Allegheny Health Network CFO James Rohrbaugh has value-based care, workforce support and digital transformation on his mind.
Mr. Rohrbaugh joined Pittsburgh-based Allegheny Health Network in 2014 and has served as CFO since 2020. Allegheny Health Network is part of Highmark Health, which also operates Highmark Blue Cross Blue Shield.
He sat down with Becker's to talk about his top priorities for 2024, the system's partnerships and digital transformation initiatives.
Editor's note: Responses have been edited for length and clarity.
Question: What are your top three financial priorities for 2024, and how do those align with your system's goals overall?
James Rohrbaugh: I think about value-based care. At the top of our list is provider transformation. We believe that we can transform ourselves to be financially sustainable in the long run through value-based care. An important element of that to us is the provider and payer partnership.
I think we're in a unique situation because we've got Highmark Health as a parent company, so we've got a provider and a payer. When we think about the challenges we're facing and the opportunities, the biggest one is the fact that we can figure out ways to align opportunities for providers and payers to work together better, to benefit the payer's members and our patients. I think at the top of the list is to be able to leverage that, because that, from my perspective, that's a really unique opportunity for us in terms of how we make sure that we're financially stable.
The second priority is really around the workforce. As we've worked to recover from the pandemic, the challenges that providers have during the pandemic were exacerbated and challenged and accelerated by the workforce challenges. Making sure that we've got the workforce to take care of our community has been an important priority and will continue to be an important part of our strategy going forward. We've done a lot of things during the pandemic around being innovative. We set up an internal staffing team, for example; we worked at reducing agency cost, we've deployed innovative staffing models, and we've worked really hard to improve retention. A big part of our ongoing improvement has been the fact that we've had improvements in the workforce, in terms of the number of people in the organization as well as retention.
The third one is digital strategies. When we think about nursing in particular, internally, the initiatives, we call them "reimagine nursing." Thinking about how we remove administrative burdens on our most important resource — our people — and how we let them work at the top of their license.
Q: What are the biggest financial challenges you're facing right now? On the other hand, what are the biggest opportunities?
JR: I would put workforce at the top of it. Just look at nursing shortages we've had across the industry, and the number of people that have exited the nursing workforce during the pandemic. We're fortunate we have two schools of nursing. We've added a part-time nursing school program and a weekend program to give people flexibility. We provide financial support for those programs. Most importantly, we've increased retention rates from the graduates for those programs, in terms of the folks we keep in our system.
I think that from an opportunity perspective, digital strategies are at the top of the list. I talked a little bit about reimagine nursing. For example, right now we have a pilot program at Allegheny General Hospital for virtual patient discharges. We've used this program to return nurses to the workforce that don't want to be at the bedside. Patients can speak with them on a face-to-face basis via virtual technology to get the discharge instructions. It's saving time for the bedside nurse, and the focused attention has also improved patient satisfaction with the process. It's been really valuable.
There's other programs we have in place around digital strategy. We have a tele-ICU program where we're providing virtual support to our ICUs, we've got a tele-stroke program. We also stood up a virtual patient safety program, where we have virtual sitters who are able to provide attention for those patients that need additional attention. I would say the technology piece is the single biggest opportunity in healthcare we have around bringing more resources that we need to do and doing it in a more efficient way, and frankly, I think there's opportunity to leverage it to improve patient satisfaction as well.
Q: Looking ahead to 2024, what partnerships, joint ventures or mergers and acquisitions are you looking at in terms of growing your system or strengthening your financial position?
JR: Partnerships are an important part of success in any healthcare organization, where we look for partners that share values. We've got a number of partnerships we've put in place this past year with skilled nursing facilities focused on providing us capacity for patients that need to be discharged to [those facilities]. During the pandemic, we went through a challenging period of time, as all providers did, where when it's time for a patient to be discharged, there were not skilled nursing facility beds available. So we partnered up with skilled nursing facilities to make sure there's better availability for discharge.
I talked a little bit about Cedar, the financial services work we're doing. That partnership has not been just about deploying their product, but it's been about us working with them, between the health plan, Highmark, AHN and Cedar together, figuring out how we can continue to improve the patients' experience with the billing, registration process. We're working strategically with them on identifying additional opportunities there.
We have a partnership with [microhospital developer] Emerus for neighborhood hospitals. We've got four neighborhood hospitals, and those are joint ventures between Emerus and ourselves. Those have also been an important part of our growth strategies, at AHN … putting those small-footprint hospitals out in the community to provide better access for our patients in a little bit different model.
Q: Given the unpredictability of events like global pandemics, what are you doing to ensure your financial resilience and sustainability for the future?
JR: I started the conversation talking a little bit about value-based care. I do think that's important: transforming the way we deliver care becomes important. I talked about some of the ways we're transforming it, whether it be digital health, whether it be just value-based care initiatives in general, but we believe those will help drive down the cost of care. We know that work needs to be partnered up with our payers in a way that drives new economic models that will allow us to share in economics between the provider and the payer.
As I think about the future, I think that's a really important part of the work we do. When you think about the pandemic, what became challenging for providers in the pandemic was volumes dropped quickly, right? When volumes drop, if that's unnecessary utilization, of course that's a good thing for the payer. The work we need to do between us, between the payers and the providers, is making sure that our economic incentives are aligned. I think that's at the top of my list.
I also think continued work around resilience and supply chain. When I think about the pandemic, one of the things that created the most fear on everybody's part is the availability of supplies and the challenges that came from the availability of supplies. We were fortunate that we have our own distribution center. While it was challenging, we didn't have a lot of disruption. I think that's a risk area we have to continue to take a look at.
The think workforce and digital enablement are the third legs of the stool around what we need to make sure we do in order to make sure we reduce the vulnerability of providers. To make sure we have the right pipeline around the workforce for the future. Given the fact that nobody's ever going to have access to all the resources they need, we need to make sure we're enabling digital technologies to help provide some level of efficiency to providers.