Mike Dewerff spoke to HealthLeaders about his new position in the system, and how to balance the needs of millennial and baby boomer patients.
Mike Dewerff has transitioned from one UnityPoint hospital in Iowa to another, beginning his new role as CFO of UnityPoint - Des Moines. The change transfers Dewerff from rural Fort Dodge and its population of roughly 25,000 to Iowa's urban center, home to more than 215,000 people.
Dewerff joined UnityPoint in 2010 as CFO of UnityPoint - Fort Dodge, before being promoted to president and CEO in 2015. Prior to joining UnityPoint, he served as CFO of Buena Vista Regional Medical Center in Storm Lake, Iowa, with additional experience at Banner Health in North Dakota.
While he is operating in a different location and demographic, Dewerff says he anticipates similarities between the responsibilities he held in Fort Dodge and the expectations ahead of him in Des Moines.
A veteran of the healthcare finance sphere, Dewerff talked to HealthLeaders about how his years in leadership positions across the midwest have affected his strategic perspective, the challenges ahead of him in a more concentrated provider market, as well as why he says he thinks data collection and analytics are driving health systems to improve performance.
The following transcript has been lightly edited.
HL: What would you say have been some of the similarities and the differences between being a CEO and the CFO?
Dewerff: I say the similarities between the CFO and the CEO are that you're still asked to make financial decisions and think financially as a CEO. My CFO background and that transition to the CEO role was valuable in the sense that I still used my analytic skills to think through decisions. Obviously, the differences are much more patient- and employee engagement-focused. I was able to shift much of my day-to-day activities to more physician engagement, patient engagement, and employee engagement, but when it came to strategic decisions and strategic planning, I’d often fall back on my finance analytics background.
I think the role of the CFO has been changing over the years. I think [CFOs] need to be thinking more strategically, particularly as you get into a larger organization. For example, as a CFO 10 years ago in a critical access hospital, I'd wear many different hats and get more involved in day-to-day operations. I think in a large organization [in Des Moines], I'll be more involved and asked to do more strategic planning.
HL: How was your organization been positioned in the change to value-based care, and what has that experience been like for hospital?
Dewerff: I think it's definitely been a transition, particularly in a state like Iowa where there wasn't a lot of value-based purchasing. My experience with value-based purchasing started in 2011, when I was in Fort Dodge, and we were one of the first organizations to go into the value-based model. It's been a very enlightening transition, particularly for a finance person traditionally used to negotiating fee-for-service rates. It's a different type of negotiating when you talk about access to data and what the PMPM is going to be.
One of our early findings was the new access to the amount of data that we had. [It] was overwhelming at first, and we really had to become more disciplined at how we [were] going to use this data and what kind of questions should we [be] asking. One of the biggest challenges that we're still working through is how do we translate that data to the frontline caregivers and help them most effectively manage care to the new type of reimbursement that we're getting.
Home [care] is a fairly new pilot for us and it's on a very limited basis. There are not many diagnoses that would qualify right now, but I think that concept is good especially as we move more into value-based care.
Because Des Moines is such a growing community, and we are moving into the high consumption ages of 70 and 80 years old, out inpatient businesses are growing, and we're at capacity quite often. So the hospital at home concept is intriguing to me and it will take some time to mature, but I think it says something that I'm excited to delve into and watch mature. I think that virtual care is starting to take off, and then with our rural communities, I think telehealth is starting to mature more here, though I think the reimbursement on it needs to catch up.
HL: What strategic initiatives are you looking to implement in Des Moines in the next few months or year?
Dewerff: I think UnityPoint is not unlike other health systems that have grown as a provider-based organization. I think we're all trying to get more in front of the premium dollar, and I think those types of growth opportunities on the premium side or accepting more risk is something that many systems that have grown up as provider-based systems are looking to do. I think that's an opportunity that we need to look hard at and be a little more aggressive on the risk side, and being able to do a good job of that.
How I think healthcare can make this transition is with access to data. We've been looking at [our] data for eight years now; the systems are much more robust, and the professionals that we hire and work with are much more talented at being able to manipulate and manage the large amounts of data we have. I touched on it a little bit with regard to translating that data to the caregivers, but I think that's a huge opportunity that we're just starting to tap into. We're working with our physicians and caregivers on interpreting the data and taking actions to improve not just the care for the patients, but also the cost of the care, and being more intelligent about high quality and low cost.
HL: What gives you hope about healthcare's ability to transform itself and adapt as an industry?
Dewerff: I think this transformation is being led by consumers and purchasers more than other transformations that have happened. I think the consumer-driven part of healthcare is becoming more evident, especially as the younger generations start to consume healthcare, but also as the baby boomer generation moves into their 70s and 80s. The consumers are driving this transition.
I think the new access to the amount of data that providers have is going to help us do a better job of transforming the change, and [making sure] that the care delivery system follows the care-financing system and that they go hand in hand. I think data is a new part, and access to the amount of data we have is new to this transformation.
What always gives me hope about the healthcare industry [is that] people are in healthcare because it's what their calling is or it's what their heart tells them to do. And in healthcare, whether you're on the clinical side or the analytics side, it's because you want to help patients feel better and get better. When it comes down to it, the healthcare industry has always been able to transform and react to whatever the changes are, because ultimately, we're trying to do the best thing for our communities and our patients.
Jack O'Brien is the Content Team Lead and Finance Editor at HealthLeaders, an HCPro brand.