Becker's Hospital Review

14 CFO / FINANCE — they shi into the underinsured or uninsured population, according to Mr. Conrado. Nonprofit health systems care for everyone in their communities, regardless of coverage, which means the financial burden shis directly onto them. "In many cases, we cover 85% to 90% of the cost of care [for the uninsured]," he said. "Uninsured enrollment is a financial burden to the nonprofit systems that are already under pressure in many of our rural and inner-city communities." Mr. Conrado said Ascension supports lawmakers' effort to eliminate waste, fraud and abuse from public programs, but argues that proposed legislation making its way through the House does not do that. "It creates unnecessary red tape which causes eligible people to lose coverage because of paperwork problems and system errors," he said. "Cuts of this scale would deepen financial pressure on hospitals, shi even more burden to the private sector, and limit access for everyone — not just those covered through Medicaid. Cutting critical services make it harder to hire and keep caregivers, risk hospital closures and limit states' ability to fund Medicaid using proven tools like provider tax." SSM Health: "A crisis in rural healthcare" Joe Hodges, regional lead executive and president of SSM Health's Oklahoma/Mid-Missouri market — which includes Wisconsin, Illinois, Missouri and Oklahoma — underscored the risks for rural hospitals. In Oklahoma, he noted, 70% of hospitals operate at a loss. at figure climbs to 87% in Kansas and 76% in Washington. "It is a crisis in rural healthcare," Mr. Hodges said. "Any challenges that are associated with taking away access or funding to rural hospitals will make them even more vulnerable." Rural healthcare bears a disproportionate share of the country's chronic disease burden — with obesity rates 30 percentage points higher and premature death rates 20 percentage points higher than national averages, according to Mr. Hodges. Additionally, 25% of all U.S. veterans live in rural communities. e reality is when reimbursement declines and fewer paying patients come through nonprofit health systems' doors, they're forced to shi those costs elsewhere — oen to commercial insurance. "We have to shi that over to commercial insurance where we would have to negotiate and raise the prices for those rates that, in turn, gets pushed back down to employers," Mr. Hodges said. In effect, the financial burden doesn't disappear; it simply moves "from one bucket to another," he said. "And we have to be able to shi that around in order to continue with our mission and provide services to all people who walk through our doors," he said. "We take care of [everyone], no matter their payer, no matter who they are, or where they're from. All those things are irrelevant to us. When people need us, we are there. at's why we're in Catholic healthcare." Policy alternatives: Value-based solutions over cuts Leaders across all four systems agreed that the focus should shi from blunt funding cuts to value-based models and provider-led accountability. Rather than routing funds through third parties, they urged federal and state policymakers to partner directly with health systems to manage costs and improve outcomes — bypassing intermediaries and aligning incentives more directly with patient needs. "Health systems that provide the full continuum of care are very willing to address and take on more alternative payment models in which we can assume total cost of care and outcomes for populations," Mr. Slubowski said. "We've been able to prove through participation in all the Medicare demonstration projects, our own Medicare Advantage programs and in several Medicaid programs, that we can improve outcomes at a lower cost if providers are given that responsibility instead of working for middlemen like commercial insurance companies that first want to burn their margin and are very adept at denying claims of needed care that we provide to people." Mr. Slubowski pointed to Trinity's Program of All-Inclusive Care for the Elderly (PACE) as an example in which the health system has been able to manage the care for seniors with superior outcomes at a lower cost. "We urge lawmakers to pursue innovative, value-based solutions rather than resorting to funding cuts or eligibility reductions that would harm our most vulnerable communities," he said. n Oregon hospital CFO to retire after nearly 17 years in role By Alan Condon R ichard Rico, vice president and CFO of Sky Lakes Medical Center in Klamath Falls, Ore., will retire on May 30, concluding a nearly 17-year tenure at the 176-bed, nonprofit hospital and a 40-year career in healthcare finance. Mr. Rico earned his MBA from California State University in Fresno and began his career in healthcare finance in 1990 as CFO of Sacred Heart Hospital & Health Center in Hanford, Calif. During the 1990s, he held several CFO roles at hospitals across California and Oregon, including Lindsay (Calif.) Hospital Medical Center, San Leandro (Calif.) Hospital, and several district hospitals. In 2004, Mr. Rico was named COO and CFO of St. Anthony Hospital in Pendleton, Ore., a facility within Englewood, Colo.-based Catholic Health Initiatives. After nearly three years as CFO of NorthBay Healthcare System in Fairfield, Calif., he transitioned to the for-profit sector as CFO of McKenzie-Willamette Medical Center in Springfield, Ore., a member of Franklin, Tenn.-based Community Health Systems. Mr. Rico's leadership at Sky Lakes Medical Center was marked by his dedication to financial stewardship and his extensive experience across diverse healthcare settings. n

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