Mark Behl, president and CEO of Fairfield, Calif.-based NorthBay Health, isn’t against bold investments. But right now, with federal policy uncertainty squeezing margins and workforce costs still elevated, he has imposed a discipline on his organization that a lot of health system leaders might find uncomfortable.
He told his team if a new initiative can’t demonstrate a return in the near term, it doesn’t get funded.
“The challenge that we all have been facing around HR 1, and the financial headwinds in front of us, is how do you continue to invest in growth? How do you continue to invest in technology when you have limited resources?” Mr. Behl said during an interview with “Becker’s Healthcare Podcast.”
His answer has been to reframe the question entirely. Rather than choosing between growth and austerity, Mr. Behl has pushed his teams to find solutions that do both by generating enough short-term return to fund the next round of growth.
“We’ve had to go back and challenge our teams to really find solutions that can also help us grow while at the same time having a short term ROI so that we can ensure that we do have enough resources to be able to continue to grow,” he said.
NorthBay Health serves communities across Napa, Solano County and Yolo County — a mix of suburban, rural and agricultural areas in the corridor between San Francisco and Sacramento. The system’s strategic priorities this year have centered on growth, workforce stability and access to care, all of which require investment at exactly the moment when spending money is hardest to justify on paper.
That tension is real for CEOs across the country. But Mr. Behl has found that enforcing it requires going beyond individual financial discipline to bring the workforce along.
“Aligning the workforce around that has been obviously challenging,” he said. “But I think it’s important that we are very honest with our teams about those challenges that we face and the importance of getting things right.”
That honesty has changed the breadth and depth of proposals crossing his desk. When frontline teams understand the constraints, they stop waiting for solutions to be handed to them and start generating their own.
“The people that should improve the work are the people that actually do the work,” he said. “All of our clinicians are really smart people. If you give them the data and you help them understand the challenges that we’re facing, they’ll figure things out, much like we would. They’ll come to us with solutions that maybe we weren’t thinking about because they have a different perspective.”
After green-lighting a project, the team is accountable for producing results. Mr. Behl has built his operating cadence around dashboards and meeting rhythms designed specifically to surface whether stated priorities are actually moving — not just whether activity is happening. In a moment when uncertainty is high and morale is fragile, visible progress matters as much as actual progress.
“When you start to put points on the board, so to speak, I think everybody gets energized around that because they’re seeing progress,” he said.
Even workforce strategy runs through the ROI filter, though on a longer horizon. Physician, nursing and clinician shortages in the U.S. are structural, not cyclical, and that filling gaps reactively is not sustainable.
“We’re going to have to find ways to really tap into some other labor forces, and that includes international workforces that we can really start to build a pipeline,” he said. “We have to be a little bit more thoughtful and proactive about how we can really take care of the long term supply issues that we have in our country by finding ways to work with those other countries and those other systems to help develop future pipelines.”
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
