Becker's Hospital Review

6 CFO / FINANCE AdventHealth doubles revenue in 7 years as a 'growth-oriented company' By Laura Dyrda A ltamonte Springs, Fla.-based AdventHealth has doubled its operating revenue in the last seven years, growing from a $9 billion organization into an $18 billion multistate health system. How was that growth possible? "Number one, we're in great markets. Number two, because we bring a philosophy of care to a world where people really wants to be treated as a whole person and not simply, 'hey, I've got this issue with my diabetes'," said Randy Haffner, president and CEO Of AdventHealth Florida, at the Becker's CEO+CFO Roundtable, Nov. 13-16 in Chicago. "People want to know that you are looking into them as a full human being, and so we live that faith on a daily basis relative to how we treat patients. I do believe that is a core of what is behind our growth." AdventHealth is now a 53-hospital system with locations across nine states. irty of the hospitals are in Florida, which has a rapidly growing population. Mr. Haffner noted around 1,250 people are traveling to the state to become residents daily. "If you're in a growth mindset, this is a place to be," Mr. Haffner said. "It is one of those scenarios where the demand is outpacing the supply in healthcare, which is not true of every other market that we are in. Many of the other markets are seeing declining populations and competition rise." Mr. Haffner said AdventHealth develops hospital strategies relative to the marketplace conditions based on supply and demand, but systemwide remains a "growth-oriented company." Leadership sees many opportunities to foster success despite local challenges. "We hire and we train our executives to very much be looking at opportunities, understanding the needs of our community, be community-based and understand what it is that needs to be offered and then putting that into the marketplace," said Mr. Haffner. He later added, "You don't grow from a $9 billion to $18 billion and keep your [leadership] structure the same, so we've recently gone through a series of reorganizations." e day-to-day operations of running the hospitals and clinics has been passed from the top CEO position down to newly appointed divisional leaders, including Mr. Haffner. e health system also set up a leadership institute eight years ago with courses led by leaders and former CEOs for the purpose of identifying, nurturing and developing talent within AdventHealth. "Recognizing that our approach both being a faith-based organization as well as being a growth-oriented company requires that we train our own talent that thinks like we do and is able to advance the cause in such a way that as these opportunities come along, that we have a bench strength to be able to run in the marketplace," said Mr. Haffner. e health system is also shaking up how they think about the organizational chart. "I've taken on a role that did not exist in terms of overseeing the entire state so that we don't run things just from a local geography standpoint, but that we look at bigger populations and determine where the opportunities are, how we can service more individuals, how we can be both in the inpatient as well as the ambulatory space," said Mr. Haffner. "e second significant reorganization was creating a primary health division." AdventHealth's primary health division was developed to understand what the future holds for population health and risk-based payment methodologies. e health system is also investing in ambulatory strategies such as hospital-at-home and primary care, which will be a big focus for the next year. e system is setting up primary care-plus clinics which provide aer-hours and weekend care for residents who aren't able to receive healthcare during office hours. "ere are a lot of different methodologies that are going into this idea of primary care and setting up a separate division that has its own accountabilities and quite honestly will work in tandem with and sometimes independent of our hospitals because there will be some rub from time to time, and that's understood, acknowledged and encouraged to make sure that we're able to grow that ambulatory and primary care base in a significant way," said Mr. Haffner. n Hospitals' cash on hand dwindles By Molly Gamble T he median health system saw its cash reserves fall 28% from January 2022 through June 2023, dwindling from 173 to 124 days, according to a new report jointly commissioned by the American Hospital Association. Fewer days cash on hand leaves hospitals and health systems across the U.S. less prepared for sudden emergencies, such as natural disasters, mass casualty events, or an epidemic or pandemic. The joint report from AHA and Syntellis suggests payers' inconsistent reimbursement practices and delays have contributed to hospitals' cash flow problems. The median hospital saw its percent change in overall revenue reductions related to Medicare Advantage denials increase nearly 56% from January 2022 to July 2023. Denial-related revenue reductions from commercial payers increased 20% over the same period. Hospitals' fluctuations in accounts receivable are another contributing factor. Through the 19-month period analyzed, the dollar amounts in AR for every $1 million in net patient service revenue fluctuated up to $14,287 for commercial payers and $8,872 for Medicare Advantage payers from one month to the next, according to the report. The report is based on data from over 1,300 hospitals and health systems, analyzed by Syntellis Performance Solutions and the AHA. n

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