See how this CFO balances inpatient and outpatient capacities at a Level II Trauma Center.
At Medical City Denton, a 228-bed, acute care hospital with more than 900 employees and 1,100 physicians, balancing several different types of patient care, — from strokes to open heart surgery — is a big task.
Whitney Bendel took over as CFO of the organization in August 2024; she shared what goes into the financial management of an organization like this, from insurance challenges to growth opportunities.
The Pulse of the Organization
With over 10,000 annual admissions, Bendel's organization takes on a variety of specialty services including cardiology, imaging, neurological care, orthopedic care, spine care and surgery.
A big component to ensuring these services and reimbursement run smoothly is coverage, which can become tricky, Bendel says. The organization sees many critically ill patients coming from all over the state, requiring subspecialty coverage, which comes with the weight of policy complexities.
Two big factors come into maintaining a Level II trauma center, according to Bendel. One is ensuring there is comprehensive subspecialty coverage in place, and the other is having physicians to cover those services.
"We see patients coming from all over, and many are unfunded or underfunded populations, which can make it challenging from a reimbursement standpoint," Bendel says. "Of course, we want to serve our community and will always provide care for anyone who walks through our doors, but that dynamic can cause some financial challenges."
But Denton is prepared for these challenges and works to help these patients obtain coverage.
"We have financial counselors and public benefit coordinators to help support patients in obtaining insurance coverage while they are in the hospital," Bendel adds.
Labor costs for these specialty physician groups also come into play, but at an organization like Medical City Denton, a part of HCA Healthcare, Bendel says the organization is stable in its market.
"We offer our teams relocation and referral benefits to help bring in experienced staff. We also partner with technical schools and college programs to allow students to do their clinical rounds at the facility. HCA also started the Galen College of Nursing and there is a local DFW campus," Bendel says. "[Also,] we have a robust nurse resident program to onboard new graduates and give them the opportunity to grow within the organization."
Aiding in this stability are the organization's sister hospitals like Medical City Heart and Spine, and Medical City Argyle, which recently joined the Medical City group; through both locations Denton can serve the community in cardiac services.
At Medical City Heart and Spine specifically, the organization helps to "offer higher levels of care for ECMO and heart transplant patients," allowing Denton to focus on its various acute cardiac patients.
Bendel highlighted a key focus of the organization: exploring the opportunities for growth through these service line expansions.
"For the Argyle Campus we are excited about our current and growing orthopedic and robotic GYN volume as well as identifying new opportunities for spine and robotic general surgery," Bendel says. "We also continue to drive awareness around the free-standing ER located on the front corner of campus. Patients can get in and out quickly."
Innovative tools also come into play here. To ensure Denton's patients get the highest level of care with the least complications, the organization has invested in the Inari Thrombectomy device to treat pulmonary embolism.
"It's fairly new to Medical City Denton, it's a device that allows the proceduralist to grab the pulmonary embolism in a single case as opposed to the patient going to the operating room multiple times," Bendel says. "There are less complications, shorter length of stay, less ICU time; this device has played a key role in innovation in our cardiac service line."
Growth and Understanding the Market
For Denton, one of the largest and most comprehensive providers in North Texas, understanding the market from both a broad perspective and a community one is crucial to understanding and creating opportunities for growth.
Staying vigilant on circumstances such as shifting population growth, shifting age demographics, new providers, and new service line offerings all help in understanding the market and where opportunities may lie, Bendel says.
"Understanding the market demand is vital, then you can help align your facility and your team to what the market needs. We also have to make sure we are balancing inpatient capacity," Bendel says. "You have to understand the service area and market needs to be able to provide services in demand. As the population grows, ages, shifts there are different service lines that become more in demand while others decline. Understanding the population and competitors in the market drives your strategy for growth."
With many services being pushed to outpatient settings, Bendel says Denton must find a balance to ensure it is aligning its "inpatient needs with services that are being pushed to outpatient."
"We have to ensure we are leveraging our operating room capacity appropriately to maintain our current book of business and continue to grow," says Bendel. It's a multifaceted approach, she explains, ensuring that the organization has the equipment, the services, and the staff it needs to continue to grow in specific service lines.
Understand that the market comes first, says Bendel. Then make adjustments to make sure "that your current team is aligned and supported to meet the demand."
"Proactive not reactive" cost containment strategies are vital for finance executives.
Healthcare costs are rising. From labor costs, to technology investments, to shifting reimbursements models, many components are fueling heightened costs. It's enough to give CFOs whiplash.
In this week’s episode of The Winning Edge, sponsored by HealthTrust, panelists dove into the nuances of cost containment for finance executives in 2025. Lynn Ansley, Vice President of Revenue Cycle Management at Moffitt Cancer Center, James Dregney, Chief Financial Officer and Vice President of Finance and Operations at Sauk Prairie Healthcare, and Rich Philbrick, SVP, Strategic Accounts and Performance Solutions at HealthTrust, discussed what cost containment means for health systems and how they are strategizing in 2025.
From new tech to supply chain innovations, here's how CFOs can implement effective cost containment.
Healthcare costs are rising. From labor costs, to technology investments, to shifting reimbursements models, many components are fueling heightened costs. It’s enough to give CFOs whiplash.
In this week’s episode of The Winning Edge, sponsored by HealthTrust, finance executives dove into the nuances of cost containment for 2025. Lynn Ansley, Vice President of Revenue Cycle Management at Moffitt Cancer Center, James Dregney, Chief Financial Officer and Vice President of Finance and Operations at Sauk Prairie Healthcare, and Rich Philbrick, SVP of Strategic Accounts and Performance Solutions at HealthTrust, discussed what cost containment means for health systems and how they are strategizing in 2025.
Check out this infographic for a breakdown of four tips for CFOs looking to tackle cost containment.
"Proactive not reactive" cost containment strategies are vital for finance executives.
Healthcare costs are rising. From labor costs, to technology investments, to shifting reimbursements models, many components are fueling heightened costs. It's enough to give CFOs whiplash.
In this week's episode of The Winning Edge, sponsored by HealthTrust, finance executives dove into the nuances of cost containment for 2025. Lynn Ansley, Vice President of Revenue Cycle Management at Moffitt Cancer Center, James Dregney, Chief Financial Officer and Vice President of Finance and Operations at Sauk Prairie Healthcare, and Rich Philbrick, SVP, Strategic Accounts and Performance Solutions at HealthTrust, discussed what cost containment means for health systems and how they are strategizing in 2025.
Shifting Into Value Based Care
Reimbursement timelines and collaborating with payers are key challenges, according to the panelists.
Payer-provider disputes have risen 70% in just the last two years, and collectively providers now spend nearly $20 billion annually on claims denials, with half of that wasted on disputes that should have never happened.
One opportunity that comes into play here is value-based care, which is designed to shift the focus from volume to value. But a large component of value-based care is a strategic focus on preventative and primary care.
While shifting the focus toward preventative care is certainly crucial for success in VBC models, it can't all be done at once. Data sharing is a large factor, panelists said, and providers and payers will need to examine more effective ways to transparently share data.
For health systems looking to utilize VBC models for effective cost management, panelists had some advice:
Create a balance in shifting services. Ensure there is continuous balance between inpatient and outpatient settings as more focus is placed on preventive care services and programs.
Ensure thorough data sharing with payers. Hold payers accountable to transparent, accessible data for all services.
Be creative with the available options. Stay curious and vigilant about what resources and opportunities are available when shifting services.
Considering AI Investments
New technologies like AI are also prime candidates for cost containment opportunities. While initial AI investments can be expensive, the long-term pay off is usually worth it for a health system. Not only can AI help with streamlining and automating certain processes, it can identify areas of inefficiency and waste.
Dregney, whose organization consists of a 36-bed acute care hospital, pointed out that not every health system is going to have the resources to carry out its own AI operations.
This is where partnerships come into the picture. For finance executives looking to implement AI but unable to tackle the large costs or technological nuances of implementation, third-party partnerships can be a great resource for creating advanced technology opportunities, especially for smaller organizations.
Tariffs and Supply Chain Woes
Tariffs pose yet another big challenge for providers, and budgeting for these changes may certainly play into cost containment efforts for 2025. Panelists spoke about supply chain disruptions during the COVID-19 pandemic, and said today's fast-paced policy changes are leaving many health executives with a blurry idea of how healthcare costs will be impacted over the next few years.
Having an effective supply chain strategy is critical, said Dregney. Partnering with outside organizations is also a good option for smaller health systems and hospitals. He said it's crucial to do the homework to select the right GPO and ensure the organization is purchasing items on contract .
Ansley discussed how her organization prioritizes the cross-examination of data for its pricey oncology drugs. This is a collaboration between the pharmacy side and the revenue cycle side, she said. It's important to have a strategy that is "proactive not reactive," to price increases, she added.
For providers looking to mitigate these extra costs as much as they can, diversifying supply chains and utilizing domestic suppliers may be helpful. Panelists suggested having an efficient inventory process and utilizing innovative technology for data analytics within the supply chain.
This episode of our Winning Edge series is sponsored by HealthTrust.
In a dynamic healthcare landscape, effective cost containment can help health systems Manage their expenses and improve the bottom line.
Health systems have been navigating rising costs for some time now, and CFOs are at the forefront of this challenge. Healthcare costs have steadily been increasing since 2021, making cost containment a crucial strategy going forward.
From high labor costs, to the advent of artificial intelligence (AI) and shifting reimbursement models like value-based care, CFOs are finding they must be agile in their approach. What’s more, external factors such as tariffs and supply chain disruptions add further pressure on health system budgets.
In this week’s episode of The Winning Edge, sponsored by HealthTrust, we’re diving into the nuances of cost containment for CFOs in 2025. Tune in to hear Lynn Ansley, Vice President of Revenue Cycle Management at Moffitt Cancer Center, James Dregney, Chief Financial Officer and Vice President of Finance and Operations at Sauk Prairie Healthcare, and Rich Philbrick, SVP, Strategic Accounts and Performance Solutions, HealthTrust, discuss what cost containment means for health systems and how they are strategizing in 2025.
Value-Based Care Models
The transition from fee-for-service to value-based care (VBC) is reshaping how providers deliver services and get reimbursed. But often, this model can be a double-edged sword for CFOs. While value-based care aims to reduce unnecessary spending by prioritizing preventive care, it also requires significant investment in infrastructure, data analytics, and care coordination.
To get serious about VBC, CFOs must prioritize investments in electronic health records (EHR) and other technologies that allow for better tracking of patient outcomes. A shift to value-based care may involve financial risk, but it can also result in more sustainable and predictable revenue streams when implemented strategically and effectively.
Factoring AI into the strategy
AI offers a promising avenue for providers to streamline operations and reduce unnecessary expenditures, but with so many AI solutions on the market, CFOs must be careful in choosing the right technology.
Despite the industry hype, health systems should not invest in AI simply for the act of hopping aboard the new technology train. CFOs must consider factors like costs of implementation, training, and continued governance. There’s also the question of how new technology could disrupt workflows and affect staff.
While initial investments in AI technology can be substantial, the long-term savings and efficiency gains often outweigh these costs.
Tariffs
Tariffs pose yet another challenge for providers. The fluctuating costs of medical devices, pharmaceuticals, and personal protective equipment (PPE) due to international trade policies can quickly disrupt budgets. CFOs will need to work with supply chain managers to develop contingency plans, such as diversifying suppliers, leveraging group purchasing organizations (GPOs), and investing in local or domestic suppliers where possible.
Additionally, negotiating long-term contracts with vendors and suppliers can also help to give a little price stability in a volatile market. Leveraging data analytics to track supply usage and optimize inventory management is also a crucial strategy. Budgeting for tariffs may certainly play into cost containment efforts for 2025.
High Labor Costs
In the previous finance episode of The Winning Edge, panelists discussed the best strategies for lowering labor costs as this challenge grows for health systems everywhere.
Labor expenses remain one of the largest healthcare budget items, and with increasing demand for healthcare services due to factors like an aging population, these costs are expected to rise. CFOs will have to consider innovative approaches to workforce management, such as enhancing the use of nurse practitioners and physician assistants to handle routine care, which can free up specialists to focus on higher-acuity cases.
Additionally, technology can also play a role here; implementing flexible staffing models, such as telemedicine, can help alleviate the strain on in-person resources and reduce costs without sacrificing quality.
Join us on Tuesday for a deep dive into the most effective cost containment strategies for healthcare finance executives in 2025.
This episode of our WInning Edge series is sponsored by HealthTrust.
Here's how CFOs can navigate the impact of HHS layoffs.
The Trump administration has proposed downsizing the Health and Human Services Department (HHS), and CFOs need to be prepared for the potential effects to their health system.
Downsizing HHS particularly through the technology department and the Agency for Healthcare Research and Quality (AHRQ), could negatively affect healthcare. The impact could stretch from the technology infrastructure supporting electronic health records (EHRs) and cybersecurity, to the pace and quality of medical research. CFOs will need to adopt proactive strategies to minimize these impacts for their health systems.
Check out this infographic for 3 CFOs Strategies to use if HHS layoffs and the healthcare regulatory space shake-up prevails.
Is AI helping or hurting the payer-provider relationship?
In this episode of HL Shorts we hear from Evan Zaslow, Vice President of Payer Strategies at Moffitt Cancer Center. Zaslow dives into how the technology like AI has impacted payers and providers and how it could potentially impact this relationship in the future.
Curiosity, collaboration, and risk evaluation are key to this CFO’s strategy.
Whitney Bendel took over as CFO of Medical City Denton in August 2024. Now, roughly eight months into her role, she’s sharing what she is learning, working on, and looking out for as the financial overseer of a specialty advanced care center.
Medical City Denton is a 228-bed, acute care hospital with more than 900 employees and 1,100 physicians in Denton, Texas. In addition to being a Level II trauma center, the organization is also a primary stroke center and an accredited chest pain center offering advanced open-heart surgery.
Prior to this role, Bendel served as CFO for Medical City Lewisville, where she contributed to facility-wide enhancements. During her tenure there and at Medical City Dallas prior to that, she helped to build processes that tracked the organization's volume, revenue and financials in support of the campuses' growth agenda.
Collaboration
Collaboration with clinical teams is key for organizational success. For Bendel, this collaboration is vital to making informed financial decisions.
“I stay very close to my clinical leaders. It is important for me to hear what is happening on the front line to ensure we are addressing their needs while staying aligned in our goals,” Bendel says.
“We meet regularly at a senior team, a director and manager level to discuss productivity, staffing, and contract labor management. This allows me to understand how I can support them,” Bendel says.
“We also have a multidisciplinary team of leaders that discusses throughput opportunities and length of stay to ensure we are getting our patients safely in and out of the hospital. The clinical leaders are also imperative when we increase capacity or add new service lines. We set up a task force to talk through many things including resources, equipment and supplies.
Challenges and Hurdles
One constant to Denton’s specialty care challenges is comprehensive coverage.
“I believe the organization as a whole is concerned about the premium tax credits set to expire in 2025 that will make health insurance more costly for those that have been able to access the marketplace plans and to be able to provide care for themselves and their family,” Bendel says. “That is the number one focus for HCA Healthcare and Medical City.”
As the country sees more medical debt, this will be a prominent issue for many health systems.
A recent report found that roughly 12% of U.S. adults (about 31 million) say they collectively borrowed an estimated $74 billion last year to pay for healthcare, either for themselves or a family member. Additionally, a majority of Americans, about 58%, say they are concerned they would experience medical debt if faced with any major health event.
Taking the Risk
Bendel shares that curiosity remains a vital component of her strategy as a finance leader.
“A mentor of mine told me to stay curious. When you are curious, you ask questions, and you find creative ways to solve problems. Or your curiosity could cause someone to think of a situation differently,” Bendel says. “So being curious is really important to understand the issues and think creatively at solutions."
Being curious goes hand-in-hand with exploring unconsidered options and creating pathways to take risks that can ultimately pay off for the health system.
“I am naturally conservative and more risk averse. However, experience has taught me that it is imperative to take risk in the right situations to continue to grow,” Bendel says.” If the business case supports the risk then go for it.
Here's how CFOs can leverage their unique position.
As health systems spend billions annually battling payers—CFOs have to recognize the power they have to turn financial losses into policy-driven reform. Healthcare CFOs must step up as strategic leaders to bridge the growing financial and operational divide between payers and providers. To drive real change, CFOs must move beyond financial strategy and into policymaking to advocate for fair reimbursement and operational sustainability.
Check out this infographic for three CFO tips for jumping into policy reform discussions.
The growing tension between payers and providers is no secret. And it's forcing CFOs to take action.
The following is an excerpt from our March cover story.
Providers have been fed up with payer behavior for decades; many have suffered financial turmoil from payer tactics, smearing contention across the picture of healthcare for everyone involved.
About 84% of health system CFOs cite lower reimbursement rates from payers as the top cause of low operating margins, according to a study published by the Healthcare Financial Management Association (HFMA).
Among HFMA survey respondents, 75% have also added more FTEs to handle insurance denials, and 63% have added staff to follow up on accounts receivable, both of which eat into a health system's budget just to keep up with payers.
Over the last few years some components of this dynamic between payers and providers have shifted, but arguably, not enough. There have been some wins, like increased transparency laws and modernized care models, but there have also been some losses, — and lawsuits — like payers using AI to inappropriately deny claims, fanning the flames of these disputes.
Even as recent as this month, health systems are opting out of settlements and choosing to fight back against payers with legal action. Dozens of health systems are currently suing Blue Cross Blue Shield for paying healthcare providers, "far less than they would have been paid in a competitive market."
Mayo Clinic is also currently suing Sanford Health Plan over $700K in unpaid medical bills for a patient that was treated over two years ago. Mayo said is not seeking payment from the patient.
It's instances like these that bring to the surface the strife between payers and providers, and patients that suffer.
Resentful Consumer Outcry
The murder of United HealthCare CEO Brian Thompson shone an uncomfortable, blinding light on the contention within healthcare; not between payers and providers—between consumers and the modern healthcare system.
The online backlash after Thompson's murder was nothing to shrug off, but in many ways, that's exactly what happened. Consumers used the opportunity to fire back over the struggles of obtaining affordable healthcare through today's insurers, painting a stark silhouette of spite against a horrific tragedy.
The harsh, inappropriate backlash from consumers took over the narrative for a brief second, but despite its widespread intensity, despite the decades of patients' rage that led to this horrific outcome, it didn't spark any significant change to healthcare or healthcare policies, it only brought about tension. Under this constant tension, cracks form, and systems break down.
"Though an unjustifiable action, we must recognize that there is a lot of friction that a lot of people, both payers and providers, know is there," said Rick Gundling, Senior Vice President for Content and Professional Practice at HFMA and a former CFO.
This incident was tragic and will always be tough to face. But the industry shouldn't let the discomfort of the situation muddy the waters of the underlying sentiment: many people have died because of denied care.
"It makes no sense to me that there is no true system that captures physical harm to enrollees related to denied or delayed prior authorizations," says Kurt Barwis, CEO of Bristol Hospital, registered lobbyist in Connecticut, and former governor of the American College of Healthcare Executives. "Healthcare is supposed to be evidenced based/do no harm … yet the use of prior authorizations gets a complete and total pass?"
According to a report by the Kaiser Family foundation, 19% of in-network claims and 37% of out-of-network claims were denied in 2023, for a combined average of 20% of all claims. All of this is not to say that payers undoubtedly carry all the blame, but rather that the American healthcare system has failed many, many people when they needed it most.
CFOs stand in a unique position that enables them to use their voice and expertise to advocate for policy reform. Read the full story to understand how, as well as the best strategies for seizing the opportunity.
