot of the traditional ways [to contain costs] — constant year-over-year improvement in our labor management, supply management through single-source, dual-source contracts, finding ways to reduce utilization. Much more recently, we're putting focus on changing care delivery models.
Q: CHI Health's parent company, Catholic Health Initiatives, is among the founding systems that will launch nonprofit generic drug company Civica Rx. Do you think the drug company can successfully lower costs for insurers, employers and ultimately, patients?
JW: We've struggled with [drug] shortages, availability of drugs, [and] generic drug prices rising dramatically. We're a very large healthcare provider, so it is our goal and target to provide services at the lowest cost. This means having to have some connection with that supply chain. I think [Civica Rx] is going to have a better result for our patients, and I do believe there is going to be lower costs as a result.
Q: How has the CFO role evolved during your tenure with CHI?
JW: I would say some of the biggest changes is the significant requirement to be so much more connected with the strategy, understanding the business, [and] the impact of our decisions on our patients. I described it some years ago as, 'CFOs really need to be a COO with a financial twist,' because it's that important to understand it's not just worrying about total days of cash and operating EBITDA. It's so much more than that to make good decisions for the future.
Q: During your tenure at CHI, what has been one of your proudest moments as CFO?
JW: I'm so connected with the mission of Catholic healthcare, and our ability to serve patients is a big deal to me. But during this time [at CHI Health], the proudest moments were probably when we're faced with a significant challenge and a need to dramatically change how we manage our care and maybe bring costs down. [The proudest moments are] coming together to make the change and being successful.
Q: If you could pass along one nugget of advice to another hospital CFO, what would it be?
JW: Listen to different ways, different opinions. Don't get stuck in your ways. I've learned from my clinical counterparts [by] listening and understanding the implication of decisions on our patients that I think has helped us make better decisions.
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