The role of the hospital chief financial officer has been undergoing a serious remodel. Instead of chiefly focusing on "what's happened" from a financial standpoint, today's CFO plays a much more significant role in defining and determining "what's happening" in all aspects of today's healthcare environment. And while all of the financial responsibilities remain, the new roles required of CFOs by healthcare's steady shift to value-based reimbursement necessitate the use and mastery of a whole new set of skills and approaches.
Not just about the numbers
CFOs are shifting from reactive financial reporting to proactive operational planning with all members of the hospital executive team. Becky Speight, CFO of Lake Pointe Medical Center located in the Dallas, Texas, suburb of Rowlett, describes the daily "huddle" that takes place with her hospital executive team every morning. In the past, Ms. Speight and her financial team were solely responsible for providing the monthly financials; now, she is an active participant in discussions about scheduling, optimal length of stay, clinical outcomes, quality metrics and patient satisfaction scores. "It's required less involvement in accounting, and more on the front end," says Ms. Speight. "It's not just about numbers anymore."
CFOs now focused on quality
Value-based reimbursement requires providers to show proof of quality to receive the highest reimbursement. In response, CFOs are now collaborating more than ever with the hospital medical staff. Charles Handley, CFO for Providence Memorial Hospital in El Paso, Texas, has described how much his role has changed, particularly over the last three-to-five years. "In the beginning, my role was only in the financial aspects of the business and that was it. Now, we're really pulling in the quality side with respect to how it impacts the financial side."
As reimbursement becomes tied to more than volume of services, he now partners with clinical leaders. "We're working closely with medical staff to help the organization as a whole stay focused on those things that help provide good quality care and how it impacts the financial viability of the organization." Instead of just "scorekeeping," as Mr. Handley puts it, it's now "financial management with a quality component." Ms. Speight refers to it as the "marriage of financial and clinical data."
Partnering with clinicians
Today's hospital CFO works with physicians and nurses now more than ever. Ms. Speight focuses on forging positive relationships with the physicians in her hospital. She views them as partners on the same team. "Ultimately, we all care that the patients get the best outcomes." She recommends getting comfortable talking with physicians and learning their communication style. She has also focused on ways to communicate financial information to clinicians in the clearest way possible.
Mr. Handley has learned he must be more flexible than ever. He finds himself meeting with physicians much more frequently than in years' past — and their schedules are much more unpredictable than others in the organization — necessitating he be flexible with meeting times and adjusting his schedule accordingly.
Investing in population health
As a result of value-based care's focus on population health, CFOs are also participating in the adoption of population health management capabilities and technology. Both Ms. Speight and Mr. Handley discussed the work being done in their respective hospitals and communities on providing wellness communications and proactive medical care. Both of their hospitals are working with Conifer Health Solutions to gather appropriate data and apply population health technology to determine the best ways to help people in their communities with preventive care, early diagnosis and treatment, and other cost-saving and life-saving strategies. Ms. Speight and Mr. Handley emphasized that population health management is of critical importance and an integral part of their jobs moving forward.
Seeing the bigger picture
In addition to working with the hospital executive team, today's CFOs also have to help their own internal financial teams see the bigger and changed picture that value-based care provides. This requires the mentoring, educating and modeling of new ways of doing business. Ms. Speight makes training her staff a priority. She often takes direct reports with her to meetings, gives them opportunities to go on rotations at the hospital and provides ways to help them better understand the "why" of the many different data requests that come her way. She also schedules a monthly meeting with each individual on her financial team where no computers are allowed and where the team just can just talk with each other about current issues they are facing without any electronic distractions.
Getting it all done
According to Mr. Handley, the new role of the CFO is really a "juggling act." With increased responsibilities, the requirement of being more things to more people, and less cyclical downtime overall, it often feels like the CFO job has now become "a marathon with no finish line." Mr. Handley has found that while multitasking is often necessary, it's still important to take the time to "sit down and set some priorities." Sometimes, the more things change, the more things stay the same; it's still hard to beat focused, well-thought out work, even with significantly evolved responsibilities.
Don Seamons is a freelance writer based on Salt Lake City.