20 hospital CFOs, revenue cycle execs share advice, challenges and what's ahead for 2020

Hospital and health system CFOs and revenue cycle leaders have navigated many changes in the healthcare industry in 2019. Many headed up initiatives to make prices more transparent to patients, revamped billing and payment practices, and developed strategies to expand into new markets or partner with other organizations.

This year, dozens of finance and revenue cycle leaders from hospitals and health systems across the U.S. shared their perspectives on a variety of topics with Becker's Hospital Review. Below are quotes from 20 of those executives, discussing everything from the best piece of advice for their peers to how they overcame challenges this year and are preparing for headwinds they'll face in 2020. 

Note: Responses are listed in alphabetical order by hospital or health system.

1. Daniel Morissette, CFO of CommonSpirit Health (Chicago). "I believe inspiration is a two-way street — when times call for innovations in the way things have always been done, you never know where a good idea will come from. CommonSpirit has a unique opportunity to enhance the delivery of healthcare in communities across the country, and we want every person in our organization — from the radiologist technician to the physician's assistant — to be inspired to provide the best possible care to every patient, and to each other, every single day. It is my hope that every person in CommonSpirit is inspired along our journey."

2. Douglas Myers, senior vice president and CFO of Driscoll Health System (Corpus Christi, Texas). "I think the biggest challenge is always staying ahead of the curve. Being able to look into the future and plan out where the organization is heading and course-correct if necessary. It's better to be proactive than reactive. So, the challenge is looking for new and diverse revenue streams, making sure you are hitting benchmarks on expenses by staying disciplined and making hard decisions if necessary. I don't want to be the one to hit the iceberg."

3. J. Britton Tabor, executive vice president, treasurer and CFO of Erlanger Health System (Chattanooga, Tenn.). "I believe that revenue cycle is not just a finance function. A well-run revenue cycle is dependent on the total team. The team should be inclusive of all the constituents, including physicians."

4. Julie Georgoff, vice president of finance and CFO of Magruder Hospital (Port Clinton, Ohio). "Work to help your hospital to think differently. Explore strategies for the 'yet to be defined' competition and think like an insurance company about access, cost of care, service definitions and what is sustainable."

5. Donna Graham, executive director of revenue cycle at MetroHealth System (Cleveland). "Stay ahead of what's going on while managing the day-to-day tasks. You can't do one without the other. Vision and sustainability require integration — not sequential steps. With the revenue cycle, you have to be tenacious, you have to be passionate, and you have to be unyielding with vision so you're always ahead of the game. You can't be hesitant to be a pioneer, and you have to persevere."

6. Ron Christenson, CFO of Morris County Hospital (Council Grove, Kan.). "Find out what your true cost of delivering healthcare services are. Be prepared for changes that are inevitable surrounding the delivery, and payment of healthcare services. Everyone is screaming about the high cost of healthcare today. Everyone wants access, but no one wants to have to pay for it."

7. Jana Danielson, executive director of revenue cycle at Nebraska Medicine (Omaha). "Technology continues to change. It's bringing significant opportunity for us to evaluate how we do our work, to automate things as much as possible where we can, so we can focus on things that are most important to our patients and bring the most value to the organization as a whole."

8. Jim Meyers, system vice president of revenue cycle at Norton Healthcare (Louisville, Ky.). "Reach out and network with your peers. The best consultant many times is a colleague or someone else in that situation. We are all dealing with many of the same challenges, and there are occasions where someone just may have figured it out. I've found time and time again how receptive, informative and gracious my contacts are, and I value them tremendously."

9. Gerard Brogan Jr., MD, senior vice president and chief revenue officer at Northwell Health (New Hyde Park, N.Y.). "This year we have very aggressively deployed the utilization of bots for robotic process automation technology to make tasks that are highly repetitive and have low levels of variability as automated as possible, freeing up staff for more labor-intensive functions within the revenue cycle. That's probably yielded the greatest efficiencies and the bigger process/operational change in the revenue cycle of anything we've found."

10. Michelle Taverna Farrell, assistant vice president for revenue management at Orlando (Fla.) Health. "Make sure you have the right team in place. There is no system or technology that can substitute for an engaged workforce."

11. Michael Allen, CFO of OSF HealthCare (Peoria, Ill.). "There are complexities to [pricing and billing]. But we as an industry need to figure out how to get the complexities off the consumers' plate, put that in the background so they don't have to see it, and come up with a better and simpler approach for them."

12. Dan Angel, vice president of revenue cycle at Penn State Health (Hershey, Pa.). "Listen to your consumers. I personally interact with many patients and prospective patients and like to take their feedback. Like any business, the leaders of that business should listen to their consumers to understand what their expectations are and would make them comfortable in choosing your facility."

13. Jane Gray, vice president of revenue cycle at Phoebe Putney Health System (Albany, Ga.). "I'm big on weekly review of metrics. We've gotten into a rhythm where we review operational performance every week, whether we need it or not. Our entire management team gets together for a couple hours to review performance against preset targets for each major function of each area — it holds people accountable."

14. Kari Cornicelli, vice president and CFO of Phoenix Children's Hospital. "My advice is simple … find a position and team that you enjoy working with; leverage your skills and talents to make a difference. Enjoy the job and enjoy the journey. This is a great industry to be a part of and the role of a CFO is essential to every organization's success."

15. Brian Unell, vice president of revenue cycle transformation at Piedmont Healthcare (Atlanta). "The best way to mitigate the risk of a billing dispute is to ensure the patient knows their benefits and expected out-of-pocket costs for the services they are receiving prior to service. At Piedmont Healthcare, this is done through ensuring we have an accurate order for the service that will be performed as well as the correct insurance information."

16. Venkat Bhamidipati, executive vice president and CFO of Providence (Renton, Wash.). "When I consider our day-to-day operations at Providence, what stands out most to me is how our revenue cycle team has accelerated our use of insights and analytics. Even functions as simple as visualization tools have enabled greater access to and engagement with data among our revenue cycle and finance colleagues. This has made a real difference. We have more conversations, and more problem-solving conversations that advance us toward issue resolution, than before."

17. John Doll, executive vice president and CFO of RWJBarnabas Health (West Orange, N.J.). "More so than ever, in 2020 and beyond, we have to be nimble. The tools and techniques that have helped make us successful continue to be important. We need to ensure that our organizations have the right level of financial discipline, but we also have to recognize that a lot of the changes that are necessary in our industry are new and different — and are going to require different sets of skills and ways of looking at things. Flexibility will be a crucial skill for CFOs to help everybody in the organization, from the operations leaders to executives, make the right decisions."

18. Robert Mueller, vice president of revenue cycle at St. Luke's Health System (Boise, Idaho). "Focus on developing revenue cycle leaders in your organization. You're only as good as what your leadership can do. I think that's what helped me be successful — training up leaders. I also think it's important to stay connected with operational leaders so that they understand the complexity of the revenue cycle, and you can work with them when changes occur and have to be implemented."

19. Kristine Hanscom, senior vice president and CFO of Tufts Medical Center (Boston). In the future, taking on risk will be increasingly important. This, in turn, drives the need for greater collaboration with our physicians and partners to manage the cost and quality of care for our patient population. We need to fully embrace outcomes-based healthcare in order to survive the transition to value-based care."

20. Dan Rieber, CFO of UCHealth (Aurora, Colo.). "UCHealth's focus on providing an excellent experience for our patients includes increasing transparency in the insurance and billing process. Real-time authorizations help to eliminate surprise billing. As we provide accurate estimates for patients and expectations of what a bill will be, patients are able to have a choice."

More articles on healthcare finance:

10 states with the most for-profit hospitals
How 2 former debt collectors helped erase $1B in medical bills
29 hospital closures, state by state

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