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Analysis

Niagara Falls Memorial Medical Center CFO on Remaining Independent

By Jack O'Brien  
   October 31, 2019

Wright joins Niagara Falls Memorial Medical Center from A.O. Fox Hospital in Oneonta.

In mid-July, Mark Wright, a lifelong native of upstate New York, was named chief financial officer of Niagara Falls Memorial Medical Center (NFMMC) in Niagara Falls, New York.

Wright previously served as the CFO of Oneonta-based A.O. Fox Hospital, part of Bassett Healthcare Network, in addition to executive roles at Hudson Valley Hospital Center in Peekskill and St. Joseph's Hospital in Elmira.

A few weeks after taking the helm in early August, Wright spoke with HealthLeaders about finding ways to remain operational as an independent community hospital and facing the challenges of a reeling economy in upstate New York with a high Medicaid population.

This transcript has been lightly edited for brevity and clarity.

HL: What is your mindset coming into this role at NFMMC?

Wright: I see finance as a support role for healthcare organizations. I've always preached to all the different departments that people don't come to the hospital for finance. We're here to make sure that the mission of the hospital can still be supported. We do a lot of important functions but, at the end of the day, it is about patient care services.

Part of what attracted me to this position is that the hospital is still an independent hospital. [NFMMC] is pursuing a lot of different partnerships with the bigger networks around [the Buffalo area] to bring more services to the community.

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A couple years ago, [NFMMC] opened up a [catheterization laboratory], which is a joint venture between NFMMC, Kaleida [Health], Erie County [Medical Center], and Catholic Health. It's unique to be able to get all of those competing systems to play together in the sandbox for something that they felt was a need for the community.

We're currently in the process of doing a venture with Roswell Park [Comprehensive Cancer Center] to bring cancer care services—in concert with them—to our facility, in order to utilize a portion of the facility.

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HL: What are some of the challenges facing NFMMC and what are the plans to overcome those obstacles?

Wright: The challenges for NFMMC are the same challenges Fox and most of the upstate New York hospitals are facing. The economy has not bounced back upstate like it has in other parts of this country, so you're seeing less commercial-based payers and more of a migration to governmental payers. [Those insurers] have their own budgetary issues and continue to not give large rate increases, so there's an economic challenge involved with that.

The other challenges are staffing shortages around nursing, lab technicians, radiology technicians, and physicians. That presents the challenge of getting them to the community and as those [roles] continue to become more scarce, the price tag goes up.

HL: What are your expectations about the shift toward value-based care?

Wright: [The hospital] is about 40% Medicaid as a population. The state of New York is actively pushing to get the Medicaid program more and more into the value-based world. I know the commercial side may lag behind the Medicaid side, but I think we're already seeing a second round to the movement. We were in a Level 1 arrangement with one of the large Medicaid managed care organizations [MCO]. In Level 1, it's basically a shared model where you target some costs and if you can get some savings out of it, you share the savings.

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In Level 2, the MCO is trying to migrate the groups more towards where there's shared risk and some downside. Based on the current philosophies, I do believe you're going to see the Medicaid side of the population start to be moved more towards the value-based system. There's going to be some sort of capitation involved and the quality metrics that the hospital's going to have to meet or participate in.

When I was at Fox, we were part of one of their initiatives where they were moving people through this value-based purchasing quality initiative program. We were required by certain time frames to have Level 1 contracts in place and to start having Level 2 contracts as well; it's a large initiative by the state.

I think it will play a fairly significant role in the near future for NFMMC just because of how big their Medicaid population is. 

HL: From your experience, what have been the most effective approaches to streamlining the billing process for patients?

Wright: It's always important to maximize the information technology function and utilize the capabilities of the IT function. Sometimes I see organizations try to tailor the IT world to be like the paper world and it doesn't quite work that way. As the processes start to break down, you're starting to make the patient upset.

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In some of the other organizations [I’ve worked at], I've seen a little bit of a different interface up front to the process where we started to introduce options for people to register themselves as opposed to having someone stand in front of a person. This opens things up where people can [register] online in advance instead of filling out forms when they first show up.

You can try to streamline and make some of those processes more user-friendly to them. If you can capture the information and the eligibility stuff up front and get clean claims out while having the bills paid appropriately, the patient side goes fairly smoothly.

HL: Do you have advice for your fellow CFOs, especially some of the younger ones who might be leading their first health system or hospital?

Wright: I was 31 when I became a CFO. For me, you have to view the finance area as being a support for the rest of the organization. You have to keep that focus that you're [here to treat] patients.

Jack O'Brien is the finance editor at HealthLeaders, a Simplify Compliance brand.


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