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CFO Sets Up Community-Based Healthcare System as 'Indispensable'

Analysis  |  By Jack O'Brien  
   August 16, 2018

Dennis Ressler spent more than 30 years rising through St. Vincent and Ascension, but has moved to a community-based system to provide low-cost care to Hendricks County. 

While some CFOs move around from system to system, and even state to state, Dennis Ressler, CPA has remained a longtime member of the healthcare community in Indiana.

Starting in 1981, Ressler worked at St. Vincent Hospital in Indianapolis, eventually becoming CFO of St. Joseph Hospital in Kokomo in 1998.

The hospital was rebranded as St. Vincent Kokomo, and Ressler served as its lead financial executive until January, when the system—a subsidiary of Ascension Health—went through a corporate reorganization effort.

Thanks to Ressler's connection with Hendricks Regional Health (HRH) President and CEO Kevin Speer, who formerly served alongside him on the board at Kokomo, Ressler was brought on as CFO at Hendricks in February.

Ressler told HealthLeaders that Speer reenergized him with the opportunity to lead HRH's financial performance and bolster the system's commitment to Hendricks County.

The following transcript has been edited for brevity and clarity.

HL: What has been the biggest change coming over from St. Vincent and being part of Ascension?

Ressler: St. Vincent was approximately 40% of the bottom line within all of Ascension, so there was a lot of pressure within St. Vincent to perform at a very high rate to support the other ministries throughout the country.

At Hendricks, we don't have those issues. We have a strong balance sheet, we have a strong income statement, and our focus is on how do we make sure that we are good stewards of resources.

Related: New CFO Talks Rural Hospital Strategy, Clinical Partnerships

HL: What has the transition been like coming to a community hospital from a larger health system?

Ressler: We're not just a community hospital; we employ close to 150 positions, so [we think about] how do we take all of that and be part of a community-based integrated system with the physicians, employers, and third-party payers to do that as effectively as possible.

What I've had to navigate around here is not being part of a larger system and advantages that I don't have immediate access to [anymore]. One [example] is contract management with third-party payers.

With St. Vincent being part of Ascension, it was viewed by Anthem and other payers as absolutely essential to their network.

However, what we have here in central Indiana is a group of community-based hospitals that formed together and are part of the Suburban Health Organization (SHO). There are 12 hospitals within SHO, and they negotiate the payer contracts with the member hospitals.

Another example is we had an audit network with Ascension called Catholic Health Audit Network (CHAN). That's one of the things that we're working through because you want to make sure you have adequate controls. You want to make sure that your charging systems are working well, that you're not inappropriately billing individuals.

HL: When you look at your market in Indiana, what do you see as some of the immediate challenges facing your system, and how will you overcome them?

Ressler: Basically what we've seen is that more people are looking for the best value or the lowest costs out of healthcare services. That's obviously not just reflective of HRH but everywhere; third-party payers and employer groups are looking for the greatest value that they can achieve.

One of the ways that we're trying to set ourselves up differently is that we have a well-integrated physician network with 150 physicians serving within the county, and more than half of those are primary care physicians.

We also just set up a new hospital in Brownsburg, which is 13 miles away from our hospital. We opened that in January and, within that [building], we have both an immediate care center and an emergency department right next door to each other. The only thing that patients have to do is, as they come in, they go to the left to go to the immediate care center, [or] they go to the right to go to the emergency department. And we are engaged with the third-party payers and the employers to work collaboratively to actively keep [patients'] total costs of healthcare low. I think we've set ourselves up as being an indispensable healthcare provider within Hendricks County.

HL: What do you say to other community hospital leaders, especially CFOs, in the face of growing consolidation among providers?

Ressler: This is not just about the dollars. A nun from the Daughters of Charity once told me, while I was working up in Kokomo, that it's important to remember: "It's not the margin that's driving the mission, it's the mission that's driving the margin."

One of the things that I tend to say is that financial performance is sort of a lagging indicator of everything else that we're doing. If we're focused on our mission, if we're focused on providing outstanding care to the community and employers that we serve, then that's going to drive the financial results. We don't have the leverage of a St. Vincent or Ascension, but what we've been able to do is band together through the SHO to provide those things that individually we could not afford.

HL: Where do you see the future of community hospitals going? Are we going to see them folding into consolidation, or even closing their doors?

Ressler: First of all, [community hospitals] have to be focused on what is it that you're in business to do, and then how do you develop the strategy to achieve that? I think as we go forward, we're looking at the expectation of the people that we serve. We have to be able to accommodate the [needs of] Medicare populations as well as the millennials.

I think by virtue of developing our Epic system, having convenient access points, and making sure that we can respond quickly to the healthcare needs of [patients], this puts the organization in a position that we can work with members and employers to provide the highest value we can to the community.

Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.


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