Hospital and health system CFOs have navigated many changes and challenges in the healthcare industry in 2020, many of which were related to the COVID-19 pandemic.
This year, dozens of finance leaders from hospitals and health systems across the U.S. shared their perspectives on a variety of topics with Becker's Hospital Review. Below are quotes from 14 of those executives, discussing everything from the best piece of advice for their peers to how they overcame challenges this year.
1. Jenni Alvey, senior vice president and CFO of Indianapolis-based IU Health, on how IU Health is getting through the pandemic without layoffs or pay cuts.
"We plan and prepare for disruptions. From a financial perspective, we learned a lot from the 2008 recession. We learned that events typically aren't isolated; you can have problems in the market with your investment portfolio, while also experiencing a recession, which is often driven by some other factor. In 2008 it was mortgage-backed lending. This year it's a pandemic. At IU Health we make sure when we are planning that we think about the possibility of financial challenges compounding so that we have enough reserve to weather through. We don't ever want to be in a situation where we can't provide needed healthcare in Indiana or we can't afford doctors or nurses to care for patients."
2. Michael Breslin, CFO of NewYork-Presbyterian, on what makes a strong CEO-CFO partnership.
"When I came to NewYork-Presbyterian, I had spent 20 years at a public accounting firm, and NewYork-Presbyterian was a client of mine for the better part of a decade. I left and then I was the CFO at two turnarounds and a CEO of a small turnaround. But I kind of liked the turnaround business because it was like a benevolent dictatorship. You didn't have to ask a whole lot of permission and questions. When I got to NewYork-Presbyterian, it became pretty obvious pretty quick that this was a very, very competent, successful organization with some incredible talent and an incredible opportunity to learn and kind of expand horizons. To me, the characteristics really are about trust, respect and then just that ongoing learning from each other, and that happens every day in our leadership team. I think that really is what kind of keeps us going here at NewYork-Presby."
3. Robert Glenning, president of the financial services division and CFO of Edison-N.J.-based Hackensack Meridian Health, on making challenging decisions as a CFO.
"When you look at the decisions we make, the logic behind them is really compelling. The decisions themselves aren't the hard part. The hard part is executing them. The thing to guard against [when making decisions] is spending so much time analyzing a decision or reanalyzing that decision as it is not productive or useful to obsess over one once it's made. The decision is the start of the process, but not really where most of the difficulties lie. The known challenges or unknowns can be dealt with after the decision."
4. Melinda Hancock chief administrative and financial officer at Richmond, Va.-based VCU Health System, on direct contracting relationships with employers.
"Our market is not that mature yet in this space. We are just starting some of those conversations. The pandemic has sped some of that up, to be honest with you. More employers are wondering, how can you help us? And some of those reach-outs are turning into, well, how should we be working better together? Can you bring your expertise on-site? We've been trying to actively reach out from that perspective."
5. Divya Matai, CFO of Amarillo-based Northwest Texas Healthcare System, on the greatest risk or surprise related to COVID-19 that he navigated as CFO.
"One challenge for us was how quickly we started to lose volume in mid to late March. We had to quickly flex our staff based on that volume, had to curtail some of the expenses to be able to still have a margin. We had to quickly adapt. Then at the same time, we had to quickly innovate."
6. Bashar Naser, CFO of Alamogordo, N.M.-based Gerald Champion Regional Medical Center, on where he goes for inspiration and fresh ideas.
"Attend seminars and focus on new ideas, what's working well and what's not. Know what your competition is planning and be proactive and reactive."
7. Matthew Nealon, CFO of Terre Haute, Ind.-based Union Health, on the most underrated traits of the best leaders.
"Availability and a consistent message. I think the best leaders are visible, willing to take the time to listen and provide a consistent message to all levels of the organization to gain alignment."
8. Mark Runyon, executive vice president and CFO of Tampa (Fla.) General Hospital, on the piece of advice he would pass on to other hospital CFOs.
"Effective financial leadership in healthcare or any industry requires a relentless pursuit of process improvement, serving up performance data that's easily understood and actionable, and always and most importantly keeping the best interest of the patients in mind when making decisions. Doing the right thing for the patient more often than not is the right thing to do financially."
9. Shelly Schorer, CFO of CommonSpirit Health's Northern California division, on the greatest risk or surprise related to COVID-19 that she navigated as CFO.
"[This spring] we had testing and lab issues. We have had so many tests, especially bringing elective surgeries back, trying to pretest patients. As a result we are running into lab turnaround time issues and capacity issues. That's been one unique challenge I think that we didn't foresee. The entire nation was dealing with the same thing, but it's trying to figure out how we can navigate testing, who gets tested and how to reserve those resources."
10. Rich Silveira, executive vice president and CFO of the University of Chicago Medical Center, on the piece of advice he would pass on to other hospital CFOs.
"The CFO is no longer just someone who completes the audit, does the Medicare cost report, pays checks and collects bills. It's more than that now; you need to help shape strategies and organizational management approaches. I'd recommend actively seeking dialogue with others and really participating in it. You learn a lot from others. As a leader, you need to actively communicate with colleagues, intake information, get the best ideas and leverage the collective wisdom of those around you to help make decisions. Sometimes those decisions are unilaterally yours, but sometimes you will be in a war room-type situation, and you can help shape the best decision."
11. Britton Tabor, executive vice president, CFO and treasurer at Chattanooga, Tenn.-based Erlanger Health System, on the greatest risk or surprise related to COVID-19 that he navigated as CFO.
"From a public hospital standpoint, we don't have the strong balance sheet that some of the for-profits have. We were surprised about not only the electives dropping, but also heart attack, stroke and emergency room visits dropping as well. We literally had a hospital that was very empty [this spring.] We had to act very quickly regarding staffing, furloughs and overtime. We also even got to the issue of having to curtail some of the benefits, PTO and retirement matching. Being a public hospital, all of these decisions are highly critiqued by the public. But we had to do that for the sustainability of our mission."
12. Doug Watson, CFO of Dignity Health's Arizona service area, on the greatest risk or surprise related to COVID-19 that he navigated as CFO.
"We spend a tremendous amount of time planning for disasters, planning for all the things that we think could happen. When this really started, we faced things that we hadn't really thought we would have to deal with. We're part of a large health system. So if we get short of something in a disaster, usually you can have another part of the system send you more of whatever that is. But what happened was everyone was short of things… We had to think differently, and thankfully, we had folks that were able to get creative fairly quickly. The biggest lesson is to not wait around trying to solve it."
13. Jeanette Wojtalewicz, senior vice president and CFO of CHI Health in Omaha, Neb., on direct contracting relationships with employers.
"We have entered into several direct-to-employer arrangements over the past 10 years, including full-risk arrangements, and learned a ton, some good and some not so good. To date, while we continue to have that be an option in our portfolio for employers, we're just trying to be available and be a resource now more than ever. We're actually going together with the insurance company and the broker as a team of three to the employer to explain options. How do we use virtual care in this new model? How do we develop primary care networks with no copays to help keep your people out of the ER? These are just some examples of the conversations we're having."
14. Bert Zimmerli, executive vice president and CFO of Salt Lake City-based Intermountain Healthcare, on a piece of advice he remembers clearly.
"When I was early in my career, I was complaining to an executive of one of my clients about several problems I was experiencing. He listened patiently and then told me that everything I had listed as a problem wasn't really a problem since it could be 'fixed' with money. Actual problems are those that can't be solved with money."