Legacy Health Positioned to Navigate Portland Provider Market

CFO Anna Loomis, MBA, says it is important for health systems and hospitals to build the capabilities to stay 'financially sustainable in a multitude of reimbursement environments.'

For Legacy Health in Portland, Oregon, a CEO transition last year, followed shortly by a CFO departure, left a vacancy.

Anna Loomis, MBA, then-CFO at MultiCare Health System in Tacoma, Washington, had not been actively looking for a new position but had admired Legacy's track record from afar. Conversations between Legacy and Loomis began and she was presented with an offer that Loomis said was "too good to pass up."

According to Loomis, one of the most intriguing prospects that drew her to Legacy was the organization's recent move into the payer side through purchasing 50% of PacificSource Health Plans. 

In an interview with HealthLeaders, Loomis expanded on initiatives at Legacy, her experience as a healthcare finance leader, advice for aspirational young executives, and her take on value-based care.

This transcript has been lightly edited for brevity and clarity.

HealthLeaders: Other than differences in state Medicaid programs, what are some other discrepancies, whether good or bad, that you've seen in moving from Washington to Oregon?

Loomis: There's a different Kaiser [Permanente hospital] here, and Kaiser was new to the Washington market with their acquisition of Group Health and Kaiser owns hospitals in Oregon; they didn't own hospitals in Washington. That leads to different kinds of competitive forces in the market that I think gives Legacy some different opportunities on how to connect to the community.

Most of the rest of the landscape is fairly similar; the Medicaid piece is different like any other state but it's extremely unique in Oregon, and I'm rapidly getting up to speed and learning that aspect. Also, Portland is a different market in terms of being more competitive. There are more players here, and I think Legacy's in a unique position to change the market dynamics, given all the capabilities that we have.

HL: What is the Portland provider market like, and how is Legacy positioned to navigate it?

Loomis: I'd say the Oregon market is a little more fractured. Providence [St. Joseph] is a big player. And you've got Kaiser; you've got [Oregon Health & Science University], an academic facility; and then you have a lot of independent [hospitals] still, which is somewhat unique.

Then you've got Legacy, and I think Legacy's in a strong position of being an independent, not-for-profit system. We've got a children's hospital. We just started up a behavioral health hospital with our partners; that's a unique joint venture, and I think that's a new model that's still getting off the ground. Then we have a whole network of community hospitals, and we have an opportunity to look at how we provide services even beyond what our current geographic scope is.

HL: What were the changes you witnessed at MultiCare from when you joined in 2006 to when you left in 2018?

Loomis: There was incredible growth [at MultiCare.] I actually joined MultiCare through an independent hospital called Good Samaritan Hospital, which I'd joined in 2002, and they made a decision in 2006 that they needed to have a partner and be part of a broader health system.

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That was the first major move for MultiCare, getting out Tacoma. It took several years to integrate, [but] it was successful. And then the organization, over the last six years, has been on a growth mode both in terms of geography as well as capabilities and services.

MultiCare acquired a large health system in Spokane that consisted of two hospitals and clinics from [Community Health Systems]. That was the first time that the organization went outside its geography in terms of patients not being able to just drive 10 miles down on the street; it was across the state. This makes [leaders] think differently when you do something like that.

The organization did some major things like that, but probably even more critical is the organization started developing capabilities along the full spectrum of healthcare services. There was a major expansion in urgent care services, other outpatient services, surgery centers, virtual care …  to make sure that [the organization] had all the capabilities that was needed.

For MultiCare, the biggest change I saw was the organization move from being Tacoma hospital­–centric to a fuller set of capabilities and a much broader reach in terms of the patients in the communities.

HL: You were recognized by Puget Sound Business Journal as 'CFO of the Year' in 2018. Can you walk me through your personal growth at MultiCare and offer advice to younger CFOs?

Loomis: I moved up through the ranks in a somewhat traditional fashion. I was controller and then vice president of finance. I was the type of person who was always focused on the role that I had, always developing myself, and trying to learn new skills.

The opportunities always came to me. I didn't necessarily have to seek them out, so I didn't have a set plan of, 'I need to have this title by this date.' In fact, if you'd have asked me six years ago if I wanted to be a CFO, I would have said no.

The reason I would have said no was because I don't think I had good insight into what was possible being in this seat; meaning, that what I love about my role and being a CFO is I have an ability to make a big difference in an organization and connect with people in a different way. I love the ability to do that.

My advice to [younger CFOs is]: One, get your MBA, because it becomes a necessity.

The other piece is to develop the soft skills as much as you develop the hard skills, because it's the soft skills that allow you to succeed in a role like this. You need to have the emotional intelligence, executive presence, and know how to communicate strategy.

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It's not that you can close the books and do all the traditional finance things—sometimes you need that background—but what's going to differentiate you are your leadership skills and capabilities. That's not always natural for people in finance. I think it's important to be intentional about increasing your self-awareness and improving those skills to the best that you can.

Once I got insight into what a CFO could accomplish, I haven't really looked back.

HL: Are you optimistic about the gradual push toward value-based care?

Loomis: I think it's difficult to predict, and I think we as health systems need to be ready for any path that that could head down. I think building systems and capabilities to be sustainable in a value-based world are valuable, regardless of how far we get there on the reimbursement side.

That's what's most critical, is that we focus on doing the right things that are going to be successful regardless of what happens with Medicare, Medicaid, where commercial is headed, and every once in a while, you hear a single-payer piece is coming down the pike again. We need to continue to stay involved in that and help influence as appropriate, and we have to build the systems and capabilities to be financially sustainable in a multitude of reimbursement environments.