What 68 health system leaders have done to boost the bottom line

Becker's asked C-suite executives from hospitals and health systems across the U.S. to share their organization's areas of growth for the next few years. 

The 68 executives featured in this article are all speaking at the Becker's Healthcare 14th Annual Meeting on April 8-11, 2024, at the Hyatt Regency in Chicago.

To learn more about this event, click here.

If you would like to join as a speaker or a reviewer, contact agendateam@beckershealthcare.com. For more information on sponsorship opportunities, contact Jessica Cole at jcole@beckershealthcare.com.

As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. The following are answers from our speakers at the event.

Question: What is the smartest thing your team has done over the last 12 months to contribute to your system's bottom line?

Shelly Schorer. CFO of the California Division at CommonSpirit Health (Chicago): I would say that the one thing we have done is a deep dive/focus on all aspects of the revenue cycle. This includes denial management, coding accuracy, documentation, timely filing, cash collections, payer receivables, follow up and working large balance and clinically complex accounts. Made quite a difference to really focus and have all hands on deck!

David Verinder. President and CEO of Sarasota Memorial Health Care System (Fla.): Remaining laser-focused on sustainable staffing and workforce development. Our team's multi-pronged approach to improve recruitment and retention, reduce turnover, decrease our reliance on costly contract staff and drive performance excellence includes:

  • Establishing robust training and research programs, with plans under way for a state of-the-art dedicated facility, to promote staff development and innovation.
  • Offering defined career paths, internships and tuition reimbursement to support the professional and personal growth of staff in both clinical and non-clinical positions. 
  • Partnering with academic and community institutions to strengthen the talent pipeline, while improving onboarding to boost new employee retention and engagement. 
  • Ensuring that staff safety is a top priority with the enhancement of workplace violence prevention initiatives. 
  • Focusing on staff's work-life balance by developing a "mobile float pool" for employees who need maximum flexibility. We also have increased staff's paid time off and reinforced employee assistance and wellness programs, including offering an initiative targeting nurses' well-being.

Our investment in our workforce has resulted in improved turnover rates, increased efficiency, lower contract and premium labor expenses, increased employee engagement and superior outcomes, all while maintaining a positive bottom line. We recently earned Magnet Nursing Recognition for the fifth consecutive time, which is a tribute to our success in creating an environment that promotes excellent care. Sarasota Memorial also was included among Forbes' "Best-in-State" employers, ranking No. 1 among all healthcare employers on the Florida list.

Seth Ciabotti. CEO of MSU Health Care at Michigan State University: Rolling out an employee satisfaction survey – then using the results to lay out an action plan offering our middle management leaders better tools to lead more effectively. In many ways we had neglected their input and had taken their talents for granted. Our managers are vital for our transformation. This has shown as having a positive impact on our bottom line both last year and for the current fiscal year. 

Michael Stapleton. President and CEO of Thompson Health (Canandaigua, N.Y.): Coming out of the last three years, recruitment and retention is our number one strategic priority. We started a Recruitment and Retention Committee which meets weekly. This committee is led by our executive team and has set specific recruitment and retention targets. Goals included hiring 50 new RNs by July 1st and we surpassed this goal. We have numerous metrics we are now utilizing around fill rates, accepted offers, declinations among other metrics. The success of this group has led to a 50 percent decrease in travelers and we will be in single digits by the end of the year.

Jared Antczak. Chief Digital Officer of Sanford Health (Sioux Falls, S.D.): At Sanford Health, we are dedicated to focusing on our people, our patients, and our communities and acknowledge that at the end of every decision is a person. Remaining viable as a healthcare provider in our communities requires us to identify opportunities to increase efficiencies and sustainable processes. Over the past year, we have leveraged technology to automate many manual tasks and empowered our workforce to focus their valuable time and attention on more important responsibilities. 

We have also launched a new digital registration experience that has enabled patients to self-serve their check-in process. The engagement from our patients has been incredibly high, resulting in reduced no-show rates, increased co-payment and prior balance collections, increased patient satisfaction, and significant workforce hours saved. Digital transformation is one of the smartest things we have done and will continue to do for the benefit of our organization and our patients.

Stephen DelRossi. Interim CEO and CFO of Northern Inyo Healthcare District (Bishop, Calif.): 

  1.  "Right-sized" – aligned staff and services to meet the flow of patients.
  2. Expansion of high-yield services such as cardiology and urology.
  3. Reduction of expenses, especially in SWB.
  4. Contract re-negotiations with vendors and payers.
  5. Closed and/or reduced elective services that were losses.

Steven Airhart. Group CEO of Hartgrove Behavioral Health System and Garfield Park Behavioral Hospital: As we are abundantly aware of how the pandemic had long-lasting impacts to our business. One such impact was the extreme shortage of critical staff resources. During the last few years, it became a significant challenge to secure the talent we had grown accustomed to. As a result of the talent pool shrinkage, we also experienced the quality of employees including professionalism, customer service, and patient-centric focused care impacted. During 2023, the smartest thing my team and I have done has been to return to the pre-pandemic hiring practices. 

We have resumed the more restrictive and selective protocols to once again ensure that our patients are not only provided the best care, but also provided the most professional, customer service-oriented, and patient-centric care. As leaders, we did what we had to do in order to survive the pandemic, but we are back to the pre-pandemic hiring practices, and that impacts our bottom line in many positive ways. 

Kenneth Waller. CEO of Norwalk Community Health Center (Conn.): Norwalk CHC has been able to strengthen its workforce through medical provider retention and recruitment. In addition, we have enhanced our telemedicine strategies to ensure our patient population is able to receive access to medical care wherever they are. Moreover, we continue to seek new opportunities to establish strategic service offerings that will meet the medical care demands in our market. We believe these specific initiatives have certainly been attributed to our organization's viability and long-term financial sustainability.

Gina Calder. President of Barnes Jewish St. Peters Hospital (St. Peters, Mo.) and Progress West Hospital: The intentional hiring of diverse leaders for the two hospitals in St. Charles County has enabled us to lean into our three 2023 BJC Priorities and contribute almost +0.4 percent favorable impact to system overall revenue compared to plan for 2023.

Growth: Strategic planning and recruiting/retaining/aligning quality providers in the bone and joint, heart and vascular, stroke, and cancer services has increased revenues by more than $85 million or 8 percent over the prior year for 2023.

People: Reduction in both the adjusted voluntary turnover to ~16 percent and the use of agency nursing, respectively, is saving approximately $578,000 annually and will decrease expenses by $3.2 million over a 12-month period. 

Value: Expanding hours and improving process efficiencies in several key strategic areas has increased MRI revenue by $5.8 million. GI revenue is projected to increase by $1.1 million over 12 months and surgical capacity has increased by ~12 percent which will generate another $18.2 million in incremental revenue.

Bharat Magu, MD. Senior Vice President and Chief Medical Officer of Yuma Regional Medical Center (Ariz.): In FY 2023, the team's paramount achievement was securing actual savings of $15 million compared to the expenditure in FY 2022, not merely against projected budgets. This substantial reduction represents 2 percent of the operating margin. Remarkably, each department had established savings targets that collectively enhanced the overall financial performance, and this feat was accomplished with two months still remaining in the fiscal year.

Christine Larson, BSN, RN. Vice President of Medical Group Operations at Advocate Aurora Health (Downers Grove, Ill.): One of the smartest things we've done over the past 12 months to enhance and increase the medical group's contribution to the system's bottom line, is to increase access to primary care physician practices through scheduling optimization to ensure patients have a clear and easy pathway to obtain primary care and continuing chronic disease management by leveraging our patient portal and online presence. 

We have reduced the number of visit types in our scheduling system to reduce patient confusion and standardized appointment lengths or enabled physicians / advanced practice clinicians to use a balanced average instead of long/short appointments. This has resulted in excellent patient experience improvements and increased clinician engagement. 

John Nickens. President of Hospital Services and Chief of Pediatrics at LCMC Health (New Orleans): Over the past year, one of our team's most insightful and innovative moves has been the implementation of 'Delivering on the Vision' – a program that offers a more centralized approach to the way LCMC Health operates our hospitals and supports our patients. By uniting all nine of our hospitals under this initiative, we've effectively harnessed the collective power of our diverse healthcare network to address challenging issues with creative and efficient solutions. 

Delivering on the vision is a collaborative effort that not only allows us to leverage the strengths of some of our hospitals but also provides essential support and guidance to areas that require improvement. This initiative simultaneously addresses two critical nationwide issues – the ongoing challenge of workforce shortages and the need for stringent budgetary efficiencies. By establishing a culture of continuous improvement, we create a strong sense of community between all hospitals, and overall, offer our patients a better experience.

Ginny Torno. Administrative Director of Innovation and IT Clinical, Ancillary, Research Systems at Houston Methodist: The Houston Methodist Innovation team has piloted several technologies over the past year that will transform patient care and reduce the impact on the bottom line by helping decrease the pressure on nurse/ patient ratios. We are currently planning a system-wide expansion of BioIntellisense's Bio Button technology. This technology captures multiple patient vitals and trends them over time, as well as capturing the data in Epic. 

We have already adjusted the amount of time between manually checking patient vitals and plan to continue spacing out manual checks, freeing up the nurses to do more critical tasks while improving patient satisfaction. It will also take the place of more expensive telemetry monitoring in some areas. We are also piloting platforms that enable virtual visits in the inpatient setting. All of this and more is under an umbrella project we call "Care Redesign." We plan to reduce the bottom line impact while improving patient and care team satisfaction.

Holly Geyer, MD. Chair of Mayo Clinic Opioid Stewardship Program of Mayo Clinic (Rochester, Minn.): We treated opioid use disorder (OUD)! Dependence on opioids occurs in 3-19 percent of patients who ever receive the drug and complications are costing the US healthcare system $35 billion annually. For every one opioid overdose, there are 4.3 ER, outpatient and inpatient visits for that patient and those with OUD have 8 times higher annual healthcare costs and 12 times more ER visits than patients without the condition. If you want to save your bottom line, save your patients from these drug toxicities. 

Every DEA-licensed provider in America can now offer two life-preserving treatments for OUD without special training: buprenorphine and naloxone. Make these standards of care and educate from the C-suite to the basement. Build your providers the infrastructure to support OUD diagnosis, treatment and external referrals. This epidemic has cost more than we can fathom. Let's stop focusing on what we can't afford to spend and look at what we can no longer afford to lose.

Laurie Hunter. Senior Director of UAB Medicine (Birmingham, Ala.): UAB Medicine has decreased readmissions by improving access to timely follow-up care for high-risk patients. We implemented the Post Discharge Clinic to provide a clear and efficient pathway for patients to be scheduled for ambulatory follow-up after they are discharged from our emergency departments or hospital. These appointments may be the same day, next day, or at a follow-up time most appropriate for the patient's needs. 

Our timely follow-up pathway improves the continuity of care for patients who are experiencing effects of illness or disease that do not currently require hospitalization, such as management of diabetes, hypertension, or cardiovascular disease. The Post Discharge Clinic helps us "close the loop" by providing a more consistent and efficient management of patients facing challenges with medication or home health care, or who miss their post-discharge appointments.

Ebrahim Barkoudah, MD. System Chief and Regional Chief Medical Officer of Baystate Health (Springfield, Mass.): Operational Efficiency: The team should leverage technology to streamline operations and reduce costs. For instance, implementing AI-powered predictive analytics can help manage patient flow more efficiently, reducing unnecessary costs. Partnerships and Collaborations: Forming strategic partnerships and collaborations with other healthcare providers, or research institutions can contribute to the bottom line by sharing resources and knowledge and potentially opening up new avenues for revenue. 

Patient engagement: Increasing patient engagement through personalized care, user-friendly digital platforms, and enhanced communication can improve patient satisfaction. 

Value-Based Care Models: Some organizations have transitioned to value-based care models, which focus on patient outcomes rather than the volume of services provided.

Matt Lutz. COO at HCA Florida Largo West Hospital (Largo): In a resource-constrained environment, the smartest path has been to focus attention on length-of-stay management. By ensuring that we are properly tailoring our care for patients and ensuring that the right care is provided in the right setting, we've been able to increase the amount of patients that we are able to serve. Focus around emergency department throughput and inpatient LOS has allowed our team to increase earnings without the need for capital expenditure or new expense.

Stephen Merz. COO of Sheppard Pratt Solutions (Towson, Md.): Daily operating tools to more effectively manage volume and expense.

Mark A. Davis, MD. COO of Miami Cancer Institute / Baptist Health Cancer Care: In the last two years we have undertaken an organizational redesign to consolidate many reporting verticals in service areas in favor of a local team approach. Each service line team receives data including from our operations and finance areas. Metrics have been created and each team leader has responsibility and authority in their area with interpretive and tactical support provided by senior leadership. 

We established a new comprehensive dashboard to house all data in one place for executive review. And, very importantly, culture has been advanced to be team-based and Just – I call it "flipping the org chart." Results have been a $100 million margin turn around in less than 2 years and greater than 90 percent patient satisfaction.

Sam J. Foss. Vice President of Nursing and Chief Nursing Officer of Mount Desert Island Hospital (Bar Harbor, Maine): Upskill and cross train staff to multiple departments creating a flexible workforce and access to care.

Kristin Wolkart, RN. Executive Vice President and System Chief Nursing Officer and Operational Integrity of Franciscan Missionaries of Our Lady Health System (East Baton Rouge Parish, La.): Earlier this year, FMOLHS launched our own in-house agency that we call Flex Choice. Phase one was adoption of a vendor management system system with a standardized health system contract with all the external contract agencies we were using. This new VMS system allows for greater transparency and management of our external contract labor and offers the ability for FMOLHS to hire staff at the end of their contract if they so desire, without any penalties. 

The second phase is direct hiring of staff into our internal agency. The team created a tiered system that allows new hires to select if they want to work in one market, two markets, or the travel pool. The third phase is coming later this year when we move all local market in-house contracts to the Flex Choice agency. This new model centralizes outsourced/contract staffing and scheduling with greater transparency on rates and usage and takes much of the burden off of local leaders for selection, training and orientation. 

Last fiscal year we were able to reduce external contract labor expense by $30 million dollars across Mississippi and Louisiana markets, and expect further savings this fiscal year, as well as enhanced recruitment and retention opportunities.

Trey Crabb. Senior Vice President and Chief Business Development Officer of Methodist Le Bonheur Healthcare (Memphis, Tenn.): We have a number of internal businesses that support our organization that are really high quality, and available to serve regional healthcare organizations outside our umbrella, but it's not something we have pursued until recently. We discovered that many of our services can be shared with these outside organizations at a significant discount to what they are paying today, and still be profitable to us. Or, we can provide a service they aren't able to replicate on their own. 

For example, we have a nationally-known 'repair depot' within our BioMedovation business that takes in broken medical equipment from customers, we provide the expert repair, and send it back with a warranty via FedEx (based in Memphis as we are). It's also good for the environment!

Kim Bennion. Director of Respiratory Care Research at Intermountain Health (Salt Lake City): Intermountain Health is an organization all about healthcare innovation. For the last year, we have been collaborating with a company creating the framework of data for chronic lung patients with chronic obstructive pulmonary disease and adult asthma. The framework is set on an artificial intelligence platform utilizing remote patient monitoring devices unique to identifying early symptom exacerbation and earlier intervention. Our key objective is to further decrease 30-day hospital readmission rates. Secondary objectives include but are not limited to:

  • Improved healthcare access to provide high-touch, personalized care via the integrated AI-based technology platform 
  • Enhanced knowledge of care plan compliance to include individual patient motivation and behavioral modification
  • Appropriate medication utilization and overall care plan compliance
  • More timely referrals to medically necessary care (e.g., pulmonary rehabilitation, advance care planning discussion, sleep study)

We believe in doing, for each patient, the right thing at the right time and in the right location, preferably the home. By doing so, a decrease in total cost of care always follows.

Adele Webb, PhD, RN. Executive Dean of Healthcare Initiatives at Capella University (Minneapolis): At SEI I think the smartest thing they have done is to add perks to encourage retention. Turnover is so costly and now that we are requiring people back in the office; some employees are making the decision to leave. There is hope that the perks will encourage people to stay, therefore improving the bottom line.

Daniel Siegal, MD. Vice Chair of Radiology at Henry Ford Health System (Detroit): The smartest thing any health system can do today is invest in its people. This includes pipelines for training and developing new talent in a variety of areas (from support services all the way through care providers), and retaining them long term with programs and tools that support a modern versatile workforce. Technology can also go a long way in helping understand and optimize staffing levels, and give employees the tools they need to focus more time on the clinical care that matters most.

Joyal Pavey. Vice President of Advisory Group and John F. Butzer Center for Research & Innovation at Mary Free Bed Rehabilitation Hospital (Grand Rapids, Mich.): At Mary Free Bed, our bottom line is driven by our culture to care for staff, patients, and the communities we serve. We understand that great patient care is cultivated by the great people providing that care, and we have made large investments in our team. Most recently, across our system we have focused on nurse recruitment and retention. We've also created the Mary Free Bed Nursing Agency which has limited the need for external nursing agencies, kept beds on-line, and decreased associated agency costs. 

We also provide financial education to our operational leaders and have daily, weekly, and monthly financial review meetings. These meetings don't focus solely on the metrics, but the process to achieve those metrics so that everyone in our organization is aligned and focused on what needs to be done to drive results. We have also doubled down on growth initiatives. While others reduced overhead positions we invested to maintain and gain market share. Engaging our interdisciplinary teams in strategies to tackle challenges, has resulted in novel strategies, greater collaboration, and organizational alignment around system priorities. 

This fall, we are opening another 20 beds in our flagship location in Grand Rapids and have been focused on philanthropy efforts which have raised over $35 million in public and private support towards our new free-standing pediatric hospital in partnership with Corewell Health. 

Pooja P. Vyas, DO. Vice President and Chief Medical Officer at Christian Hospital Northeast & Northwest Healthcare (St. Louis): Our team has worked on trust building and communication amongst ourselves which has contributed to our bottom line, as well as our quality metrics. We've seen an increase in our quality scores as we focused last year on building our teams, engaging our members, and supporting our leaders. We've done multiple retreats and exercises, including rounds, which have helped the leaders build trust, maintain trust, and support each other through effective communication.

Tipu Puri, MD, PhD. Associate Chief Medical Officer of University of Chicago Medicine: Coming out of the pandemic our institution, like all of our peers, is seeing challenging staffing and resource constraints and concerns about the well-being of our clinical teams. This in the context of ever growing demands for access to care and the need to grow our programs. 

The smartest decisions my team has made over the last 12 months have been focusing on initiatives that improve operational efficiencies to increase capacity and access to care and also support better communication and ease of practice for our clinical teams. These have included at the elbow support by operational physician leaders to address barriers and delays in care and patient logistics improvements that support more efficient rounds and improved multidisciplinary communication. We've looked for the win-win initiatives and started with those.

Zinkeng Asonganyi. Director of Ambulatory Pharmacy & Infusion Services at the University of Texas Medical Branch (Galveston): Instituted a hardship waiver with criteria to help patients with their OOP amount for specialty and specialty-like drugs. Because we are a DSH hospital, this is another way to pass on those savings to the patient and improve treatment compliance, adherence and reduce time to treatment. Over the first month, we've helped over 70 patients saving them about $50,000 in copay assistance. Prior to having this, we relied heavily on patient assistance programs which often meant patient's treatment initiation was delayed and financially for us, it was a lot of effort for no revenue because you cannot bill for the drug. 

Ruby Skinner, MD. Chief Medical Officer of Dignity Health, Community Hospital of San Bernardino (Calif.): Our team has worked to continue to provide multidisciplinary quality care that aligns with the evolving medical and social complexity of post-pandemic patients. Restructuring service lines and ensuring appropriate technology availability has also been vital.

Tony Reed, MD, PhD, MBA. Senior Vice President and Chief Quality, Safety and Experience Officer at Inspira Health (Vineland, N.J.): Our organization has incorporated "waste walks" into our strategic plan and performance improvement work. These efforts engage our staff and frontline leadership in the process of enhancing efficiency and optimizing processes.

Kim Meeker. Chief Nursing Officer at Henry Ford Wyandotte Hospital (Detroit): We implemented technology within every patient room that allows for two way video and speakers. This new technology opens several options that allow for nursing resources to be supplemented. We started this project by implementing a virtual patient sitter program which has so far resulted in a 30 percent reduction in falls with injuries. We have also, just recently, expanded the use of this technology by implementing a virtual ICU in which we now have physicians and nurses working virtually to be an extra pair of eyes and ears to assist our staff in our ICU. The possibilities for use of the technology are endless and come at a time in healthcare in which innovation is necessary. 

Dani Hackner, MD. Chief Clinical Officer of Southcoast Health System (New Bedford, Mass.): We took a strategic approach to gastroenterology care and screening, creating a systemwide program from primary care to specialty consultations to hospitalist coverage to access sites and procedural queue management, and in doing so, we drove down COVID-related backlogs in thousands of patients needing screening and care to create laminar flow, high throughput, provider satisfaction and patient safety, while driving the system's bottom line. 

Jerry Rebo. Director of Pharmacy Value and Outcomes at Novant Health (Winston-Salem, N.C.): We have leveraged technology and partnerships to gain a more in depth understanding of opportunities on the expense reduction and growth/revenue generating aspects of the business. We have harnessed technology to allow us to peer deeper into our business to understand current actionable prospects while also giving us the ability to model potential decisions and subsequent impacts. In conjunction with technology, we have simultaneously leaned on strong partnerships with the clinical, operational, technology, and financial teams to make more informed decisions. By working with team members with great passion and expertise in these areas, we can appreciate more fully the data and opportunities. This has led to more creative solutions and the implementation of more robust strategies. 

Finally, we continue to prioritize the engagement of our teams. Consistently messaging the priorities and performance of our organization and department has allowed a better connection to the work being accomplished. Importantly, simultaneously engaging in their professional growth ambitions strengthens team cohesiveness. Purposefully connecting ongoing achievements to individual professional goals and the larger purpose has had a positive impact on overall performance. 

Cindy H. Harrison. Vice President of Human Resources at Henry Ford Health (Detroit) - Central Market: My team developed, in partnership with the local school system, a one week Healthcare Camp to get middle school kids interested in health careers. In addition, we developed, with the public schools and the local college, career pathways and curriculum to prepare them with the right courses to set them up for success in college. We are growing much needed healthcare workers for our future and providing opportunities for kids in this community!

Ria Paul, MD. Clinical Associate Professor, Chief Medical Officer, Stanford Health Care Alliance (Los Altos, Calif.), Executive Medical Director, Value Based Care Program, and Associate Chief Quality Officer of Population Health and Ambulatory Quality at Stanford University School of Medicine (Calif.): In the world of population health and accountable care it is imperative that we stay connected with our patients. Annual wellness visit is a vehicle that can be utilized to connect with our patients on an annual basis which will provide the opportunity for our primary care team to address various issues like appropriate diagnosis coding and documentation, fall risk, SDOH, advance care planning amongst others. At Stanford we have been focusing on annual wellness visits and that has helped improve various metrics like advance care planning and also appropriate risk scoring of our patients so we can direct our resources accordingly to keep our patients healthy and away from the hospital or emergency room.

Rebekah Compton, DNP, FNP-BC. Chief Clinical Officer of The University of Virginia (Charlottesville): We have created a finance 101 presentation for each of our local clinical leaders to help them better understand their budgets and the areas they have ability to control. Often, it is assumed that clinical leadership understands the nuances of healthcare budgets and unfortunately, that is not the case. We are actively working towards ways to increase transparency and understanding to help support our financial goals. As we have rolled out this finance 101 education, we have seen greater leadership partnership and engagement in identifying ways to reduce waste, review contracts and identify opportunities for improving our bottom line!

Tanira B.D. Ferreira, MD. Chief Medical Officer of the University of Miami Hospital and Clinics; Associate Professor, Medicine, Pulmonary, Critical Care and Sleep Medicine Division at University of Miami Miller School of Medicine: The most effective way to contribute to our system's bottom line is to have a laser focus on quality, safety, efficiency and patient experience. The care must be evidence based, with a protocolized approach to minimize variation and safety events and all patients need to leave our hospital happy. That is a mantra we expect all employees to live by. To achieve and monitor that, you need to have data driven outcome measures that track that progress, so you can hold people accountable. By focusing on improving quality, a favorable financial performance will be a natural occurrence.

Linda Stevenson. CIO of Fisher-Titus Health (Norwalk, Ohio): Fisher-Titus has developed an enterprise analytics team that is building key dashboards for executive level and service line level monitoring. Providing the right data to the right people is key to ensuring we can manage our revenue and costs. To ensure that our leaders are ready to digest this more comprehensive set of information, we are also planning for a focus on data literacy with a training program to be completed this fall.

Andrea Turner. COO of Zuckerberg San Francisco General Hospital (San Francisco): Zuckerberg San Francisco General Hospital's organizational culture is to consistently review our processes to mitigate gaps and improve in areas of opportunity. One of the smartest things my team has done over the last 12 months that was impressive and improved the system's bottom-line, was to redo their staffing model to improve capacity, which addressed the exponential increase in our census, while reducing overtime (OT) and registry/contracted use. Here, they partnered with human resources to expedite hiring and also built an internal ladder to train staff within to fill vacated positions permanently. 

Michael Prokopis. Senior Vice President of Supply Chain at Steward Health Care System (Dallas): We have started working on "Inventory Location of One" which will de-risk our supply chain and remove carrying cost of inventory as we consolidate to main distributor partner and vendors. Goal will be to improve inventory turns 100 percent while also reducing carrying costs by 33 percent.

Liz Popwell. Chief Strategy and Transformation Officer of Stony Brook Medicine (N.Y.): The smartest thing that Stony Brook Medicine has done over the last 12 months is to have a dual focus on financial recovery while building a strong and innovative five year strategic plan. The strategic plan is focused on our mission of transforming lives through scientific discovery, education and healthcare, and it is focused on transforming our organization to a healthcare platform. Additionally, we have invested in interdisciplinary research and education to help advance the health science schools as we educate the next generation of healthcare providers and leaders.

Nasir Khan, MBBS. Regional Director of Clinical and Quality Analytics at Loyola Medicine, Trinity Health (Livonia, Mich.): Among many, one of the smartest things our team has done this past year is leveraging a data-rich EHR platform and developing custom in-house advanced analytics and prescriptive solutions, sparking a change in practice and behavior, resulting in a measurable improvement in some of the patient quality outcome metrics, financial performance, and overall operational efficiency for our organization. Data drives change if it's crafted to tell an actionable story.

Patti Artley. Adjunct Associate Professor and Former Chief Nursing Officer at Medical University of South Carolina (Charleston): I am especially proud of the remarkable work our clinical team has accomplished this year while working with healthcare organizations. Medical Solutions prides itself on providing a complete healthcare talent ecosystem to the organizations we serve by leveraging services, strategy, and technology. Our clinical team plays a crucial role within our ecosystem by vetting and supporting our clinicians. Our team has also guided organizations on how to introduce flexibility in care delivery models and reduce their reliance on contingent labor. These achievements help organizations accomplish sound fiscal responsibility while ensuring the highest standards of patient care.

Vikram S. Kashyap, MD. Frederik Meijer Endowed Chair of the Meijer Heart and Vascular Institute and Vice President of Cardiovascular Health at Corewell Health (Royal Oak, Mich.): The smartest thing we have done in the last 12 months is to keep our teams engaged. Turnover of cardiovascular physicians and APPs leads to tremendous costs with ramp-down and ramp-up (similar to turnover in any area). We have listened carefully to our teams and addressed concerns. We have communicated both short and long-term plans using multiple modalities including in-person meetings, virtual town halls, a newsletter, and social media. Importantly, we recognized individuals for the amazing work they do with complicated patients in challenging situations. 

Lastly, we have adjusted compensation where there were inequities. Keeping our caregivers and staff engaged elevates our patient care, fuels growth, mitigates work-life imbalance, and eventually affects our fiscal position positively.

Christy Bray Ricks. Vice President of Provider Talent at Ardent Health Services (Nashville): My role is to lead the transformation of our physician and advanced practice provider talent acquisition across the organization. This includes both employed and temporary staffing for our facilities. Our greatest need was to establish the foundational resource of active sourcing strategies. In collaboration with our director of sourcing, we have added key resources and implemented standardized processes to more quickly fill our critical provider needs and reduce our reliance on external search firms. Additionally, I actively engage our leading temporary (locum tenens) staffing vendors to align processes and desired partnership outcomes in order to secure talent. 

Lori Wightman. Professor of Washington University (St. Louis): Create standard work for leaders and frontline caregivers! There is so much noise and complexity in the healthcare environment today. Additionally, the workforce is filled with novice caregivers and leaders who may have been slighted on a proper orientation due to the pandemic. The creation of standard work brings to the forefront process and cultural changes needed within the environment to optimize productivity and promote retention. Standard work for leaders allows for robust coaching conversations about what is important, what can be delegated, and what should be let go. 

Manish Chadha, MD. Director, Co-Chair, Equity, Diversity, Inclusion & Belonging Committee at Northwell Health (New Hyde Park, N.Y.): Our team is working on developing AI-enabled solutions to help improve the rate of screening for lung cancer with LDCT.

Manish Tanna, MD. Senior Vice President and Value-Based Care Medical Director at Nephrology Associates of Northern Illinois and Indiana (Oak Brook, Ill.): Our team at Nephrology Associates of Northern IL and IN (NANI) has been laser-focused on improving quality of care, decreasing unnecessary utilization, and measuring patient outcomes. NANI has been committed to value-based programs since 2015, and we have now expanded our goals to include stage 4 and stage 5 CKD patients as well as ESRD patients in a full-risk model. As the largest nephrology practice in the country, we have partnered with Strive Health to optimize team-based care delivery so that our clinicians have access to dieticians, social workers, transplant, and CKD care coordinators to address the needs of this complex population.

Julie Oehlert, DNP, RN. Chief Experience and Brand Health of ECU Health (Greensville, N.C.): At ECU Health we implemented non-clinical patient experience coordinators in the ED and on medicine units. These are not patient advocates, they are non-clinical support for nurses and other clinicians as well as support for patients' non-clinical needs. During this nursing shortage, these are highly regarded positions. This group improves ED wait experiences, decreases Left Without Being Seen (LWOTS), improves patient experience (HCAHPS) and improves nurse engagement, decreasing nurse burnout and improving retention. LWOTs and increased HCAHPS has a strong return on investment but improving the experiences of our nurse workforce is priceless!

Matthew Webber. Director of Pharmacy Business at Novant Health (Winston-Salem, N.C.): Over the past year, our team's most intelligent strategic move to enhance our system's bottom line has been a concentrated effort in allocating resources towards leveraging data and technologies. By harnessing the power of data-driven insights and applying them comprehensively across all our markets, we have successfully bolstered our system's bottom line across various facets of our pharmacy operations. This approach has not only improved the precision of our financial forecasts but has also significantly expedited our decision-making processes, thanks to the heightened confidence derived from data-driven insights.

Mara Nitu. Chief Medical Officer at Indiana University School of Medicine and Riley Hospital for Children, IU Health (Indianapolis): We are constantly working on optimizing access. However, space and workforce constraints limit the extent of the response. One solution we found to circumvent that, was to offer evening and Saturday morning clinics. Most recently, we used that solution for MRIs, and we were able to reduce the waiting queue by 50 percent.

Jonathan Berkowitz, MD. Medical Director of Emergency Telehealth, EMS and Transfer at Northwell Health (New Hyde Park, N.Y.): We have continued to expand our emergency telehealth program to fill in gaps in our system. There are lots of great programs that require a bit of support for a few hours or support for a specific function. By providing that support we allow these programs to maximize their cost effectiveness.

Traci Biondi, MD. Chief Medical Officer of Prominence Health Plan (Reno, Nev.): As healthcare continues to evolve we are always looking for innovative solutions to care for our members and enhance their health and well-being while staying focused on financial performance. In 2023 we developed and launched our Prominence Home Program in collaboration with local home health agencies. This innovative program is designed to support our members in a manner that exceeds traditional home health services. This program enables our members who are hospitalized to return home sooner by providing high-quality customized services, support and personalized care right in their homes. This includes services like medication management, home safety assessments/modifications or emotional and mental health support for both the member and their family. This, in turn, has resulted in reduced hospital length of stay, reduced readmissions, cost savings and improved operational efficiency for our organization. Through this initiative we have experienced enhanced collaboration with our hospitals, better patient outcomes and a reduction in financial burden on the healthcare system. 

Thomas Maddox, MD. Vice President of Digital Products and Innovation at BJC HealthCare/Washington University School of Medicine (St. Louis): Our digital products and innovation teams have embraced user-centered design, product management, and agile delivery capabilities to better deliver digital transformation to our system. These capabilities allow us to build digital tools and products that truly serve our patients' and care teams' needs. 

Design helps us clarify the "problem to be solved" for our users. Product management helps us identify a digital solution that both delights our users and serves the business. Agile delivery allows us to quickly develop product prototypes (often within two weeks) and get them into our users' hands to see if they are meeting their needs. These capabilities have been initially deployed to support our digital front door and inpatient nursing experiences. 

In both cases, our products have been deployed and scaled within a matter of months. Collectively, they have brought over 30,000 new lives into our primary care practices, allowed our nurses and other clinicians to schedule over 240,000 shift hours, and improved our inpatient nurses' satisfaction, turnover, and documentation rates by providing virtual nursing assistance.

Tyler L. Hill, DO, FACEP, MBA. Chief Medical Officer of Sierra Nevada Memorial Hospital (Grass Valley, Calif.): One of the biggest challenges for Sierra Nevada Memorial Hospital is a large primary care physician deficit in Nevada County, California. At SNMH, we have developed a creative strategy to combat this challenge. This year, we started a Rural Family Medicine Residency Program, partnering with a local FQHC called Chapa De Indian Health. This will immediately begin to provide additional primary care capacity for our community. 

We are confident this will also lead to a strong future primary care workforce as those residents graduate and remain in the community as attending physicians. Another strategy has been our creative approach to recruiting. Last year we started an annual resident weekend retreat, where we host senior residents for a weekend of multiple activities and events. This allows senior residents to tour the area, facilities, and meet many of our local primary care providers in a relaxing and fun way. 

Karyn Baum. Chief Transformation Officer of Essentia Health (Duluth, Minn): There is so much innovative work happening across Essentia to improve the health and well-being of the population we are called to serve; I have been lucky enough to be a part of some of it. One unique aspect to Essentia Health is our rural focus, which carries with it financial and structural challenges. 

Our focus means our needs (and solutions) may look slightly different than systems centered in large, urban areas. For example, ensuring ongoing access to inpatient care across large geographic distances has resulted in the use of a centralized admission and transfer center for each market; teams are also able to transfer patients back, closer to home, as appropriate. Fully leveraging our rural facilities allows us to free up hospital capacity and better connect patients with the appropriate level of care. 

This work resulted in a pronounced increase in bed days, as well as additional patients, for our rural hospitals. It also generated an additional $2.7 million in revenue. We also just opened a new, state-of-the-art tertiary care hospital in Duluth, Minn., to ensure those we serve have the best care right here in the Northland. It's all about making sure people can be served as close to home as possible.

Brett Daniel, MD. Chief Medical Informatics Officer of OptumWA (Eden Prairie, Minn): Our digital patient journey has undergone rapid improvement and modernization. Our clinicians led the effort, with support from our acceleration office and technology team. We identified opportunities to activate established functionality in our EHR and quickly scale its implementation, as there was already ample evidence of its positive impact on improving our operational efficiencies. 

We also started a number of new digital care offerings to patients to improve our access and keep patients connected to our multispecialty system for all of their care needs. Since around 80 percent of our patients are already enrolled in our patient portal, MyChart, we have leveraged this connectivity to create and expand these access points, without the need to establish new integrated platforms. As a result, we have already surpassed our aggressive annual target for new digital touches and have seen rapid patient adoption to help us deliver more connected care with fewer hands.

Holly Muller, DNP, RN. Chief Nursing Officer of Presbyterian Delivery System (New Mexico): Two Presbyterian initiatives come to mind. The first is launching a gig-workforce app that connects us with local nurses who can fill scheduling gaps, reducing our dependence on traveler contracts while still providing quality, safe and accessible care for patients and members. 

The second is introducing a new care model to improve both the patient experience and the caregiver experience through meaningful connections. It's providing our employees with resources to help discover or reignite their passion for healthcare and their connection to purpose. These initiatives contribute to the bottom line by avoiding costly traveler contracts and by retaining our talented and dedicated caregivers and staff.

Paul Coyne. Senior Vice President and Chief Nurse Executive of HSS | Hospital for Special Surgery (New York): A renewed focus on people and culture not just in words, but in dollars and genuine authenticity. If there is a sincere and universal focus on people, the bottom line will improve as a byproduct. The inverse is not true. A spreadsheet simply shows the bottom line. It does not change it. The only thing that can make every part of an organization better, including the bottom line, is the people that work there. 

Beth Steele. Chief Operating Officer of Owensboro Health Regional Hospital (Ky.): Our team, including the board of directors, has agreed that there is not a singular solution to the headwinds we are facing. This means keeping open minds about things we have tried in the past, new partnerships, and creative solutions. This willingness mixed with our ability as a small system, to be nimble, are what has impacted our bottom line most.

Julie Gauderman. Associate Director and Assistant Professor of Saint Mary's University of Minnesota (Winona) Graduate Program in Nurse Anesthesiology: In these challenging times, our team has had to get creative to stretch resources further. We have taken an active role in seeking Healthcare Policy change to help all health systems to utilize all of their providers and improve critical payments for many services. One way we have done this is to work actively to support the "I CAN Act" which was introduced earlier this year in the House and just introduced in the Senate this summer. The health systems we work with are experiencing many of the same challenges: provider shortages, increased salaries and patients losing access to care. This legislation provides many key solutions to removing barriers and improving the bottom line for hospitals and the access to high quality, timely, cost-effective care for all of our patients.

Desi Kotis. Chief Pharmacy Executive of the University of California San Francisco Health System; Vice Dean of Clinical Affairs at the University of California San Francisco School of Pharmacy: Our team has continued to look for opportunities to become more efficient and effective. The transitions in care pharmacy team has helped with hospital patient throughput to make sure patients are ready with their medications needed prior to discharge. Others have come up with additional cost savings with drug use management, decreasing waste with drug dose rounding, and strong drug inventory management. 

Our leaders have also taken the "just do it approach" to increase growth and revenue by providing expanded services to our specialty patients through specialty pharmacy. We have partnered with our revenue cycle team to make sure we are capturing charges including JW waste billing. Great leadership team as well in managing our workforce and FTEs with a pharmacy resource network or float pool to cover our pharmacists and pharmacy technicians leaves and vacations. So very proud of a dream team of leaders.

Jody Reyes. Senior Vice President and COO of Penn State Health ( Hershey, Pa.) - Milton S. Hershey Medical Center: In the past year, Penn State Health has placed substantial emphasis on functioning as a cohesive entity, encompassing both our clinical practices and the five hospitals within our network. This approach optimizes the internal referral process for high-acuity healthcare services. It also serves as a countermeasure against any diminishing referrals from competing health care systems. We are encouraged by the developments in our system's capacity to maintain and serve these complex cases effectively.

Matthew E. Harinstein, MD. Senior Vice President, COO and Associate Chief Medical Officer of UPMC International (Pittsburgh); Vice President, Medical Affairs, Chief Medical Officer of UPMC McKeesport; Associate Professor, Medicine, University of Pittsburgh School of Medicine of UPMC Heart & Vascular Institute: Our UPMC teams are focused and dedicated to streamlining our patient discharge process. Our multidisciplinary care teams work together daily to plan next-day discharges in advance. We promptly address any potential challenges or opportunities in real-time, ensuring outpatient requirements and follow-up appointments are arranged before patients leave our care. This sets our patients up for a seamless care transition to best support outcomes and recovery, and it positions our team to free up more inpatient beds for the people who need them, optimizing our throughput and bed utilization.

Natalie Kennett. Chief Nursing Officer of Cottage Hospital (Woodsville, N.H.): To reduce our use of travel staff we have created a contract for per diem nurses to work as regular nurses for a bonus incentive. This helped us reduce our need for travelers on our medical/surgical floor and intensive care unit. It also had the added benefit of creating consistent staffing who are part of our community.

Hillery Shay, MBA. Vice President of Marketing and Communications at Children's Minnesota (St. Paul): One of the many recent success stories that sticks out to me is how my marketing and communications team rolled out a detailed, multi-channel content plan to promote the opening of Children's Minnesota's hybrid intraoperative MRI (iMRI) neurosurgery suite. The cutting-edge brain surgery facility is the first of its kind in North America, and required a multi-faceted, year-plus long campaign to promote its life-saving capabilities to the public, employees, referring providers and others throughout the upper Midwest and beyond. 

This plan incorporated paid, earned, owned and shared media content to generate consumer awareness and also promote a year-long fundraising matching challenge for the facility and the neurosciences program at Children's Minnesota. Through these efforts, recent data shows Children's Minnesota experienced a nearly 40 percent increase in both neurosurgery clinic visits and neurosurgery procedure volumes between January and April of 2023 compared to the same timeframe last year. I'm proud of my team and their efforts to showcase how Children's Minnesota fulfills its vision of being every family's essential partner in raising healthier children.

Susmita Pati. Chief of Primary Care Pediatrics and Chief Medical Program Advisor of The Alan Alda Center for Communicating Science at Stony Brook University (N.Y.): The smartest thing our team has done over the past year to contribute to our bottom line has been to focus on creating a positive workplace culture. In turn, this positive culture supports employees to function at the top of their license, think creatively, and solve problems together. Communication within and between team members has improved with positive downstream effects on team cohesion, patient quality and safety outcomes. 

Our clinical quality metrics remain above national benchmarks with equitable outcomes among publicly and privately insured patients. As a result, we continue to maintain our patient-centered medical home recognition from the National Committee for Quality Assurance for the tenth year in a row.

Nick Rogers. President of Revenue Cycle at One Medical (New York City): At One Medical, the revenue cycle and tech teams collaborated to develop automated copay collection functionality within our EHR, which made a dramatic improvement in copay collection rates. Additionally, it enhanced the patient experience, by speeding up the check-out process at the end of a visit, due to patients no longer needing to present a form of payment.

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