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Q&A: ProMedica's New CFO Talks Population Health

July 14, 2014

ProMedica CFO Alan Sattler talks strategies for dealing with the financial pressures on the non-profit system, including its focus on community-based population health efforts that strive to meet patients' basic needs as well as their healthcare requirements.


Alan Sattler, CFO of ProMedica

When Alan Sattler stepped into the system CFO position at ProMedica—a Toledo, OH-based health system with 2,268-licensed-beds and FY 2014 budgeted revenue of $2.5 billion—on June 1, he brought with him a wealth of healthcare management experience.

In his nearly 30-year career at ProMedica, Sattler has served in various roles, including senior vice president for acute care hospitals, senior vice president and chief financial officer for ProMedica Physicians, and most recently, as president of ProMedica Flower Hospital.

The knowledge he has gained from working in different areas throughout the organization will help him in his efforts to provide executive oversight to its financial operations, he told me during a recent conversation.

We discussed ProMedica's strategies for dealing with the many financial pressures all hospitals are currently experiencing and the system's focus on community-based population health efforts that strive to meet patients' basic needs, as well as their healthcare requirements.

HealthLeaders Media: What do you see as the biggest financial challenge that ProMedica is currently facing?

Alan Sattler: At ProMedica, disruptive innovation is our biggest financial challenge. All of the work we're doing in the community and internally to create value for our patients is a paradigm shift where we're now working to keep patients out of the traditional hospital setting.

Also, as performance networks, marketplace offerings, and other consumer-based insurance products and benefit designs take hold, the need to enhance consumer value by improving quality and lowering cost are becoming increasingly important.

Finally, unique system-to-system alliances and clinically integrated networks will challenge historical referral patterns and patient access.

HLM: How will the organization go about preparing for these changes?

Sattler: With the dramatic changes in healthcare, there is great emphasis on offsetting lower utilization rates and associated reductions in acute care revenue with increases in performance-based revenue and efficiency. At ProMedica, we have designated a division for process improvement, including staff trained in Six Sigma and LEAN. 

We're also implementing a new electronic health record and an information exchange that will allow ProMedica not only to improve data and information sharing within our system, but to also share appropriate data and information within our community of providers. 

By maximizing efficiency, clinical collaboration, and payer performance contracts, and attracting new patient volume by delivering greater value to consumers and purchasers, we may be able to mitigate the financial risk from lower utilization.

HLM: As the healthcare industry continues to evolve rapidly, are there skills that health system CFOs need today that may not have been essential five years ago?

Sattler: Today's CFO will play a key role in implementing innovative methods to improve population health management with a focus on value versus volume. CFOs need to continue to develop strategic focus while maintaining an eye on operating and financial performance outcomes.

Additionally, change management and effective communication skills will become increasingly important as we manage executive team and board member expectations and in addressing business, operational, and financial strategies.  

HLM: With reimbursement models moving toward value instead of volume, it's creating a new need for CFOs to work closely with their CMOs and other clinical leaders. How important is it to break down the silos between the financial and clinical teams that often exist within healthcare systems?

Sattler: It's critical that the CFO and CMO work together to develop programs to improve the value we provide to our patients and community and to maximize our performance-based outcomes. In order to achieve our organizational goals, we must have alignment from the top down in these critical areas. Vertical and horizontal silos must be torn down to build effective clinical and financial teams that work together towards a common goal of better quality and cost performance.

HLM: New reimbursement models are also driving the need for providers to increase their population health management capabilities. What initiatives is ProMedica undertaking in order to improve the overall health of the communities you serve?


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Sattler: At ProMedica, we have established a population health division which works closely with our clinical operations, advocacy, and care management teams across our operating units. Our goals in population health are to better manage all aspects of the health of our community from basic needs and wellness programs to complex care.

We believe that hunger and other social determinants of health must be addressed in order to improve the health and well-being of our patients and the community. As a result, we are focused on the care we provide inside and beyond the walls of our hospitals and healthcare facilities. Internally we are improving care coordination and clinical integration through care navigation, telemedicine and other clinical programs.

Externally, we are working closely with local and national organizations to identify and address social determinants of health, in particular hunger as a health issue. Through ProMedica's Come to the Table hunger-free community initiative, we are taking a leadership role nationally to elevate awareness and engage communities in addressing hunger.

HLM: Every hospital and health system is working to reduce cost and waste from the care delivery process. Where are the big gains that are left to be made at ProMedica and how will you achieve them?


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Sattler: As a not-for-profit organization, we have a greater obligation to reduce cost and waste now to sustain our long-term success and ability to care for our communities for generations to come.

One way this will be accomplished is through the deployment of electronic health record system and further consolidation of services to avoid duplications while managing to Medicare payment levels. Additionally, there must be further development of supply chain through clinical value analysis.

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