Becker's Hospital Review

51 PRACTICE MANAGEMENT THOUGHT LEADERSHIP Northwell Health's New CFO Michele Cusack Talks Financial Goals, Challenges By Kelly Gooch M ichele Cusack is new to her role as senior vice president and CFO of New Hyde Park, N.Y.-based Northwell Health — but she's no stranger to the world of healthcare finance. Appointed to the position Nov. 1, Ms. Cusack is responsible for fi- nancial reporting, financial planning, cash management and tax management, among many other areas. She also has administrative responsibilities on the Northwell Board of Trustees' finance and audit committees. Prior to her recent appointment, Ms. Cusack was Northwell Health's senior vice president of finance and deputy CFO. Given her current duties and past experience, Ms. Cusack knows the financial challenges in today's healthcare environment. She recently answered questions from Becker's Hospital Review about these chal- lenges and her goals for 2018. Note: Responses have been lightly edited for length and clarity. Question: What's your favorite part about being the CFO of a health system? Michele Cusack: e daily challenge. I would say that given the cur- rent healthcare environment, there isn't a day that goes by that does not present a new challenge or opportunity. e size of our organiza- tion and the depth and breadth of the services we provide positions us well for taking advantage of both. Q: What is the biggest challenge you're facing as CFO? MC: e dynamic changes with respect to our top line. ere are the traditional pressures stemming from competitors and insurance com- pany payment issues. In recent years, there are new pressures from consumer disruptors like Walmart, Google and Amazon that are now competing with hospitals, health systems and other providers. For ex- ample, we could soon have Amazon offering mail-order prescription drugs and other health services that we now provide to our patients directly. It's kind of a piecemeal assault of the services we provide. Q: In August, Northwell Health announced plans to even- tually shut down its health insurance business, CareCon- nect, due to financial losses. What kind of impact will this have on the health system? MC: We incurred losses primarily as a result of the way the ACA rules played out relative to the risk corridors and risk adjustment. We are in the process of winding down the company over 2018 as we continue to honor our customers' existing policies. We'll wrap up operations with some administrative costs of the wind-down in 2018 and 2019. It was the right strategy at the wrong time. We accomplished what we wanted in terms of getting into the health insurance business, coor- dinating high-quality care for our patients, and aligning our clinical performance and outcomes with financial incentives that historically have benefited insurance companies only — not providers who are on the front lines of delivering care and the patients they serve. It also provided us with additional insight on how to enhance our capabilities and competencies in population health management, and diversified our revenue stream. Unfortunately, government rules, regulations and constraints made it impossible for us to be successful in the current environment. Q: What is one of your goals for 2018? MC: Maintaining and delivering a higher operating margin as we con- tinue to diversify our revenue stream, getting the most out of our reve- nue cycle and staying as competitive and lean of an organization as we can — all while maintaining high-quality care to our patients. Q: What advice do you have for other hospital and health system CFOs on going beyond the typical CFO duties and getting involved in other aspects of the business? MC: It's important to be in step with your COO and other chief exec- utives to understand more than just the numbers, but what's behind the numbers and their strategic vision from an operational standpoint. at's how to make sure you're a true partner. n 4 Most Important Healthcare Trends in 2018 By Michael Dowling, President and CEO of Northwell Health T o say it has been a tumultuous year for the healthcare industry is an understatement. Federal policy changes and recent transac- tions involving large insurers, health systems and retailers will affect pro- viders, payers and patients alike. While there are many new and emerg- ing trends we need to pay close atten- tion to in 2018, here are what I think are the four most significant issues that will command our attention in the year ahead. 1. Inconsistent healthcare policy will continue to domi- nate the headlines. The federal debacle with so-called healthcare reform this year has been a case study in confusion, inefficiency and lack of focus. Every week seemed to bring a new twist in the direc- tion of healthcare policy, especially in regards to the ACA, with almost no consistency to the legislative thought process. In many ways, the whole focus of ACA repeal and replace ef- forts was misguided — you can't take something apart without some ideas for a replacement. The federal government's lack of direction on healthcare policy has created chaos among all industry players.

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