From Cleveland Clinic to Crouse Health: New CFO Focuses on Data, Culture

Michael Tengeres discusses the competitive central New York healthcare market, why systems should embrace cost accounting, and how culture can drive success. 

After years spent in executive positions at Cleveland Clinic and Bassett Healthcare Network, Michael Tengeres assumed a new role on April 30 as CFO at Crouse Health in Syracuse.  

In his most recent role, Tengeres served as corporate vice president and CFO of Bassett Healthcare in Cooperstown, New York.

Before that, Tengeres served as senior director for international finance operations for Cleveland Clinic, where he worked to establish the financial operations for the system's Abu Dhabi location.

Tengeres spoke to HealthLeaders Media about his homecoming to central New York, the importance of cohesive organizational culture, and his efforts to build on Crouse's culture of success. 

The following transcript has been lightly edited.

HealthLeaders Media: What strategies are you pursuing to ensure the financial well-being and growth of Crouse Health?

Tengeres: I would like to take my CFO hat off and share what I have learned and directly observed from healthcare leaders I have been fortunate to work closely with.

If you put the patient first, provide quality outcomes, stress that all employees are caregivers, make operational decisions acting in the best interest of the patient and, most importantly, show empathy, the bottom line will follow and allow you to reinvest in the mission.

An engaged workforce is key to providing high-quality patient care, but many do not understand the significance.

Overall, key strategies to maintain and build on financial viability include workforce management, employee engagement, innovative care model integration, smart growth, rationalizing resources, and population health.

HLM: The healthcare market in central New York is quite competitive. How does that affect your perspective on the financial expectations of your organization?

Tengeres: Both [Bassett and Crouse] have challenges and what I've learned coming back to New York is that it's highly regulated, which I think is a good thing in terms of controlling costs. But with coming back here to Crouse and having three other hospitals so close to each other, what's nice is that the data's here.

I talk a lot about cost accounting and I think only about 50% of the healthcare institutions or hospitals in the country have seasoned cost accounting, which is going to be really important going forward. The challenges are that you're back into a market where the physicians can move back and forth at their convenience.

You have to look at productivity and quality closely. One of the things I learned at Cleveland Clinic is transparency of information and data. Ease of patient access is key, as is providing the right care in the right setting. That's why I think there are only certain organizations that are patients first, although most say they are.

HLM: What are the most prominent challenges facing health systems in central New York and how are you working to address them at Crouse?

Tengeres: Aside from New York being highly regulated and the continual pressures in declining reimbursement, major challenges are physician recruitment, nursing shortages, pharmaceutical costs, and external entities' continual movement into the healthcare arena.

First and most critical is transparency of information with our external partners. At times, the patient seems to get lost in the conversations given the financial challenges. This is where I believe standardization of care paths and order sets aligned with seasoned cost accounting data will drive reimbursement of services in the future versus standard rate increases.

Although difficult, and it may take many years to mature, this model may drive the sustainable margins to meet [these] challenges, and maintain routine and strategic capital initiatives.

HLM: What are some challenges or areas of concern that you are focused on that other CFOs should take note of?

Tengeres: I think especially with these [healthcare] mergers, even before the financials, it's important to have the culture and management of both organizations be on the same page. And more importantly, can you bring the physicians, whether employed or not employed, together.

I was given those opportunities at [Cleveland Clinic] because everybody was always approaching and saying, 'We want to be a part of [the system]' and we had to do our due diligence.

What I didn't understand then—I was always about the numbers and financials—what's more important is if those cultures don't align, regardless of the fact that the financials are good on each side, it might not be a good match to merge moving down the road.

HLM: What gives you hope about healthcare's ability to transform itself?

Tengeres: First, it will have to since it is never going away. Cost of care will always be an issue, but when will the federal government and state governments, as well as providers, insurance companies, and pharmaceutical companies better understand providing high-quality care at lower cost without putting the patient at risk?

I think as big data matures, and as care paths are aligned with cost accounting and preventative medicine grows, this will help transform healthcare in the future. System consolidation over the years will not be the only answer in regard to economies of scale.