Several hospital finance executives have stepped up to face unprecedented challenges related to the coronavirus outbreak.
The financial impact of the coronavirus disease 2019 (COVID-19) pandemic on hospitals and health systems across the country cannot be understated.
The temporary widespread cancellation of elective procedures sidelined a reliable revenue generator for provider organizations and caused already stressed operating margins to shrink even further.
Through it all, hospital CFOs have looked at ways to effectively reduce expenses and drive ancillary revenues in a time of crisis.
Below are nine hospital finance executives, including a few members of the HealthLeaders CFO Exchange, have stepped up to face unprecedented challenges related to the coronavirus outbreak.
- OSF HealthCare CFO Michael Allen, FHFMA, CPA
"We may be facing a future where our revenue stream is less than it was pre-COVID," Allen says. "The only adjustment you have, if that's the case, is growing your market. It's going to be challenging to do that in a market that's shrinking, if that's in fact the case; whether it's shrinking in activity because people are being more cautious about getting their care, or it's shrinking because of your payer mix, it's going to be harder and harder to try to grow market [share] in those environments."
- LCMC Health CFO Jenny Barnett-Sarpalius
"On our cost-saving initiatives, we're also focused on getting our expenses back in line [to] pre-COVID [levels]," Barnett-Sarpalius says. "We saw a spike in our supply costs, which was tremendous, and also our labor costs. We're paying a lot of premium pay and shift differentials to keep our labor force intact and redeploy the labor as needed. We had significant premiums in all areas of expense due to the surge of COVID-19."
- UI Health Care CFO Bradley Haws, MBA
"Where [this crisis] is leading us to is that we need to be a little more consistent in making sure that everybody has compensation or risk for reasonable performance, and that performance would adjust with the financial times, so to speak," Haws says. "If we have a second spike in COVID or we have some other kind of emergency like this down the road, we're able to be a little more nimble and agile than we were able to be in this round."
- CareMount Medical CFO Kevin Conroy, MS
"My sense is that CMS and CMMI [Center for Medicare and Medicaid Innovation] remain committed to increasing the level of value and looking to providers to take care of patients more directly and have more responsibility for the premium dollars," Conroy says.
- Edwards County Medical Center CFO David Usher
"We're never going to be cash-rich. We're always struggling, and reimbursement is always on the down," Usher says. "As a small organization, you'd like to think that you are able to respond quickly to changes, but these are very conservative, with a small 'c,' rural communities. Change is not something that happens easily. Cash control is critical, expense control is critical, [as well as] the optimization of cost reports, which are what drives most small hospitals that are massively dependent on reimbursement from Medicare."
- John Muir Health CFO Chris Pass
"It's an interesting challenge that is very different now; [with] the way we came into COVID, it was abundantly obvious that safety and taking care of our patients and community was the No. 1 [priority]. It was: 'We're going to do this at all costs,'" Pass says. "As [the pandemic] continues, there's a point where we've got to make sure we remain balanced with financial responsibility and stewardship, along with needing to still [focus] on our No. 1 priority."
- Gundersen Health System CFO Jerry Oetzel
"Every time we think we have a handle on the issues that are causing payer denials, the payers just switch the rules up," Oetzel says. "It doesn't seem like over a long period we make any progress at all. The predictive analysts within Olive, I believe, will help us. They're bringing us the technology closer to what the payers have."
- Yale New Haven Health CFO Vincent Tammaro
"When the patients come in, the cost of doing business is definitely going to increase. We have been exploring 24/7 [care], but that is expensive," Tammaro says. "We need to space out more of these cases; the days of people waiting in a waiting room are over. But, again, that's just going to contribute to the overall cost. Personal protective equipment and testing for our employees are all costs that we're going to incur, as well as the testing and contact tracing for not only our employees, but also for our patients."
- Lovelace Medical Center CFO Meghann Hutchison
"There's a lot that we look at with a fine-tooth comb and as a finance person, I'm always looking at the bottom line, but always keeping the patient's perspective in mind as my priority, because that's what's appropriate," Hutchison says. "I think that with proper planning, we're going to be all right. We'll be able to continue to care for everyone during the second and third wave, if it comes towards the fall or winter, where we've got proper segregation and great policies and controls to ensure everybody's safe."
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Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.