The most pressing issues for CFOs in 2017

A panel of CFOs shared their thoughts on some of the most pressing issues CFOs address at Becker's Hospital Review 5th Annual CEO + CFO Roundtable on Nov. 9, 2016.

With physician shortages affecting hospitals nationwide, CFOs are doing whatever they can to make sure their systems are properly staffed.

Sandwiched by major health systems Donald Longpre, CFO of North Ottawa Community Health System in Grand Haven, Mich., is experiencing the shortage first hand.

"Physicians were leaving and going in all other directions," Mr. Longpre said.

The competition his health system faces has created several challenges for Mr. Longpre. Not only does he have to bring in specialists that aren't already in the area to avoid a duplication of service, but he has to consider the long standing relationships patients may have with their physicians.

"I did not anticipate that we'd have to combat that," Mr. Longpre said.

Amy Fioria, CPA and CFO at Goshen (Ind.) Health is also combating a shortage. Her system in Northern Indiana experiences difficulty adding high quality physicians to her staff; it has forced her to get creative.

"We're starting to use more nurse practitioners because of the physician shortage," Ms. Fioria said. "It addresses the access to care issue."

Her system also scaled back the services it offers to ensure that it gets the most out of its staffing costs.

R. Jason Standifird, CFO at EmCare in Englewood, Colo., and his national physician practice for hospital-based specialties are 90 percent fully recruited. However, his health system is still about 1,000 physicians short, a trend he doesn't "see changing anytime soon."

One strategy to combat the physician shortage is to ensure physicians are practicing at the top of their licenses. "We're taking those administrative tasks that are not a physician treating a patient off their plate and it helps drive better efficiency through that program at the right cost to address that shortage," Mr. Standifird said.

Another issue facing hospitals is a stagnant reimbursement rate. Hospitals are now looking to lower the provider based cost of care.

Ms. Fioria said her system has to become a little bit tougher with its spending and start considering partnerships with health systems that are making profits on certain specialties Goshen does not.

"From a pure cost perspective we need to get smarter and lower utilization," she said. "At the same time you have to grow. You have to know what service lines will be profitable and stay in those. We have a hard time stopping what we've already been doing but we try to realize that we don't have to do everything and be everything. We just have to provide access to our patients for that."

Ms. Fioria suggested examining the service lines that are doing well, working to tighten the ship to make them more profitable and partnering the with other organizations to fill the deficiencies.

Mr. Standifird believes lowering utilization and outsourcing care is a real possibility in the current health system picture.

"You have to become more mindful of appropriate utilization." Mr. Standifird said.

Mr. Longpre had one example of how his system is lowering utilization. For example, he identified a patient that had gone to the emergency room 97 times in one year. Although it helped add to the profit margin for the emergency department, it was creating an irregularity. The health system convinced the man to go to an urgent care facility instead of the ER, which helped to increase utilization rates. 

This article was updated on Nov. 22, 2016 to correct the following: it stated that EmCare was 10,000 physicians short of its recruitment goal. It is 1,000 short. It also mislabeled EmCare as a health system. It is a national physician practice for hospital-based specialties. We regret those errors. 

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Managing a patient's episode of care for bundled payment success

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