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One-On-One With Altru Health System CFO Douglas Arvin

Analysis  |  By Amanda Schiavo  
   August 24, 2022

The right strategies and a clear mission can propel rural hospitals to financial well-being.

Rural hospitals face a unique set of challenges including location and improving the healthcare outcomes of underserved communities. Maintaining the financial health of these healthcare organizations can be a challenging undertaking, but with the right strategies and a clear mission, rural hospitals can be profitable businesses and quality healthcare providers.

That's the philosophy of Douglas Arvin, CFO for Altru Health System—a nonprofit rural healthcare system with over $600 million in total revenue and 257 total staffed beds. Arvin became CFO of Altru Health System in 2020 and assumed the role with a mission to identify and solve some of the biggest hurdles impacting rural healthcare providers.

Arvin recently spoke with HealthLeaders and discussed overcoming these obstacles, his priorities as CFO, where he wants to see greater investments made, and how Altru uses tech to improve the patient-provider experience.   

HealthLeaders: What drew you to the CFO role with Altru Health System?

Douglas Arvin: I've been here for two years, and I've had a commitment to rural healthcare for some time now—it's very important and I want to support that. We're working on quality improvement and better reimbursement strategies within the healthcare system. These challenges drew me here and it's something that I wanted to be a part of and help support and provide leadership.

HL: What are some of the biggest challenges impacting rural healthcare providers?

Arvin: The ability to recruit and retain clinicians, physicians, and medical staff members is probably more challenging because we don't live on a beach or coast here. And so, there are challenges associated with that. Geography is a challenge, especially when facilities can be miles and miles apart. But people in rural communities have the same healthcare needs. So, improving their lives or, even saving their lives, is just as critical here. It's important to be able to invest in that and make sure that access to healthcare is available for people in this region and throughout the country.

HL: How does Altru Health System solve those challenges?

Arvin: One of our strategies here—from an outreach perspective—is to put ambulatory services in place, meaning providing physician practices and outpatient services in locations other than our core hospitals. We have an outreach perspective so that patients can have access to urgent care, labs, physician care, and specialty care in locations that are core to where we are. Providing access is certainly a critical piece of our investments.

Going beyond that, we look at investments in telemedicine. We can access care through technology that helps our patients and that came into play with COVID-19. In the initial stages, people were just simply either guided not to or afraid to resume some of their basic care. Telemedicine has continued to advance the ability to diagnose and treat rural patients.

It all comes back to our ability to produce a margin and having the resources to support those initiatives are critical to us. That's why our [vendor relationships] are so important. We can optimize our performance and improve quality for patients because there's a more seamless continuum of care and documentation of what's going on. [These initiatives] reduce errors and mistakes, improves quality, and improves financial outcomes for the health system.

HL: How can health systems utilize technology to create a better rural patient-provider experience?

Arvin: There is going to be even more development within healthcare technology. Eventually, we'll probably be able to monitor vitals and other things on our phones. All those things—particularly from a rural healthcare perspective or any underserved population—can be beneficial. Again, that's going to be good for the patient, good for quality, and it's also good for the cost of healthcare in this country.

HL: Where is the health system making greater investments on both the patient care side and the business side?

Arvin: On the patient care side, we are doing a replacement hospital for our primary campus here and with that will come increased capabilities, new technology, and new efficiencies for our staff. We have two primary hospital campuses in our health system. Our current core hospital operation for our health system is 35 years old. And so, we're doing a complete replacement of that facility. There are significant challenges associated with that for sure, but there are also significant opportunities again to improve technology, improve access, improve efficiency, improve amenities, and just have a more updated approach to healthcare.

We're also continuing to invest in our outreach programs, bringing specialties to those underserved locations. Frankly, we are going to have to invest in better population health and population management. We need to move away from the traditional method of treating the catastrophic patient and more toward how to prevent those kinds of healthcare issues. That is going to be more and more of the focus of healthcare in the future.

When I think of financial and administrative costs and non-direct patient care costs, I think of being the most efficient as we can—leveraging relationships that drive down the cost per unit for administrative-type costs is going to be critical for healthcare organizations. Best practices like documentation improvement initiatives are absolutely critical in making sure we get the reimbursement that should be attributable to us are critical pieces.

HL: What is your ultimate goal for Altru Health System?

Arvin: Quality outcomes and making meaningful differences in people's lives. Our financial performance is a mechanism to support that goal. Financially, we want to be responsible and provide good support for our mission, which is patient care, quality outcomes, and a good work environment for our people. That's what I would say is our long-term goal.

Amanda Schiavo is the Finance Editor for HealthLeaders.

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