Hospital CFOs in Boston, NYC offer advice to colleagues amid pandemic

Hospitals and health systems in the U.S. are feeling the financial effects of the COVID-19 pandemic.

Across organizations, executives have adjusted their strategies and operations as lower patient volumes dampen revenue streams. Here, CFOs from hospitals and health systems in states hardest hit by the public health crisis so far share their top priorities and key advice for their colleagues preparing for a surge of COVID-19 patients.

Kristine Hanscom, senior vice president and CFO of Tufts Medical Center (Boston): As this crisis first unfolded, my top priority was cash flow, fearing that we may have had to sell investments in a down market to pay our bills as our top line revenue dropped quite quickly due to the volume restrictions on ambulatory and elective procedures. 

With the advances from CMS and others, cash flow has been taken off my worry list. Now our priorities are trying to stay on top of stimulus dollars that are available, applying for them and conforming to reporting and other requirements attached to them. Also, we are focusing on the available FEMA grants and the requirements around those, in order to make sure we take advantage of all funding sources available to offset the costs we are incurring related to COVID-19. And, although Massachusetts is in its surge right now, I am focusing heavily on what our new reality will be after this passes, how that future will impact our financial performance and how we will respond to those changes to bring us back to profitability and prosperity.

Key advice: My best advice would be to allow the clinical leaders to have and do what they need to be comfortable and ready for what is coming, and to stay in close contact with those leaders, offering advice when needed. While they are fighting the battle on the front lines, you should start focusing on the pathway forward. What do your future operations look like? How will this change your business going forward and what is the financial impact of that? Build robust but flexible models so you can see what is happening to your financial performance as stimulus and financial assistance packages are announced, rate changes occur and volumes fluctuate from your initial assumptions. Lastly, start pulling together your thoughts on where the organization may look to decrease costs or increase efficiencies in the future. Having some good ideas to focus on quickly will be key to driving performance back to whatever the new normal will be as quickly as possible.

Daniel Widawsky, executive vice president, vice dean and CFO of NYU Langone Health (New York City): The priorities are very clear right now: Provide care for all of our patients at the highest quality in the midst of this pandemic, and ensure that our front-line clinical teams are fully supported.

In terms of our workforce, all employees across the organization, whether on the front lines or not, have continued to serve with professionalism and compassion, caring for our NYC and Long Island community. From a financial perspective, we do not want them having any additional stresses, especially as it relates to finances and being able to continue supporting themselves and their families.  While the financial impact of halting all non-emergent surgeries and elective care has been sobering, we have managed to pay everyone and furloughed no one. 

Key advice: My advice for colleagues is simple. Do not underestimate this virus, be prepared and communicate. Create a crisis response team, ensuring you have representation from all areas and work together on your plan.

You will need to think about creating surge space, the need for increased levels of critical supplies sourced and purchased, the need for temporary clinical staff and/or the re-deployment of existing staff, telehealth options and work remote options for non-patient facing roles and the IT support both will most definitely need, a plan for running essential financial functions remotely and for daily communication to staff so they feel connected.

Life as you know it will change and you need to be able to adapt quickly. Stay nimble, communicate frequently and you will develop a flow.



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