The Exec: WMMC CFO Turns Revenue Cycle Discipline Into a Financial Advantage

With over 17 years at Western Missouri Medical Center, Lacey Bredehoeft-Fiene is focused on balancing operational efficiency, revenue cycle optimization, and community growth.

After 17 years inside Western Missouri Medical Center (WMMC), Lacey Bredehoeft-Fiene knows what’s required to lead the organization in its next phase of financial planning. Now, as CFO, she’s leaning on her work in revenue cycle optimization and technology modernization—including digital front-door and patient portal initiatives—to drive operational performance and patient-centered innovation.

Bredehoeft-Fiene describes her leadership as collaborative, shaped by her lengthy tenure at the Warrenburg, Missouri-based hospital.

“My time here has given me a really deep understanding of how decisions play out over time,” she said, adding that “it’s not just the numbers that you’re looking at right now, it’s really about sustainability and how we look at those things in the future.”

Bredehoeft-Fiene aims to build on the work of her predecessor, the recently retired Dean Ohmart, in government reimbursement programs.

“We want to be very proactive in how we’re managing those, because a lot of those programs that affect us are ever-changing,” she said. “They're very complex.”

At the same time, Bredehoeft-Fiene emphasizes strengthening internal operations, particularly revenue cycle processes.

“Even the smallest thing there can make huge impacts when it comes to financial performance and continuing to have that strong foundation,” she said.

Opportunities in RCM

Bredehoeft-Fiene highlights revenue cycle improvement, especially at the front end, as one of the biggest opportunities for strengthening financial sustainability.

She points to patient access and intake as critical. Getting accurate information upfront can significantly improve cash flow and reduce downstream issues.

 “It’s the first opportunity we have,” she said.

Denial management is another major area, and she stresses the need to shift from reactive fixes to proactive prevention by addressing root causes.

She also sees growing potential in technology, noting that AI and automation tools are vital for improving efficiency, especially in resource-constrained community hospitals.

“AI and automation tools are huge. It's a huge opportunity in the revenue cycle space, and finding the way to utilize it the best we can,” she said. “We're a community hospital, our resources are limited, but we focus on the things we can do and the impacts we can have. Really having that focus on the whole patient financial experience is crucial.”

Ultimately, she argues that revenue cycle should be viewed not just as billing, but as a patient-centered journey, with a seamless, digital end-to-end process.

Operational Performance Tools

Bredehoeft-Fiene believes that sustainable performance improvement is driven by a mix of clear metrics, strong management, and cross-department collaboration. While metrics are foundational, success also depends on working closely across teams, especially in a smaller organization where collaboration is key.

She highlights several core tools and measures, including service line performance metrics, labor productivity, and revenue cycle indicators, all supported by dashboards to track progress. These tools help identify opportunities, but they’re only truly effective when paired with strong leadership and coordination.

“By giving the departments the right data with the right tools, that really does help leaders make informed decisions to help better their performance in their patient care,” she said.

The CFO Shift

Bredehoeft-Fiene sees finance leaders taking on a much larger, more strategic role in digital transformation, especially at community hospitals. Rather than focusing only on financial metrics, she urges the need to act as a strategic partner.

“We should focus on not just, ‘Does this make sense from a financial perspective?’ But really act as that strategic partner in those big decisions,” she said. 

This means looking beyond standard ROI to evaluate the full impact of investments, including patient satisfaction, access, and operational efficiency.

The shift in the CFO role goes beyond tackling digital transformation direction. Bredehoeft-Fiene stresses the importance of aligning financial strategy with the hospital’s mission and broader goals.

“We need to go to that table and ask the right questions,” she said.

Beyond reporting numbers, the role now involves translating insights into actionable strategies that support growth, patient access, and long-term sustainability.

Looking Ahead

Bredehoeft-Fiene views long-term financial success as maintaining a solid foundation that enables the hospital to reinvest in services, technology, and staff to better serve community needs. She prioritizes expanding access to the “right outpatient services” and specialty care based on community health needs assessments, ensuring growth aligns with local demand.

She said: “That true financial strength is being able to have the resources that we can reinvest back into the people and into those services that are really going to improve the health of our community.”