Becker's Hospital Review

20 THOUGHT LEADERSHIP room are a big issue. It's very difficult when trying to get a Medicaid patient transferred. It can oen take days, so we think we can help solve that need. We're going to feel our way through and make sure we understand everything we need to do before we enter into complete growth mode. Q: In recent months, several CFOs have moved to CEO roles at hospitals and health systems. What do you see as the biggest strength or attribute a CFO can bring to the CEO role? RA: Clearly they understand the numbers, and the reimbursement system in healthcare is becoming increasingly complex. Understanding how all the numbers come together, whether its revenues or expenses, is a clear advantage. At the end of the day, though, the CFO needs to grow into staff relations and all the key components that are more relational and outside of the CFO role. Having that advantage of understanding the numbers is great, but you have to then focus on medical staff, provider and board issues and other things that you may not have necessarily focused on in the CFO role. It's a slightly different perspective as CEO, with quality being focus number one. n 'A waste of $10B': Health system CIOs on CVS' Oak Street acquisition By Naomi Diaz O n Feb. 8, CVS Health entered into an agreement to purchase primary care company Oak Street Health in an all-cash deal worth $10.6 billion, but some hospital and health system CIOs say this deal isn't transformative as it isn't big enough to "rattle" the provider industry. According to Saad Chaudhry, chief digital and information officer of Annapolis, Md.-based Luminis Health, the deal looks like big numbers, but compared to the 1.02 million physicians and 4.2 million registered nurses in the U.S., the deal is very unlikely to make much of a difference. "If you take this latest Oak Street Health acquisition for $10.6 billion under consideration, you'll note that it includes 160 centers across 20+ states — again, big numbers. Until you realize that there are over 600,000 ambulatory sites and over 6,000 hospitals in the country," said Mr. Chaudhry. Mr. Chaudhry said CVS' deals — which now includes Oak Street and a $8 billion deal for home health company Signify Health — don't equate to the deals similar retail disruptors such as Amazon and Walgreens are entering. "By themself, the CVS acquisitions may not indicate a large enough beachhead in the proverbial skirmish but taken in together with the other similar encroachments made by Amazon, Walgreens, etc.," said Mr. Chaudhry. "One of the key factors in how well they do will be the digitization of their provider operations via technology and modern and standardized workflows for provision of care." Wasting billions of dollars? Randy Davis, vice president and CIO of CGH Medical Center, based in Sterling, Ill., said CVS' purchase of Oak Street Health "makes no sense." "Billions for an entity not making money?" said Mr. Davis. "CVS better have a plan they implement in 18 months or they'll get slaughtered. No one makes a worthy Wall Street margin on primary care. No one. And Oak Street is focused on Medicare Advantage, where the big Nurse viewpoint: Mandatory staffing ratios are the wrong fight By Mackenzie Bean M andatory nurse staffing ratios are a temporary solution to a larger issue and will not bring about the respect the profession deserves, Kathleen Bartholomew, MN, RN, a national speaker and nurse advocate, wrote in an op-ed for Nurse.org. Instead, nurses should be advocating for charge nurses to have the authority to set ratios on an hourly basis and "get as many nurses as they request. Period," she said. In healthcare's current business model, the core focus is profit. Billing codes don't exist for being the only nurse who can get a patient to take his or her medication, or for intervening just in time to prevent a medical error, Ms. Bartholomew said. "Because the work we cherish has no monetary 'value' in the current business system, our self-esteem decreases, in- group arguing prevails, and we start measuring ourselves using the language of the dominant group: turn-around time, length of stay, and hours of care per patient day," she wrote. "This is why staffing ratios are the wrong fight. It's still about control." Ms. Bartholomew said the charge nurse is the only person in a healthcare organization who is qualified to decide staffing levels based on real-time patient acuity and staff members' experience and skills. These individuals should be the ones in control of setting staffing ratios, she argued. "By playing into ratios, we are still holding ourselves in an oppressed position because we are discounting our own ability to make this critical decision," she wrote. "If you are going to fight, fight for the real thing: your own autonomy and power." n

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