Bert Zimmerli serves as executive vice president and CFO of Salt Lake City-based Intermountain Healthcare.
He oversees financial operations at the nonprofit system, which includes 23 hospitals, a medical group with more than 1,600 physicians and advanced practice clinicians, and an insurance/health plans operation SelectHealth.
He also is responsible for information systems operations, among other duties.
Previously, Mr. Zimmerli was executive vice president and CFO of the Methodist Hospital System in Houston and held various leadership roles with Houston-based Memorial Hermann Healthcare System, including CFO. He also worked in Ernst & Young’s Houston office.
Here, he shares one of his proudest achievements as Intermountain’s CFO, discusses the system's financial strategy and offers advice for other hospital finance chiefs.
Note: The following responses were lightly edited for length and clarity.
Question: Since joining Intermountain, what has been one of your proudest moments as CFO?
Bert Zimmerli: My almost 16 years at Intermountain has had many proud moments; not proud of myself but very proud of the organization and its governance and performance in demonstrating what it means to be a model healthcare system, which was the charge the founders of Intermountain gave the first board in 1975. Two of many such moments that demonstrated strong governance were as follows.
First, in October 2008, when it appeared the economy was melting down, our Board of Trustees Investment Committee met with full attendance, even though they had notice of less than 24 business hours. They supported unanimously management’s recommendation which went against the advice of our consultant, to hold the course.
This was meaningful to me because the “safe, not likely to be publicly criticized decision,” would have been to support the consultant’s very conservative recommendation, which time proved to have been absolutely the wrong one. Thankfully, the board took a long-term principled view, and were willing to accept responsibility if it didn’t turn out well.
The second was more recently, when again the board of trustees unanimously supported management’s recommendation to remain as participants in the individual ACA exchange, even when others were pulling out. Both of these proved to be great decisions that were made from the perspective of doing the right thing with the perspective of serving a forever organization.
Q: What major changes in healthcare have you seen in recent years that you would have never expected when you started in the industry?
BZ: The two most important changes occurring are the move away from a traditional healthcare model to one that has its focus on health and affordability of care. The second is moving from a “self-centered” view of healthcare (you come to us when we are open and it is convenient for us) to one that puts the needs of our patients and community first (we will provide services to you where you are, when you want them, in the way you want them delivered).
Q: What philosophies, events or people influence your leadership style?
BZ: Early in my career, in one of my first reviews at Ernst & Young, the feedback I received was that while hard work was commendable, I was being paid for results. I never forgot that message, which was tough at the time. A results orientation, and getting results in the right way, has driven me ever since. The other key learning was understanding the need to articulate a long-term vision and being willing to make necessary, often difficult, changes while things are going well. Finally, understanding that we all have capacity beyond what we think and that the collective team has far greater capacity than the sum of the individual parts.
Q: Intermountain operates 23 campuses across Utah and Idaho; how does your financial strategy differ by area?
BZ: As part of our One Intermountain approach, we strive to achieve benefits of scale by standardizing whenever possible. Unique market strategies are driven by demographics (aging population), pediatric needs and rural access (proper staffing and telemedicine adoption). In all cases, we strive to only deliver care that adds value (eliminating unnecessary utilization, variation and waste) and aspire to deliver the same quality of care and care experience wherever you access care or service in our organization.
Q: How does your role with SelectHealth affect your responsibilities as CFO?
BZ: SelectHealth is a fundamental and critical component of our health system. It is integral just like the hospitals, clinics and other access points. The role with SelectHealth is crucial in order to make informed decisions about the broader health system. A deeper understanding of health insurance in the market provides a better understanding of health insurance customers’ needs and supports our ability to align membership needs with Intermountain Healthcare services. It also helps us understand and invest in innovation that truly makes the health system better and more efficient end-to-end, and ensuring we have the ability to drive the savings we realize in the health system directly back into our communities in the form of lower insurance premiums.
Q: Revenue cycle management company R1 RCM is joining forces with Intermountain to open a 30,000-square-foot innovation and technology center in Salt Lake City. What will this look like and why is it important to the system's financial picture?
BZ: R1 has found the Salt Lake City market to be a great source of technical talent with a strong work ethic. Their new center will provide Intermountain and all R1 customers with an opportunity to leverage cutting-edge workflows that will improve service and help make healthcare more customer-friendly, digitally enabled and affordable.
Q: If you could pass along one nugget of advice to another hospital CFO, what would it be?
BZ: Keep a long-term focus and understand that behind every number and metric is a patient, member, family and/or customer that is vulnerable and trusting your organization to do the best for them. Don’t be afraid to take your job personally; when you look back, you’ll be glad you did.
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