Becker's Hospital Review

17 CFO / FINANCE CEO, CFO of HCA Florida hospital retires By Alan Condon H CA Florida St. Lucie Hospital in Port St. Lucie, part of Nashville, Tenn.-based HCA Healthcare, has announced that Terry Brown retired as CFO in April. The news comes one week after the hospital announced that CEO Jay Finnegan will also retire next month. Mr. Brown has spent more than 40 years in healthcare operations; more than 30 of which were with HCA. He has served as CFO of HCA Florida St. Lucie, a 207-bed facility, for the last three years, according to a March 16 news release shared with Becker's. Previous roles include CFO of HCA Florida Raulerson Hospital in Okeechobee and HCA's Crestwood Medical Center in Huntsville, Ala., controller of HCA's Knollwood Park Hospital in Mobile, Ala., and CEO of a national healthcare recruiting company. Mr. Brown began his HCA career as an auditor after graduating from the University of Alabama in Huntsville in 1982. n 'Reimbursement wars' keeping hospital execs up at night, Mercer Health CFO says By Alan Condon H ospitals' "reimbursement wars" with payers is one of the most pressing issues facing healthcare exec- utives in 2023, Mercer Health CFO Jon Dingledine said Feb. 22 during a board of governors meeting, accord- ing to The Daily Standard. "Our staff are going to battle every day with insurance companies who are literally changing the rules on a weekly basis in terms of what they're going to pay for," Mr. Dingledine said. "Things that were covered six months ago are now being denied, despite no evidence of abuse, despite the same trauma protocol that remained for years. For whatever reason, it's now being denied." Mr. Dingledine highlighted prior authorization as a particular challenge for Coldwater, Ohio-based Mercer. "How many hours are spent by our staff trying to get things approved that again, the treatment protocols haven't changed, there's no evidence that hospitals have abused this certain code or treatment?" he asked. "But yet the first answer for a lot of these insurance companies is to deny it. Because again, it ultimately saves them money." Staffing shortages, inflation and rising cost of supplies, equipment and medicine also continue to eat into hospital and health systems' bottom lines, according to Mr. Dingledine. From 2021 to 2022, the healthcare sector recorded an $86 billion increase in staffing expenses, while non-staff expenses such as supplies, medication and services increased by $49 billion, according to The Daily Standard. n Sovah Health, part of Brentwood, Tenn.-based Lifepoint Health, is the latest health system to drop COOs. e organization dropped COOs at both of its campuses in Danville and Martinsville, Va., and eliminated the position from its operating structure. Reasons cited for COO fragility vary. Some thinking goes that COOs can demotivate or detract strong talent by being seen as a successor- in-waiting for the CEO's chair, or by serving as a middle layer between other executives and the COO. Flattened organizational structures bring about flattened corporate structures, with more executives reporting directly to the CEO in a hub and spoke model versus the COO funneling things up to the CEO. Fewer CEOs hold onto the dual role of chairman, which allows more bandwidth for operational details and decision-making. A 2019 study found nothing to lose by combining the COO and CFO jobs, according to research published in the Journal of Management Accounting Research. e analysis, believed to be the largest of its kind at the time on dual COO-CFO executives, looked at financial and operational metrics of companies with the dual role and compared them to metrics of companies that separate the positions. ere was no evidence that the creation of the hybrid CFO-COO position hurt operations. Beyond following their mere existence, there seems to be a stubborn lack of curiosity and broader understanding about the COO. Business publications — of which there are none to few tailored specifically to the COO — follow CEO activity and behavior closely, but their second-in-command tends to fall under the radar unless the question at hand is one about succession or operational dysfunction. Perhaps one reason why is the variation COOs share. "When you start to examine COOs as a class, one thing immediately becomes clear: ere are almost no constants," authors wrote for Harvard Business Review in a 2006 article, "Second in Command: e Misunderstood Role of the Chief Operating Officer." At that time, researchers said the reason COOs aren't more common is because they are poorly understood, with the role they play varying among seven archetypes from "the executor" to "the change agent" depending on the company's reason for hiring the leader. e fuzziness around this demanding, contingent and mystified role seems to have persisted 17 years later. n

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