Trimming Weight and Balance Sheets: Q&A With Banner Boswell CFO Scott Leckey

For Scott Leckey, CFO of Banner Boswell Medical Center in Sun City, Ariz., triathlons and the healthcare system have a lot in common. Both require intense training, and both are defined by improved and sustainable success.

Mr. Leckey just started competing in triathlons a little more than a year ago, and since then, he has finished 18 different events. Even more extensive is his 20-plus years of healthcare financial experience, which has included tenures at Banner Estrella Medical Center in Phoenix and Kona Community Hospital in Kealakekua, Hawaii.

Mr. Leckey has witnessed both physical and mental benefits from staying active in triathlons, but most importantly, he ties the competitions to what has worked best for him in his healthcare career: Don't settle for a low goal. Success is achieved by continually raising the bar.

Question: You are a husband, father, CFO and tri-athlete. Can you explain how you fuse all those roles together?

Scott Leckey: I don't sleep much. It's an interesting mesh. Becoming a tri-athlete is a challenge for someone as an individual. You're kind of by yourself. You compete against yourself, and it's about your training. As a CFO, you work in teams. It's been a nice contrast for me. I rely on a lot of smart people to help me get things done in an environment that's always changing. I'm also very fortunate to have a very supportive family.

Q: How did you even get into triathlons?

Scott Leckey, CFO of Banner Boswell Medical CenterSL: About a year and a half ago, my wife, a fitness competitor, basically said I was getting fat. I was 240 pounds, and she essentially dared me to go run a mile with her. I almost died doing one mile. This was a challenge for me, but I needed to get healthy.

I met up with a fellow CFO at a different system, and he said it looked like I was losing weight. He asked if I wanted to do a local PF Chang's half-marathon in January 2011. We started training together in October 2010, did the half-marathon and it about half-killed me — but it was a life-changing experience.

Later, a co-worker here at the hospital was starting a triathlon class and said I should do it. I laughed about it — I hadn't swam over 50 yards in my life, hadn't ridden a bike in years — but I tried it, and it took off from there. It just took a whole lot of practice and time. I've lost 50 pounds since I've started doing this.

[How I prepare for triathlons] is how I've approached my work: It's about constantly going back and checking and challenging the norm. When you're training for a triathlon, you always have to set your bar higher. You can't say you're just going to run two miles. It's the same in healthcare.

Q: What has your hospital CFO experience been like, and can you explain how you got where you are today?

SL: I've been doing this for about 20 years. I started in public accounting, got my CPA and latched onto hospitals after I found myself being a patient. I was on the business side and patient side of it, and I was hooked. I started working in for-profit hospitals out in California, and I came to Arizona in 2006 to open a brand new hospital, Mountain Vista Medical Center in Mesa. That was a very challenging experience. We were starting with a skeleton crew and had three months to get ready to open. There were a lot of long, long nights back then. But I learned so much in that process that I'd do it again, and that goes back to what I was saying earlier. Even though you lay out and plan everything to the "nth" degree, it's a lot different when you're physically doing the work and have a patient in front of you.

Q: In the 20-plus years of healthcare financial experience you have had, can you pinpoint moments where challenges seemed insurmountable?

SL: MVMC was the number one thing. You're basically starting from a dead stop to a full sprint in no time, in addition to pressure from the [parent] company [IASIS Healthcare] to get it running. That was my biggest challenge, I think. Another example was when I had the opportunity to work out in Hawaii. This was going from a very fast-paced, for-profit system in Arizona to a very slow-paced system in Hawaii. Totally different mentalities there.

Q: What are some of the most novel ways other hospital CFOs can cut costs at their organizations?

SL: The number one thing is always questioning what the norm is. Are there more efficient ways of doing something?

For example, out in Hawaii — this is in 2009 — I was given a purchase request. This was a remote island, and it was once a state system up to 10 years prior, so they would send in requests for things and type it out on typewriter. There were 40 characters that the government required to process a payment. Over the 10-year span, no one looked at the request to point out payments were not processed locally and only eight characters were needed. So we quickly got rid of the typewriters and automated the process.

Q: What are some of the most important financial figures and measures that you keep track of on a daily, weekly and monthly basis?

SL: For us at Banner Boswell, we are a heavy Medicare provider, so we focus on hourly productivity. Other matrices are bed utilization and supplies. There are targets we have, and we benchmark against similar facilities, based on the level of service. In for-profit [hospitals], targets were quite honestly a lot thinner than ours. As long as our targets are reasonable and we're providing quality care, then that's where we want to be — and that's where we're at.

Q: Are there any specific healthcare issues that concern you most for this year and beyond? I know Arizona, in particular, has major Medicaid cuts coming soon.

SL: Medicaid is the top issue striking us between the eyes. Medicaid cuts have really affected us. We're heavily Medicare, but it's a $120 million problem for the entire [Banner] system — and that's on the low range. Obviously, we have to provide care to everyone who arrives at our doorsteps, but how can we optimize utilization and how they are cared for? How do we reach out to patients so they utilize the hospital less? That's kind of dovetailing into the ACO model.

Q: What gives you optimism as a hospital CFO right now, in light of shrinking reimbursements?

SL: Sometimes, it's hard, I gotta tell you. But we're all here to save lives. That's the whole reason I entered this field. I enjoyed my experiences as a patient and on the operations side. Even though reimbursements are down, at least we know we're making a difference in people's lives.

Related Articles on Hospital CFOs:

The Uninsured and Net Returns: Q&A With DeKalb Medical CFO Diane Harden

How Should Hospitals Work Around Medicaid Payment Cuts This Year?

St. Vincent's HealthCare CFO Mark Doyle: 3 Burning Questions Right Now

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