The Value of Teamwork
Healthcare organizations are challenged every day by myriad financial issues, from money-losing services to bad debt increases to clinician shortages. Financial panelists at the Top Leadership Teams in Healthcare Conference spoke at length about the value of executive teamwork to overcome operational problems.
To bounce back from bankruptcy, Crouse Health Hospital's CEO Paul Kronenberg, MD, and CFO Kimberly Boynton sought ways to engage all levels of the organization in the key measurements for success. This included not only sharing financial metrics organizationwide, but also quality and satisfaction outcomes.
"As a team, we show that this methodology is how the organization wants to work," Kronenberg said. "We want to share that with the physicians and department directors." By providing measures and outcomes to salient decision-makers within the organization, Crouse, in Syracuse, NY, has developed a new culture in which physician partners and department directors seek to improve upon the hospital's measures and outcomes. One way Crouse does this is through its detailed method of requesting additional staffing based on productivity and patient and physician satisfaction metrics. Whenever a request is made for a full-time equivalent employee, supervisors must provide measurements for what this person will achieve, said Boynton.
Sometimes a CFO can be seen as the chief number-cruncher who has to hold the line on spending. But more and more, CFOs are critical players when it comes to strategic development, said panelists. "Strategy trumps finance," said Richard Breon, CEO of Spectrum Health in Grand Rapids, MI.
Spectrum CFO Michael Freed noted that today's financial leaders need to be forward-looking because of the frequent changes in the industry. He said that given their background, CFOs--especially new ones--spend too much time "trying to get the numbers right."
"What's really important when you make the transition from controller to CFO is that you have to begin to transition from looking to get the numbers right to identifying the organization's strategy, and how you're developing a financial plan that helps achieve those goals," said Freed.
Like most other businesses, healthcare organizations target growth opportunities, but often they struggle at this in part because of the ongoing need to maintain and correct pressing internal initiatives. At MemorialCare Medical Centers in Long Beach, CA, senior leaders took a process they built for clinical best practices and applied it to business initiatives.
"It might have been the biggest home run for us in terms of balancing the tension within a hospital or between hospitals in the health system where you allocate capital for growth," said MemorialCare CEO Barry Arbuckle.
In this process, executives in the system meet quarterly and debate capital projects that exceed $5 million. One part of the discussion is designed to share information about service lines within the system, but another is to hold managers accountable for significant capital projects.
"When you're competing with your peers within the same system for those dollars, you have to have a compelling argument that's based on real facts," said CFO Rick Graniere. And the process, said Arbuckle, has helped management, the board and physicians to better understand the reasons for the system's capital decisions.
Crouse Health Hospital, Syracuse, NY:
Paul Kronenberg, MD, president and CEO
Kimberly Boynton, CFO
MemorialCare Medical Centers, Long Beach, CA:
Barry Arbuckle, PhD, CEO
Rick Graniere, CFO
Oregon Health & Science University, Portland, OR:
Cynthia M. Grueber, COO
Bradley N. King, vice president and CFO
Spectrum Health, Grand Rapids, MI:
Richard C. Breon, CEO
Michael P. Freed, CFO