What makes a strong CEO-CFO partnership? 4 health system execs weigh in

Whether navigating through the challenges presented by the COVID-19 pandemic or deciding where to make investments in the year ahead, a strong partnership between C-suite executives is essential to hospitals and health systems today. 

Strategies for building a strong CEO-CFO partnership was one of the topics discussed during a session at the Becker's Healthcare CEO + CFO Virtual Forum on Aug. 11. The panel included the following executives: 

  • Nancy Howell Agee, RN, MN, president and CEO of Carilion Clinic
  • Donald Halliwill, executive vice president and CFO of Carilion Clinic
  • Laura Forese, MD, executive vice president and COO of NewYork-Presbyterian
  • Michael Breslin, CFO of NewYork-Presbyterian

Here's an excerpt from the conversation, edited for clarity. To view the full session on-demand, click here

Question: What are the characteristics of a strong CEO and CFO partnership? 

Nancy Howell Agee: The bottom line is trust — that we trust each other's abilities, talents — and that we have a great relationship that's based on integrity. I was thinking about this question and would it matter if you didn't have a trusting relationship? And I think it sinks it.

There are other things that are important — communication, having a sense of humor, building a relationship. Don and I are lucky because we're in the same suite. We both are from this region. We have deep and abiding concern for the region in which we live. We grew our families here. And so that makes a connection that might be a little unusual for a relationship between the CEO and the CFO.

I would say there's one thing that makes a difference and that is I can be surprised by good news, never surprised by bad news. I think being blindsided by bad news is a hallmark for failure. And I think that's the kind of relationship that we've built.

The other thing I'd say, which is maybe a little unusual for us, and likewise seems to be true for NewYork-Presbyterian, is that I have a clinical background and Don has a financial background. Together we both have good leadership and business intel, we bring two pieces together. And while finance is not my first language, his first language is not in the clinical space. We bring that together and it's quite a nice relationship.

Donald Halliwill: I think an indication of an effective relationship we've probably all experienced is when either you finish each other's sentences or once one person explains something there's nothing left for you to explain because you share so closely your perspectives. I think that all of the things that Nancy mentioned are true. I would add a couple of things. One is you often hear the saying, "no money, no mission." While that's an acknowledgement that there's a financial aspect to providing care to our patients in our communities, on the finance side, you also have to understand that the patient comes first and we don't exist to make money. There are organizations where that is a primary fundamental top of the pyramid goal for them. That is not our reason for existence. We exist to provide care to the communities we serve.

All of us are able to share kind of a true north, if you will, and understand, believe in, share in the values that the organization has laid out. And then really apply those and use those. They're not just on our screensavers on our computers. We use those words and we give context to decision-making using those words. I think all of that brings a closeness and an alignment that is really important in making it successful.

Dr. Laura Forese: I want to pick up on, Nancy and Don, a little bit of what you just said, because Nancy, I think you're right. Mike and I definitely have had this where we've been teaching each other some things over the course of years. And in fact, as we've done presentations together or we've been talking to the board, sometimes we're playing each other's parts, which always strikes everyone as funny that we're doing that. I had the experience where the board member was like, wait a minute, why is he doing your role and you're doing his? Part of it is because we're doing so much of it. We absolutely don't agree on everything and are usually pretty transparent about that with our team as we're talking about that. But we do have great respect for all the different pieces that come into this, and you're sort of trying to model that for everyone else.

Mike has taught me so much. Whether we're preparing for going to the bond market or some other setting, I've learned a lot from that interaction.

Michael Breslin: When I came to NewYork-Presbyterian, I had spent 20 years at a public accounting firm, and NewYork-Presbyterian was a client of mine for the better part of a decade. I left and then I was the CFO at two turnarounds and a CEO of a small turnaround. But I kind of liked the turnaround business because it was like a benevolent dictatorship. You didn't have to ask a whole lot of permission and questions. When I got to NewYork-Presbyterian, it became pretty obvious pretty quick that this was a very, very competent, successful organization with some incredible talent and an incredible opportunity to learn and kind of expand horizons. To me, the characteristics really are about trust, respect and then just that ongoing learning from each other, and that happens every day in our leadership team. I think that really is what kind of keeps us going here at NewYork-Presby.

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