4 questions with ProMedica CFO Michael Browning

Michael Browning is new to his position as CFO of Toledo, Ohio-based ProMedica, starting the job Aug. 8. But with more than 25 years of experience in healthcare finance, he is not new to the industry.

Prior to joining ProMedica, he was CFO of WakeMed Health & Hospitals in Raleigh, N.C. Before that, he was at Parkview Health in Fort Wayne, Ind., where he served as senior vice president and CFO from 2010 to 2015.

All of this experience prepared him to become CFO of ProMedica, a 12-hospital system with about $3 billion in annual revenue.

Mr. Browning recently spoke with Becker's Hospital Review about the greatest challenges facing health system CFOs today and how ProMedica is navigating the shifting reimbursement environment. 

Note: Responses have been lightly edited for length and clarity. Browning Mike

Question: What first piqued your interest in healthcare and set you on the track to becoming ProMedica's CFO?

Michael Browning: I workedin Northeast Indiana for about five years and knew ProMedica pretty well. I met with Randy Oostra, president and CEO of ProMedica, a few times and really liked his style and the way he did things. And ProMedica has an extremely strong reputation for being high-quality and cost effective. From a CFO perspective, that's very important to me. What sets ProMedica apart is they're very strategic and innovative. A lot of health systems provide good quality care and are very cost effective, but ProMedica is doing some real strategic and innovative things, and that's where I thought bringing all these pieces together would be a good opportunity for me to further develop and become a better leader.

Q: What is the greatest challenge facing hospital and health system CFOs today?

MB: There are many significant challenges facing CFOs in the healthcare industry today. The first major challenge is related to costs. We are seeing costs rise faster than revenues with three areas rising faster than most and they are technology, drugs and personnel. This challenge requires us to be much more innovative as CFOs and look at our investment in existing service lines as well as analyze new services we can offer to grow the revenue base at a faster pace than our expense growth or at a minimum, we must keep pace.

The second significant challenge is managing both volume and value-based models simultaneously. We've always been in a situation where we've been paid based on volume but now we also must mange the value side. And if this weren't challenging enough, we've got payers that are struggling to understand how to compensate us for value, and in most instances, we're not being compensated for value at all. The lack of reimbursement is especially challenging considering the amount of investment that it takes to manage the value-based model.

The third challenge is payers and employers are shifting costs to the consumer and this shift is significantly increasing the patient’s out-of-pocket cost. This additional burden is causing patients to struggle to pay their bills. So we're working with those patients to help identify sources of assistance for them, but in some instances, patients just can't afford their co-pays and deductibles. In many of those situations, it's unfortunately going to bad debt which means we're not being compensated for the care. To manage this challenge, we must continue to work closely with our patients to assist them to identify better options on how they can manage their healthcare debt.

Q: How is ProMedica navigating in the shifting reimbursement climate?  

MB: ProMedica's been in the health insurance business since the early 1990s, so we have been dealing with the focus on value longer than most organizations. Understanding the value proposition helps ProMedica manage the change in reimbursement. But even with experience in this area, ProMedica still has its challenges because of the significant changes to reimbursement. Unfortunately, there's not a single strategy to deal with the reimbursement changes. Every transaction that we encounter is different and often requires more creative solutions. One thing that's certain is the changes in reimbursement are requiring us to be more innovative and flexible. Even though ProMedica's done this for many years, it's still a challenging environment for us that we're no different than other organizations — just a little bit more prepared.

Q: What is one goal you have for the next year and how will you achieve it?

MB: My main goal is to support our operating team to deliver safe, high-quality care in a cost effective manner for all the people we serve. It's a big goal and it takes a lot to get there. But if we're able to achieve this then we'll continue to be successful.


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