Trinity Health CFO Ben Carter talks markets, mission and sustaining momentum

Ben Carter has a long history working in healthcare finance.

He serves as executive vice president, CFO and treasurer of Livonia, Mich.-based Trinity Health, a nonprofit Catholic health system providing services to residents of 22 states through 94 hospitals and 109 other care locations.

Mr. Carter handles the system's financial planning, including the areas of risk management, revenue excellence and payer strategies.

Before joining Trinity Health in 2010, he was executive vice president and COO of the Detroit Medical Center, where he played a key role in its turnaround and six consecutive years of profitability.

He also held executive-level positions for nearly 17 years at Oakwood Healthcare in Dearborn, Mich.

Here, he shares one of his proudest achievements as Trinity Health's CFO, discusses the system's financial strategy and offers advice for other hospital finance chiefs.

Note: The following responses were lightly edited for length and clarity.

Question: Since joining Trinity Health, what has been one of your proudest moments as CFO?

Ben Carter: There have been many successes in my career at Trinity Health, but what I am most proud of is the nine consecutive years of financial success characterized by steady and predictable earnings and strong financial performance, as affirmed year after year by the ratings agencies. The achievement has come during a time of significant complexity, a time when we began transitioning our focus from volume to value, and accomplished a significant merger with [Newtown Square, Pa.-based] Catholic Health East, in 2013.

Q: What is the greatest challenge hospital and health system CFOs faced in 2018? Do you expect this to be their biggest challenge in 2019 as well?

BC: There were many challenges in 2018 — volume declines, payment reductions, cost inflation and labor shortages, to name a few. The changing focus of healthcare is the biggest challenge faced by hospital and health system CFOs today. Historically, the way hospitals have made money is different from the way we will earn in the future, but, today, we live somewhere in between these worlds.  As organizations pivot to value, we are forced to manage in these dual worlds — and that is hard. It is just a very complex dynamic that we have to live with until the health system is completely transformed. I think that last year many healthcare organizations saw their margins compressed, and we all talked about "headwinds" then. Those headwinds certainly continue today, and we are challenged to keep our momentum.

Q: What major changes in healthcare have you seen in recent years that you would have never expected when you started in the industry?

BC: I don't know that 30 years ago I would have even imagined equity investment in healthcare at the level we are seeing today.  Private equity firms are buying hospitals, physician practices, specialty clinics, radiology centers and more, really competing with traditional hospital providers in nontraditional ways. We are also starting to see much more vertical integration — CVS buying Aetna, as one example. It makes for a lot of nontraditional disruption — and surprise. I also never thought I would see the day where health insurers would be buying physician practices and competing with us, while we are also in their provider networks, but that day is here.

Q: What philosophies, events or people influence your leadership style?  

BC: I am a student of great leaders and aspire to great leadership because it brings people together and accomplishes great things. I read a lot about — and from — different types of leaders — from presidents like Abraham Lincoln and George Washington, as well as business people like John Francis "Jack" Welch Jr., Alan Mulally and Steve Jobs. In addition, I have studied under great mentors in all of the four organizations in which I've worked. I try to take the best of what I see and what I read and then try to mold my own brand of leadership. I enjoy these pursuits, and I keep trying to hone and sharpen my leadership skills based on my belief in the power of ongoing, continuous learning.

Q: Trinity Health serves more than 30 million people in 22 states; how does your financial strategy differ by area?

BC: Our overall strategy is guided by the system's focus on becoming a truly people-centered health system. Each of our markets are different, and so financial strategies for success must be tailored to each. Strategies must be based on the way our regional systems compete in their respective markets given market conditions, competitive positions, etc.  Points of emphasis may change from one region's strategy to another, but each region's strategic financial plan emerges from those strategies — guided by our strategy to build a people-centered health system.

Q: How does Trinity Health's role as one of the nation's largest multi-institutional Catholic healthcare delivery systems affect your responsibilities as CFO? 

BC: We are a faith-based organization, and we are very much guided by our mission and our core values. As CFO, those truly defining features guide the decisions I make. Financial decisions often cannot be purely financial at Trinity Health; they must also be made with full consideration of our organization's mission.

Q: If you could pass along one nugget of advice to another hospital CFO, what would it be? 

BC: I have three pieces of advice. One is to listen first — don't rush to judgments or decisions; always be well-informed. The second is read the Wall Street Journal every day — and be a continuous learner. Third, just remember you don't know everything and that you can always learn from others. It is by including the opinions, information and perspectives of others that you can bring people together and be most effective.


More articles on healthcare finance: 

For-profit hospital stock report: Week of March 11-15
MACPAC seeks more gradual phase in of Medicaid DSH cuts
Montefiore Medical Center's annual operating margin slightly declines

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