Issue link: https://beckershealthcare.uberflip.com/i/462190
17 D.S.: We've spent much of this past year or so building out our markets, starting with the acquisition of St. Luke's Episcopal Health [in Houston] in June 2013. Since then, we've added 20 additional hospitals in Washington, Arkansas, North Dakota, Ohio and other parts of Texas. We've been very focused on strategic growth that builds scale and makes CHI an essential health system in the com- munities we serve. In fact, CHI has doubled in size over the last five years, from about $7.7 billion in revenue to almost $15.5 billion in 2015. This next year, it will be all about integrating those markets and continuing to improve performance across the enterprise. We'll also be focusing on clinically integrated markets across the enter- prise, spanning a total of a dozen such markets. Q: As CFO, what is your biggest concern going into 2015? D.H.: I am most concerned with our ability to manage risk-bearing contracts. The infrastructure for managing these contracts is cur- rently under construction. My other concern relates to our capabil- ity for systematically taking cost out of our delivery system. A.M.: Patient care is always our biggest concern. Nothing else really matters if we don't get that right. Next to that, my biggest concern/focus is the execution of our financial turnaround plan while also preparing the organization for future payment models and the many reimbursement pressures that will continue to force us to reduce our cost structure. D.S.: I know that everybody in the healthcare industry has heard the expression that many hospitals and health systems have one foot on the dock and one foot in the boat. That perfectly typifies where CHI is as a system. While this remains largely a fee-for- service industry, we — like many other health systems — are preparing for the transition to valued-based payment by mak- ing significant investments in capabilities and strategic initiatives such as clinically integrated networks, a rapidly growing physician network and health-insurance products. This year, CHI will spend about $300 million building these new capabilities in areas such as information technology, care man- agement, clinically integrated networks, physician integration and health insurance products. So, it really comes down to the deli- cate balance between these huge investments and the fact that we will still have a large amount of business from fee-for-service reimbursement in the coming years. That's a challenge and a bal- ance that all health systems will have to deal with. I think we are well-positioned at this point to make that transition effectively. We view these costs as essential investments in the future. n "I know that everybody in the health- care industry has heard the expression that many hospitals and health systems have one foot on the dock and one foot in the boat. That perfectly typifies where CHI is as a system." — Dean Swindle, President for Enterprise Business Lines and CFO of Catholic Health Initiatives - EMHS employs more than 10,000 people, including more than 600 physicians. - The system includes eight hospitals, five emergency transport units and nine nursing homes and retirement communities. - Mr. Collings has served as CFO of EMHS since 2012. - KDMC has 465 beds and employs approximately 250 physicians. - The medical center serves roughly 700,000 people in eastern Kentucky and southern Ohio. - Ms. McFann originally joined KDMC in 2004 and became CFO in 2014. - CHI was founded in 1996. - The system operates in18 states and includes 96 hospitals, community health- services organizations, home-health agencies and numerous other inpatient and outpatient facilities. - Mr. Swindle has served as CFO since 2010.