Becker's Hospital Review

Special CFO Roundtable 14 Sponsored by: CFO Roundtable: 4 CFOs Discuss Changing Healthcare Economics By Anuja Vaidya I n the current volatile and uncertain climate of the healthcare industry, an experienced and passionate CFO is key to an organization's ability to navigate those choppy waters efficiently and effectively. Faced with issues ranging from declining reimbursements to the uncertainties of healthcare reform, CFOs have the difficult task of adapting their organizations' financial strategies to combat these challenges. Ultimately, CFOs must ensure that their organizations not only survive but also thrive. ally is the basics. We are looking at expenses and revenues in ways that can sustain us as healthcare reform continues to harden. Here, four hospital CFOs discuss overcoming the financial hurdles that their organizations face, the most important financial decisions they have made this year and the best career advice they have ever received. Question: What are some new financial strategies you are planning to implement in the coming year? Mark Bogen, CFO, South Nassau Communities Hospital (Oceanside, N.Y.): In these kinds of times it really is best to go back to the basics. We have a significant expense review currently going on, and we are working with a national firm for that. My hope is that they can help us identify areas that will help us save on the supply chain side. On the revenue cycle side, we have had a relatively large increase in our uncompensated care. Historically, it runs at about 6 to 7 percent of net revenue and right now it is running at about 8 percent. So we are trying to do things proactively to reduce that as well. It re- will include education for physicians on the importance of complete and accurate documentation. Typically, the healthcare industry has pigeonholed revenue cycle, but we look at revenue cycle in broader terms, and include mortality and complication indexes. Hospitals perform ancillary services and discharges at the direction of physicians, which requires accurate documentation in order to bill for those services. Physician ordering and discharge patterns drive our hospital's cost structure. Moreover, properly reflecting the acuity of the patient impacts our hospital's mortality and complications indexes, which measure our hospital's clinical outcomes. With a fully implemented CDI program, we expect more accurate mortality outcomes as well as the appropriate length of stay and ancillary utilization based on the appropriate acuity of our patients. Robert L. Glenning, CFO, Hackensack (N.J.) University Medical Center: Much of what we are considering involves risk arrangements with health plans which would include partnering with one on a branded insurance product. At the same time, we are looking at broadening our physician employment and other partnerships with physicians — all being done with the intent to reduce the cost of care of our patients. John Kasberger, CFO, Mercy Medical Center (Roseburg, Ore.): We are implementing a clinical documentation initiative. This Jennifer Mitzner, CFO, Hoag Memorial Hospital Presbyterian (Newport Beach, Calif.): Our financial strategies are increasingly focused on driving business model transition and optimizing tools and partnerships to advance the emerging care models. This includes increasing the proportion of net revenues from risk-based contracts in order to more effectively pace and match our revenue model to the underlying care model. Effective business model positioning also requires a forward-facing point of view and assessing implications on cost structure-sizing based upon what the market demands. Lastly, regional integration strategies, in both clinical and business settings, within our new affiliation

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