New NYU Langone CFO Talks Free Tuition and Mission

Former Chicago comptroller Daniel Widawsky takes the reins at a leading academic medical center.

Just over a full month on the job, Daniel Widawsky is settling into his new position as senior vice president and vice dean, and chief financial officer at the NYU Langone Health in Manhattan.

For Widawsky, who served as comptroller for the city of Chicago from 2014 to May 2016, this marks his first foray into leading a health system. Despite being an outsider, Widawsky told HealthLeaders that he is confident in his ability to strategically address numerous aspects of population health, improve the hospital's bottom line, and learn along the way.

The following transcript has been lightly edited.

HL: What lessons from your time as Comptroller of Chicago are you drawing on in your new role?

Widawsky: The city of Chicago was a complex enterprise in terms of the scope of the operation, the number of employees, and the opportunity to improve workflows. In that sense, it's not so different from NYU. There were parts of finance in the city of Chicago that worked well and other parts that needed some reworking.

Over the first 75 days of my time in [Chicago], my leadership team and I put into place a strategic and operational review of finance that guided what we undertook for the next three years and set a good game plan for my successor at the city. There are some things that we changed as time went on, but it did provide that overview for us from leveraging technology to improve the revenue cycle, redesigning healthcare to provide our employees with better access, and restructuring our financial reporting.

At NYU Langone, I'm fortunate to have a talented leadership team, and we're taking a fresh look at each component of the revenue cycle, financial reporting, supply chain, and budgeting. We're also looking at how we partner with our clinical teams, our academic and research departments as well as the university itself, and external stakeholders. We're putting together a similar plan for operational and strategic enhancements throughout finance, so it'll be a process of continuous improvement going forward.

HL: Has it been a challenge to adapt to the world of healthcare compared to investment management and municipal finance?

Widawsky: It's been great, the opportunities and challenges for finance do tend to cross industry whether it's investment management, a local government, or healthcare. In the city of Chicago one of our areas of responsibility was for city employees and their families, totaling about 84,000 people. I had actually had a lot of experience with how we redesign healthcare for these 84,000 folks in terms of getting people the right care at the right time and at the right price. Because of these similarities, it may not be exactly the same, but I think Mark Twain was once quoted as saying, 'History may not repeat as much as it rhymes,' and that's certainly what I'm finding here.

HL: Have you had conversations with other health system CFOs for advice as you take on a new role?

Widawsky: Just over 30 days in, I've been more focused on working with my leadership team, along with internal and external stakeholders. However, over the past few days, I have had a few initial conversations with CFOs at other academic medical centers. During one particular conversation, the CFO expressed admiration as we talked about what NYU just announced in terms of the tuition scholarships for every medical student. He said, 'Hey, what kind of CFO are you, after 30 days you give away the store?' But I reminded him that the [scholarship] was funded by the generosity of dedicated philanthropy.

HL: How has that announcement impacted your role?

Widawsky: It's actually had a bigger impact than I thought. I think it resonated with students and graduates throughout. [Rising tuition costs] are an issue that everyone's been struggling with for years, and we talk about how to address it at the margin, but this is really a blueprint for how schools should approach this going forward.

When you take the issue off the table, it's not as though medical students in their third year say, 'All right, well now [that] I don't have tuition to pay, I'm going to go into X, Y, or Z specialty.' The full-tuition scholarship changes how they engage and how they undertake their medical school education from day one. And I think the impact of that can't be overstated. This is the way of the future. We're in huge demand for doctors over the next 20 years, and that demand requires us [to act] now. We need to start making the changes today, and this is one important step in doing so.

HL: Do you think that plays into bolstering the system's labor culture?

Widawsky: Absolutely, it stitches us together in terms of how we move forward. And I think the culture that defines us is really our mission, it's not more complicated than that. Our mission is to serve and provide care for the community, and to teach the next generation of doctors.

HL: What similarities do you see between moving from Chicago to New York City in terms of the challenges that your population presents, and what are the similarities in how you deal with those challenges?

Widawsky: I think when you get a large enough population, you start to see some of the same themes in terms of health. It may be a little different if you go into a less dense area, but an area as dense as Chicago or New York are going to have a lot of similarities. There's so much more we want to do in terms of more research, more care, [and] continue to build our ambulatory practices and provide the highest quality of care. When you provide the highest quality of care, it's not surprising, demand comes with it, and demand for what we do has never been greater. For all of these new investments, more mission requires more funding. From a finance perspective, I see our role as helping to manage and fund our growth, which is a key challenge and a key opportunity.

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