Joe Freudenberger has led OakBend Medical Center in Richmond, Texas, since 2008. Roughly 45 minutes outside of Houston, the community hospital is located on two campuses with 245 beds combined, two outpatient locations and a physician group with more than 20 providers. Mr. Freudenberger comes from a financial background, having served as CFO for OakBend, and before then, Memorial Health System of East Texas in Lufkin and Cypress Fairbanks Medical Center in Houston.
In addition to his focus on fiscal health, Mr. Freudenberger emphasizes the importance of OakBend's clinical performance and patient experience. These pillars take on additional meaning in close-knit community hospitals such as OakBend, he says.
"As a community hospital, we can't be everything for everybody. So we're focusing on being special to the people we serve," says Mr. Freudenberger. "Our quality scores are very strong in comparison to our competitors. I think most hospitals have good quality, but our motto is, 'You're not just a patient to us, you're a family member, you're a friend, you're a neighbor.' As seventy percent of OakBend employees live in the community this is not just a motto but a fact."
Mr. Freudenberger says he's enjoyed his time as a community hospital CEO thus far, although it's been the most challenging role of his career. Here, he discusses hospital leadership in the Lone Star State, including Texas' Medicaid expansion program, how he divides and conquers his days and what he thinks the healthcare industry has forgotten.
Question: What sparked your interest in healthcare?
Mr. Freudenberger: I've been working in the healthcare industry for 26 years. The first 10 were as a consultant with Deloitte & Touche, LLP [now known as Deloitte]. The last 16, I've spent in hospital administration, including 11 years as a CFO and five years as a CEO. I got into healthcare through the course of my consulting career. I realized there was a tremendous amount of value I could add by applying business principles to healthcare operations and I thought that could make a difference in somebody's life.
I was chosen to be CEO of OakBend because of the financial challenges our board saw coming and their perception that a CEO with a financial background might be better prepared to handle those challenges. One such case is the anticipated need of the hospital to survive when average reimbursements decline to Medicare rates. If one doesn't have a financial background, it may be more challenging to identify where costs might be reduced in the face of resistance to such reductions in the organization.
Q: What are some current undertakings or developing issues in Texas or at OakBend?
JF: The state of Texas received a Medicaid 1115 Waiver, which is redefining how we deliver care to the Medicaid population in this state. The intent is to focus the healthcare community, including hospitals, physicians, mental health providers and the county health department, on the health of the community — not just the treatment of its illnesses.
The concept is that through coordinated outreach services, we can provide help for our at-risk, chronically ill population to improve their health and reduce their need for acute healthcare services, thereby lowering the cost of care to this population significantly. It's very exciting for us, but also a very challenging time. As the safety-net hospital for our community, with more than 20 percent of our services dedicated to caring for either Medicaid or uninsured patients, a program of this magnitude is extremely important both to the hospital and the community we serve. [Editor's note: To learn more about the waiver and Texas' Medicaid expansion, click here.]
Q: In what issues at OakBend do you invest the most time each day? What are your top concerns?
JF: I would say my days are broken up into three broad categories. One is physician relations, whether recruitment, managing our medical group, or working with the independent medical staff at the hospital. The other category is strategic issues. For example, at this time, our role and the partners we engage in the implementation of the 1115 Waiver is a key focus of mine as it directly affects our future. The third category is operations, working to ensure the team has what they need from a resource as well as a direction standpoint.
Q: What's one piece of advice you'd share with a first-time hospital CEO?
JF: For me, as a first-time CEO, it was striking how complex the role is. You spend your life aspiring to be a CEO, thinking that when you're CEO, you'll have authority to make the changes you always wanted. Then when you become CEO, you realize your authority comes from your ability to persuade, not from your position.
I realized the CEO requires more subtle communication skills and an ability to connect with a much more diverse group of people than a CFO. As a CFO, my role did not typically include physician relationships, setting corporate direction, board relationships, overseeing clinical operations or engaging the community, to name a few differences. Another challenge that I found in the CEO role was developing a nuanced understanding of the complex interrelationships of the numerous factors that affect patient care and physician relationships.
Q: What is an attitude, belief or norm within the healthcare industry that you most want to change?
JF: The healthcare industry started largely as a charitable endeavor to help people. I think we've gotten away, in some respects, from this mission.
For example, there's a subset of employees that seem to treat the [healthcare] job as just a paycheck. They clock in and they clock out without concern nor interest in our mission. For them, the dollar is all important, not the care we provide nor the team that provides it. I think that's a travesty and a impediment to the organization's ability to care for our community.
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In addition to his focus on fiscal health, Mr. Freudenberger emphasizes the importance of OakBend's clinical performance and patient experience. These pillars take on additional meaning in close-knit community hospitals such as OakBend, he says.
"As a community hospital, we can't be everything for everybody. So we're focusing on being special to the people we serve," says Mr. Freudenberger. "Our quality scores are very strong in comparison to our competitors. I think most hospitals have good quality, but our motto is, 'You're not just a patient to us, you're a family member, you're a friend, you're a neighbor.' As seventy percent of OakBend employees live in the community this is not just a motto but a fact."
Mr. Freudenberger says he's enjoyed his time as a community hospital CEO thus far, although it's been the most challenging role of his career. Here, he discusses hospital leadership in the Lone Star State, including Texas' Medicaid expansion program, how he divides and conquers his days and what he thinks the healthcare industry has forgotten.
Question: What sparked your interest in healthcare?
Mr. Freudenberger: I've been working in the healthcare industry for 26 years. The first 10 were as a consultant with Deloitte & Touche, LLP [now known as Deloitte]. The last 16, I've spent in hospital administration, including 11 years as a CFO and five years as a CEO. I got into healthcare through the course of my consulting career. I realized there was a tremendous amount of value I could add by applying business principles to healthcare operations and I thought that could make a difference in somebody's life.
I was chosen to be CEO of OakBend because of the financial challenges our board saw coming and their perception that a CEO with a financial background might be better prepared to handle those challenges. One such case is the anticipated need of the hospital to survive when average reimbursements decline to Medicare rates. If one doesn't have a financial background, it may be more challenging to identify where costs might be reduced in the face of resistance to such reductions in the organization.
Q: What are some current undertakings or developing issues in Texas or at OakBend?
JF: The state of Texas received a Medicaid 1115 Waiver, which is redefining how we deliver care to the Medicaid population in this state. The intent is to focus the healthcare community, including hospitals, physicians, mental health providers and the county health department, on the health of the community — not just the treatment of its illnesses.
The concept is that through coordinated outreach services, we can provide help for our at-risk, chronically ill population to improve their health and reduce their need for acute healthcare services, thereby lowering the cost of care to this population significantly. It's very exciting for us, but also a very challenging time. As the safety-net hospital for our community, with more than 20 percent of our services dedicated to caring for either Medicaid or uninsured patients, a program of this magnitude is extremely important both to the hospital and the community we serve. [Editor's note: To learn more about the waiver and Texas' Medicaid expansion, click here.]
Q: In what issues at OakBend do you invest the most time each day? What are your top concerns?
JF: I would say my days are broken up into three broad categories. One is physician relations, whether recruitment, managing our medical group, or working with the independent medical staff at the hospital. The other category is strategic issues. For example, at this time, our role and the partners we engage in the implementation of the 1115 Waiver is a key focus of mine as it directly affects our future. The third category is operations, working to ensure the team has what they need from a resource as well as a direction standpoint.
Q: What's one piece of advice you'd share with a first-time hospital CEO?
JF: For me, as a first-time CEO, it was striking how complex the role is. You spend your life aspiring to be a CEO, thinking that when you're CEO, you'll have authority to make the changes you always wanted. Then when you become CEO, you realize your authority comes from your ability to persuade, not from your position.
I realized the CEO requires more subtle communication skills and an ability to connect with a much more diverse group of people than a CFO. As a CFO, my role did not typically include physician relationships, setting corporate direction, board relationships, overseeing clinical operations or engaging the community, to name a few differences. Another challenge that I found in the CEO role was developing a nuanced understanding of the complex interrelationships of the numerous factors that affect patient care and physician relationships.
Q: What is an attitude, belief or norm within the healthcare industry that you most want to change?
JF: The healthcare industry started largely as a charitable endeavor to help people. I think we've gotten away, in some respects, from this mission.
For example, there's a subset of employees that seem to treat the [healthcare] job as just a paycheck. They clock in and they clock out without concern nor interest in our mission. For them, the dollar is all important, not the care we provide nor the team that provides it. I think that's a travesty and a impediment to the organization's ability to care for our community.
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