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Executive

Exclusives
BECKERS
A Tribute to Chuck Lauer
From His Readers, Friends
& Colleagues
HOSPITAL REVIEW
p. 61 June 2017 l Vol. 2017 No. 6

Dr. Toby Cosgrove


CEO of Cleveland Clinic 150 Hospital and Health 230 Hospital
p. 65
System CFOs to Know Benchmarks
Michael Dowling
President and CEO of
2017 2017
Northwell Health
p. 66 Meet 150 leaders in hospital finance Find out how your hospital compares
who are tackling one of the healthcare to regional and national competitors
Dr. Verdi DiSesa industry's most complex challenges: on quality, patient satisfaction,
President and CEO of the costs of care. utilization, finance, IT and more.
Temple University Hospital
p. 67
See who made the list on page 47. See who made the list on page 20.

Other Feature Stories:


Family Pays 35-Year-Old Hospital Bill by Selling Jewelry Collection
8 Things to Know About Nurse Bullying
This Unnecessary Regulation Doesnt Benefit Patients and Costs $500M Each Year
50+ CHS Records $199M Net Loss, Says Divestiture Spree is Over
STORIES 9 Healthcare Bankruptcies So Far in 2017

FEATURED 4 Tips for Developing a Great Leadership Team


Epic, Cerner Hold 50% of Hospital EHR Market Share: 8 Things to Know
Report: 3 Cyberthreats Make Up 81% of Healthcare Breaches
Inside The Issue
How Identifying High-Value PCPs Can Improve Profitability
50 Cities With the Largest, Smallest Gender Wage Gaps for Physicians

SAVE
Beckers THE DATE
Hospital Review
6th Annual CEO + CFO
Roundtable
November 13-15, 2017
Westin Michigan Avenue | Chicago, Illinois
112 Great Health System Executives Speaking with 122 Speakers Total
67 CEOs and 26 CFOs from Great Hospitals and Health Systems Speaking
To learn more & register, visit www.beckershospitalreview.com/november-ceo-roundtable-
conference/ or email Jessica Cole or Scott Becker at jcole@beckershealthcare.com or sbecker@
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FEATURES
PUBLISHER'S LETTER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

CFO / FINANCE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
CHS Records $199M Net Loss, Says Divestiture Spree is Over
LifePoint Eyes New Acquisitions as Profit Rises
Family Pays 35-Year-Old Hospital Bill by Selling Jewelry Collection
DOJ Sues UnitedHealth Over $1B+ in Medicare Claims
OIG Tags Arkansas Hospital for Incorrect Billing
Georgia Hospital to Close After Years of Financial Troubles
Brigham and Women's Offers Voluntary Buyouts to 1,600 Workers
The $12M Patient Who Drove Insurance Rates Higher in Iowa
US Drug Spending to Hit $610B by 2021
9 Healthcare Bankruptcies So Far in 2017
Tenet Sees Net Loss Narrow to $53M, Inks Deal to Sell 3 Hospitals to HCA
RAND Study: MACRA Could Cause $250B Drop in Hospital Medicare Revenue by 2030
Study: High Prices Not Necessarily Indicative of Better Quality for Outpatient Services

EXECUTIVE BRIEFING: Avoiding Friction in the Age of High-Deductible Health Plans:


How Innovative Solutions Can Help Providers Succeed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

230 Hospital Benchmarks | 2017. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

CEO / STRATEGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Truven Names 15 Top Health Systems for 2017
Cleveland Clinic President and CEO Dr. Toby Cosgrove Announces Plans to Step Down in 2017
HCA to Change Its Name Again
Governor Orders New Hampshire Hospital CEO Bob MacLeod to Resign Over Staffing Deficiency
6 Tips for Working With Someone Who Isnt a Team Player
Be Professionally Blunt 4 Tips for Developing a Great Leadership Team
OSU Wexner CEO Resigns Over Faculty Concerns About Leadership
University of Utah Health Care CEO Dr. Vivian Lee Steps Down Post-Cancer Center Conflict
Study: Executives Who Flatter CEOs Most Also Develop Greatest Resentment for Them
Words From the C-Suite: Advice From 4 Executives

EXECUTIVE BRIEFING:
The Real Reason Loyalty Lacks in Healthcare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

CIO / HEALTH IT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34


Epic, Cerner Hold 50% of Hospital EHR Market Share: 8 Things to Know
Athenahealth CEO Jonathan Bush: Trump, High Deductibles Played Role in Disappointing Q1
Vanderbilt University Medical Center Begins IT Overhaul, Epic Implementation
5

The 16 Tech Companies Paying Interns Most


Trump Establishes American Technology Council
CIOs Greatly Underestimate How Many Cloud Apps Their Organization Use
Report: 3 Cyberthreats Make Up 81% of Healthcare Breaches
Why Do Women, Minorities Leave Tech Companies? 4 Study Insights
47% of Organizations Say Virus Bypassed IT System Designed for Malware
Lifespan Notifies 20k Patients of Privacy Breach From Stolen Laptop
HIMSS Analytics Unveils 2018 EMR Adoption Model Criteria
Health IT Regulations Are Too Burdensome for Physicians, Says Price
Cerner Impersonation Scheme Leader Sentenced to 12 Years in Prison

CMO / CARE DELIVERY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38


8 Things to Know About Nurse Bullying
CDC Director Calls C. Auris Fungus a Catastrophic Threat
KentuckyOne to Cancel Contracts with 25 Employed Physicians
Trump Appoints Nurse to Serve as Acting Surgeon General
Survey: 70% of Nurses Report Burnout in Current Position
CDC Issues New Prevention Guidelines for Surgical Site Infections: 5 Things to Know
Dr. Peter Pronovost: This Unnecessary Regulation Doesnt Benefit Patients and Costs $500M Each Year
2 in 3 Medicare Clinicians Exempt From MIPS

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150 SPEAKERS FROM HOSPITALS


George W. Bush,
43rd President of the
Sugar Ray Leonard,
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Mary Alice
Annecharico, MS, RN,
Daniel J. Barchi,
MEM, Senior Vice
AND HEALTH SYSTEMS
United States of America Entrepreneur and Author,
The Big Fight: My Life In
Senior Vice President and
Chief Information Officer,
President and Chief
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255 SPEAKERS TOTAL
and Out of the Ring Henry Ford Health System New York-Presbyterian
THE BRIGHTEST CIOS, HEALTH IT AND
REVENUE CYCLE EXPERTS IN HEALTHCARE

REGISTER HERE
www.beckershospitalreview.com/
health-it-revenue-cycle-conference/
Edward Marx, Executive Amber McGraw Shafiq Rab, MD, Regional Susan Salka, Registration@BeckersHealthcare.com OR 800.417.2035.
Vice President, The Advisory Walsh, Senior Vice President and Chief Executive Officer,
Board Company; Interim Chief JD, Chairperson, Co-Chief Information Officer, President and Director, EMAIL Scott Becker or Jessica Cole at sbecker@beckershealthcare.
Information Officer, McGuireWoods LLP Hackensack University AMN Healthcare Services
NYC Health + Hospitals Medical Center com or jcole@beckershealthcare.com
6

50 Cities With the Largest, Smallest Gender Wage Gaps for Physicians
Resignation of 3 Physicians Sparks Great Concern in Small Iowa Community
How Identifying High-Value PCPs Can Improve Profitability
10 Best and Worst States for Nurses

EXECUTIVE BRIEFING:
Keys to Painless Conversions:
Transition Services and Best Practices to Prevent Disruption and Return to Baseline . . . . . . . . . . . . . . . . . . . . . . . . . 44

150 Hospital and Health System CFOs to Know | 2017. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47

EXECUTIVE BRIEFING:
Supply Chain Optimization:
How Mercy Leaders Took an Idea on a Napkin to $1B in Savings and Now Are Doing it for Others. . . . . . . . . . . 58

THOUGHT LEADERSHIP. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Remembering Chuck Lauer
Chuck Lauer, in the Words of His Readers, Friends and Colleagues
Raising the Nations Guts Quotient 5 Thoughts on the Future of Healthcare From Cleveland Clinic CEO Dr. Toby
Cosgrove
Michael Dowling: The Health System CEO's Affiliation Playbook 5 Thoughts From a CEO Who Has Executed 50+
Agreements
Corner Office: Temple University Hospital CEO Dr. Verdi DiSesa on Fatherhood and Health System Leadership

HOSPITAL & HEALTH SYSTEM EXECUTIVE MOVES. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

HOSPITAL & HEALTH SYSTEM TRANSACTIONS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

ADVERTISING INDEX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

PUBLISHER BUSINESS DEVELOPMENT 708-822-1786 / mjodoin@beckershealthcare.com


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sbecker@beckershealthcare.com 312-505-9387 / jcole@beckershealthcare.com 312-929-3682 / hjones@beckershealthcare.com
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EDITORS 219-746-2149 / katwood@beckershealthcare.com 312-448-9244 / sjones@beckershealthcare.com
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8

2017 CEO Advisory Board


Beckers Hospital Review

Nancy Howell Agee Steven I. Goldstein


President and CEO President and CEO
Carilion Clinic Strong Memorial Hospital and
Highland Hospital

Barry Arbuckle, phd


President and CEO Jeff Hillebrand
MemorialCare Health System Former COO
NorthShore University
HealthSystem

David Bernd
CEO Emeritus
Sentara Healthcare Stephen Mansfield, phd
President and CEO
Methodist Health System

Verdi DiSea, MD, MBA


President and CEO, Temple University
Hospital
Chris Van Gorder, fache
President and CEO
Michael Dowling Scripps Health
President and CEO
Northwell Health

Rhoda Weiss, phd


National Healthcare Consultant, Speaker,
David Feinberg, md Author & Editor
President and CEO Marketing Health Services
Geisinger Health System

Valinda Rutledge
Teri Fontenot Vice President, Public Payor Health
President and CEO Strategy Care Coordination Institute
Womans Hospital Greenville Health System

Pat Fry
Former President and CEO
Sutter Health
9

Publishers Letter
June Issue. This issue of Becker's Hospital Review contains a list of 150
hospital and health system CFOs, and two articles commemorating
Chuck Lauer, former publisher of Modern Healthcare, who passed
away April 30 after a battle with leukemia. Chuck was a longtime
mentor to Becker's Healthcare and a friend to all. His wisdom, gen-
erosity and kindness will be greatly missed. The issue also contains
an exploration into nurse bullying, a list of 230 hospital benchmarks
and a Corner Office interview with Verdi DiSesa, MD, president and
CEO of Temple University Hospital. I hope you enjoy the issue.
Becker's Hospital Review 3rd Annual CIO/HIT + Revenue Cycle
Conference (September 21-23 at the Hyatt Regency in Chica-
go). We are excited to host keynote speakers George W. Bush, 43rd
President of the United States, along with boxing legend Sugar Ray
Leonard. More than 150 hospital and health system leaders will also
speak on various CIO/health IT and revenue cycle topics, including

Sell Your
cybersecurity, telehealth and revenue cycle optimization. The meet-
ing includes nine tracks and 134 sessions over two and a half days. It
should be a great conference.

Surplus Surgical Becker's Hospital Review 6th Annual CEO Roundtable + CFO
Roundtable (November 13-15 at the Westin in Chicago). This

Inventory to
year's roundtable will feature 64 CEOs and 26 CFOs from amazing
hospitals and health systems across the country. We will host more
than 122 speakers total, including Howard Dean, MD, former chair-

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To learn more and register, please visit:
http://www.beckershospitalreview.com/conferences-and-events.
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CHS Records $199M Net Loss, Says Divestiture


CFO / FINANCE

Spree is Over
By Ayla Ellison

F
ranklin, Tenn.-based Community $250 million in impairment charges and loss- pitals to Boston-based Steward Health Care
Health Systems posted a net loss of $199 es related to the sale of some of its hospitals. and divested two hospitals to Clinton, Tenn.-
million in the first quarter of 2017 after based Curae Health.
recording net income of $11 million in the Commenting on the companys financial results,
same period of the year prior. CHS Chairman and CEO Wayne T. Smith said, With these transactions completed, CHS no
We are focused on performance improvements longer operates any hospitals in Ohio, while
CHS said revenues dipped to $4.49 billion in the that we believe will yield additional efficiencies it continues to operate 21 hospitals in Florida
first quarter of this year, down from $4.99 billion as we move through 2017. At the same time, we and 15 in Pennsylvania.
in the same period of 2016. The decrease in rev- are making progress with our portfolio rational-
enue was attributable, in part, to lower patient ization strategy as we work to create a stronger, Twelve other transactions are under defini-
volume. On a same-facility basis, admissions more sustainable company for the future and tive agreement and seven are under letter of
were down 1.5 percent in the first quarter of this further reduce our debt. intent, Mr. Smith said on a first quarter earn-
year. When adjusted for outpatient activity, ad- ings call May 2.
missions decreased 1.4 percent year over year. To improve its finances and reduce its nearly
$15 billion debt load, CHS put a turnaround Were about finished with our divestiture
Although CHS kept operating expenses in plan into place last year. As part of the plan, process, this 30 just about lines it up, said Mr.
check in the first quarter, one-time charges the company is selling off 30 hospitals. Smith. There may be one or two more, but
took a toll on the companys bottom line. CHS we are not specifically thinking about doing
said its first-quarter financial results included CHS on May 1 completed its sale of eight hos- anything significant for the rest of the year. n

LifePoint Eyes New Acquisitions as Family Pays 35-Year-Old


Profit Rises Hospital Bill by Selling
By Ayla Ellison Jewelry Collection

B
rentwood, Tenn.-based LifePoint Health is looking to acquire By Morgan Haefner
hospitals after a natural pause of more than year since

C
buying a new facility, said LifePoint Chairman and CEO Bill hildrens Hospital of Orange (Calif.) County re-
Carpenter on a first quarter earnings call with investors April 28. ceived reimbursement for a bill from nearly four
decades ago after a family sold their jewelry
LifePoint saw its financial picture improve in the first quarter of this
collection to pay the $10,000 tab, The Orange County
year. The for-profit hospital operator recorded net income of $64
Register reports.
million on revenues of $1.63 billion in the first quarter of 2017, up
from a net income of $23.9 million on revenues of $1.58 billion in The jewelry collection belonged to Josefina Sal-
the same period of the year prior. daa-Gaffoglio, who unexpectedly passed away from
a stroke in January. Ms. Saldaa-Gaffoglio had a long-
The financial boost was attributable to several factors, including an
time wish to use her jewelry to pay a waived hospital bill
increase in equivalent admission volumes and higher reimburse-
for treatment her son, Eric Gaffoglio, received in 1982.
ment rates from commercial payers, said LifePoint Executive Vice
President and CFO Mike Coggin during the call with investors. Mr. Gaffoglio suffered a collapsed lung after his birth at
Newport Beach, Calif.-based Hoag Hospital, and was
With its strong financial results in the first quarter, LifePoint is con-
transferred to CHOC. He spent three days at CHOC
sidering taking over additional hospitals.
and racked up a $10,000 bill, according to the report.
We believe we have opportunities for growth in each of our exist- At the time, Ms. Gaffoglio and her husband could not
ing markets by adding profitable service lines and recruiting phy- afford the bill, and CHOC waived it.
sicians, said Mr. Carpenter during the earnings call. Additionally,
Following her death, Ms. Saldaa-Gaffoglios son and
if we identify an acquisition that makes compelling, strategic and
daughter-in-law acted on her wishes and gathered about
financial sense, we have the financial flexibility to take advantage of
50 pieces of her jewelry to sell and give to CHOC. They
it and maintain a strong balance sheet.
presented a check to the hospital on April 12.
Mr. Carpenter said there is a pipeline of hospitals LifePoint is an-
Its what she wanted, Mr. Gaffoglio told two nurses,
alyzing as potential acquisition targets. The companys strategy is
who were both in the neonatal intensive care unit when
to bring any acquired hospitals from single-digit to double-digit
he was an infant. That was her wish. When she died it
margins within the first three years. n
was our responsibility to take care of [the bill]. n
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12

DOJ Sues UnitedHealth Over $1B+ in Medicare


CFO / FINANCE

Claims
By Morgan Haefner

T
he Justice Department sued Minnetonka, Minn.-based United- The DOJ filing is an intervention in a lawsuit filed under seal in
Health Group May 16, alleging the payer defrauded Medicare 2011 by Benjamin Poehling, former finance director of United-
at least $1 billion in false claims. Healthcare Medicare and Retirement. That suit alleges United-
Health billed Medicare higher payments for patients by making
In the 79-page lawsuit filed in a Los Angeles federal court, the Justice patients appear sicker than they were. In an earlier statement to
Department alleged the payer knowingly inflated risk adjustment StarTribune, UnitedHealth spokesperson Matt Burns said the pay-
payments by providing the government inaccurate data about the er denied the claims and has "been transparent with [CMS] about
health status of its beneficiaries. Department officials cited United- our approach under its unclear policies. We reject these claims
Health's "one-sided" chart review process that reportedly didn't ad- and will contest them vigorously."
dress errors elevating its revenues.
This is the second lawsuit the department has filed against the in-
The department also alleges the payer ignored "invalid diagno- surer this month. The move follows the department's decision to
ses from healthcare providers with financial incentives to furnish intervene in a whistle-blower suit filed by James Swoben in 2009. It
such diagnoses." concerns separate but similar allegations. n

OIG Tags Arkansas Hospital for Georgia Hospital to Close


Incorrect Billing After Years of Financial
By Ayla Ellison Troubles

T
he University of Arkansas Medical Sciences Medical Center By Ayla Ellison
in Little Rock failed to comply with Medicare billing require-

S
ments for 16 of 130 inpatient claims reviewed by HHS Office avannah, Ga.-based Optim Healthcare an-
of Inspector General for the audit period of Jan. 1, 2013, through nounced April 25 that it will close Optim
Dec. 31, 2104, according to an OIG report. Medical Center-Jenkins in Millen, Ga., on
June 24.
The 16 claims that did not comply with Medicare billing require-
ments resulted in the hospital receiving $197,172 in overpayments, Optim said the hospital has faced financial chal-
according to the OIG. lenges for several years caused by dwindling pa-
tient volumes and declining reimbursement from
Extrapolating from the sample results, the OIG estimated University
government payers. Optim said the hospital also
of Arkansas Sciences Medical Center received at least $278,000 in
has major infrastructure challenges, which would
overpayments from Medicare during the audit period.
require significant investments to address.
Based on its findings, the OIG recommended the hospital refund
To help stem future losses, the system will con-
$278,000 to the Medicare contractor, to which CMS outsources the
solidate the services of Optim Medical Cen-
processing and payment of claims submitted by hospitals. The OIG
ter-Jenkins with its facility about 20 minutes away
also recommended the hospital exercise reasonable diligence to
in Sylvania, Ga.
identify and return any additional overpayments outside of the au-
dit period and strengthen controls to ensure full compliance with We made this difficult decision to close our Jen-
Medicare requirements. kins facility following a lengthy analysis during
which we looked for ways to keep Jenkins open,
In written comments, University of Arkansas Sciences Medical Center
said Optim.
agreed nine of the 16 claims identified by the OIG contained billing
errors. The hospital reserved the right to appeal the OIGs determina- When the hospital closes, 55 full- and part-time
tions and the overpayment estimates for the remaining seven claims. jobs will be eliminated, according to WBJF. n
After reviewing the hospitals comments, the OIG maintained its
findings and recommendations. n
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14

Brigham and The $12M Patient Who Drove Insurance


CFO / FINANCE

Womens Offers Rates Higher in Iowa


Voluntary By Ayla Ellison

Buyouts to Iowas health insurance exchange faces a unique challenge an individual who
has $1 million per month in medical claims.

1,600 Workers David Anderson, a research associate at Duke University Margolis Center and
former health insurance official, discusses Iowas exchange market in a post on
his healthcare blog called Balloon Juice. He notes that Iowas exchange market
By Tamara Rosin is facing many of the same challenges as those in other states, such as tran-
sitional, underwritten health plans covering most of the profitable individual

B
oston-based Brigham and Womens market, but it is also experiencing the unique problem of providing insurance
Hospital said April 27 it is offering to an individual with $12 million in annual medical claims.
voluntary buyouts to 1,600 em-
ployees as a means to cut costs, The Bos- Des Moines, Iowa-based Wellmark Blue Cross and Blue Shield sent letters to
ton Globe reported. its 30,000 customers last spring, telling them it was raising their premiums by
about 38 to 43 percent for 2017. According to Mr. Anderson, about 10 percent-
Officials said the hospital, which is one of age points of that increase stemmed from one patient with a severe genetic
the citys largest employers, is profitable. disorder who receives $1 million worth of care per month.
However, its facing pressure amid shrink-
ing payments from government and com- This extreme outlier creates a difficult situation for insurers offering plans on the
mercial insurers and growing labor costs. exchange in Iowa, according to Mr. Anderson. In a competitive market where
Labor represents about 66 percent of the the subsidies are tied to the second least expensive Silver [plan] and there is
hospitals costs, according to the report. one super-outlier who cannot be reinsured against, every carrier lives in fear of
being chosen by the one outlier, he wrote. If they set their rates low enough to
Brigham is also dealing with debt from two be attractive to healthy people, they lose money on the catastrophic expected
major infrastructure projects, including a claims. If they set the rates high enough to cover a $12 million claim, no one
$510 million building that opened in 2016 buys their product.
and a $335 million software system that
rolled out in 2015, according to the report. Mr. Anderson says a solution to this issue is to remove the super-outlier from the
risk pool and use general taxes to pay for the individuals healthcare, which would
You cant just keep spending more and lower premiums in the individual market in Iowa by $10 per member per month.
more and more and not making any more,
Brigham spokeswoman Erin McDonough Wellmark Blue Cross and Blue Shield announced this month it is exiting Iowas
told The Boston Globe. We know we need ACA health insurance exchange for next year. Over the past three years, the
to work differently to sustain our mission payer has implemented double-digit premium hikes and still sustained $90
for the future. Were really looking at how million in losses on its exchange plans in Iowa. n
you reduce costs.
Although the buyouts are voluntary, hospital
officials said layoffs could come later this year
US Drug Spending to Hit $610B by 2021
depending on how many employees accept By Mackenzie Bean
the buyout offer, reports The Boston Globe.
Brigham and Womens, which is owned U.S. prescription drug spending could peak at $610 billion by 2021, according
by Boston-based Partners HealthCare, has to a new report from QuintilesIMS Holding.
about 18,000 employees, according to the Here are four things to know.
report. To be eligible for the buyout offer,
employees must be 60 or older. The deal in- 1. QuintilesIMS analysts expect U.S. drug spending to jump 4 percent to 7 per-
cludes one year of base pay. cent through 2021, hitting $580 billion to $610 billion.
About 5,300 employees including phy- 2. While analysts originally predicted an average spending growth of 6 percent
sicians, faculty and research staff will to 9 percent, the company lowered its forecast due to fewer new drug approv-
be excluded from the offer, according to als, increasing market competition and heightened scrutiny over prices.
the report. Approximately 475 unionized
workers are eligible for the buyout, but 3. When manufacturer discounts and rebates are considered, analysts expect
Brigham officials said it must get approval spending to jump 2 percent to 5 percent through 2021, reaching $375 billion
from the unions before offering members to $405 billion.
the deal. n 4. In 2016, prescription drug spending increased 5.8 percent from the year
prior to $450 billion based on list prices. When adjusted for discounts and re-
bates, spending jumped 4.8 percent to $323 billion. n
15

9 Healthcare Bankruptcies So Far in 2017

CFO / FINANCE
By Ayla Ellison

F
rom reimbursement landscape challenges to dwindling patient ter 11 bankruptcy March 1. According to documents filed with the
volumes, many factors lead hospitals and other healthcare orga- court, the proton therapy center has not operated on a profitable or
nizations to file for bankruptcy. even a break-even basis since it opened in February 2014.
Here are nine healthcare organizations that have filed for bankruptcy 5. Humble (Texas) Surgical Hospital filed for Chapter 11 bankruptcy
since Jan. 1, beginning with the most recent. Feb. 24. The hospital filed its bankruptcy petition after a judge ordered
it to pay Hartford, Conn.-based Aetna $51.4 million in a seven-year-
1. York, Pa.-based medical device company Unilife Corp., which old court battle over the hospitals out-of-network charges.
develops and markets injectable drug delivery systems, filed for
Chapter 11 bankruptcy in early April. We have conducted an 6. Louisiana Heart Hospital in Lacombe filed for Chapter 11 bank-
extensive review of alternatives to address Unilifes capital struc- ruptcy Jan. 30. The hospital shut down Feb. 10 and closed its 16 med-
ture, and we believe pursuing a balance sheet restructuring or sale ical clinics Feb. 28.
through Chapter 11 is the best path forward at this time, said John
Ryan, CEO of Unilife. 7. Aventura, Fla.-based Advanced Neuro Spine Institute, a medical
group specializing in neurology, neurosurgery and pain management,
2. Green Valley (Ariz.) Hospital filed for Chapter 11 bankrupt- filed for Chapter 11 bankruptcy Jan. 25.
cy April 3. In its bankruptcy documents the hospital says it was
poorly managed and undercapitalized since it opened about 8. North Texas Medical Center in Gainesville, which is owned by the
two years ago. Gainesville Hospital District, filed for Chapter 9 bankruptcy Jan. 17.
With the hope of regaining its financial footing, the hospitals board
3. Naperville, Ill.-based Vital Wellness Home Health, which provides approved a partnership with King of Prussia, Pa.-based Universal
home health and private duty services in the Chicago, Phoenix and Health Services in December.
Denver areas, filed for Chapter 11 bankruptcy March 2. In its bank-
ruptcy petition the company listed its liabilities as $2.3 million, and 9. The public trust that operates Atoka (Okla.) County Medical Center
the total value of its assets as about $1 million. filed for Chapter 9 bankruptcy Jan. 10. At that time, the critical access
hospital was about $16 million in debt. n
4. California Proton Treatment Center, the San Diego-based invest-
ment group that owns Scripps Proton Therapy Center, filed for Chap-

Tenet Sees Net Loss Narrow to $53M, Inks Deal to Sell 3 Hospitals
to HCA
By Ayla Ellison

D
allas-based Tenet Healthcare said May 1 it ended Tenn.-based HCA Holdings for about $725 million. The
the first quarter with a net loss. However, the com- transaction, which is subject to regulatory approval, is ex-
pany said it has entered into several agreements to pected to close in the third quarter of this year.
improve its financial picture in the long term.
Tenet is also accelerating the purchase of ambulatory sur-
Tenet recorded revenues of $4.8 billion in the first quarter gery center chain United Surgical Partners International.
of 2017, a 4.6 percent year-over-year decrease. The compa- Tenet said its ownership interest in USPI would increase to
nys ambulatory care segment and revenue cycle manage- 80 percent by July 3.
ment subsidiary had strong performance in the first quarter,
but revenue from its hospital operations was down. Tenet In addition to the hospital and ASC transactions, Tenet also
said the decrease in revenue was attributable, in part, to the announced it reached a new, multiyear agreement with
sale of its hospitals in Atlanta in April 2016 and not being Louisville, Ky.-based insurer Humana that calls for all of
able to record revenue under the California Provider Fee Tenets hospitals, hospital-affiliated outpatient centers and
Program, since extension of the program hasnt been ap- employed physicians to be phased back into the insurers
proved by CMS. network between June 1, 2017, and Oct. 1, 2017.

Tenet ended the first quarter with a net loss of $53 million, Tenet Chairman and CEO Trevor Fetter said the transac-
which was an improvement from the $59 million net loss it tions and the new agreement with Humana are part of a
recorded in the same period of the year prior. The company strategic effort to reduce complexity across the enterprise
expects its financial performance to improve further due to and enhance returns for our shareholders. In January, Mr.
several strategic agreements it recently entered. Fetter said Tenets long-term strategy is to increase the per-
centage of markets where the company has the leading or
On May 1, Tenet announced it signed a definitive agree- second-place market share. n
ment to sell its three hospitals in Houston to Nashville,
16

RAND Study: MACRA Could Cause $250B Drop in


CFO / FINANCE

Hospital Medicare Revenue by 2030


By Emily Rappleye

D
epending on the amount of risk physicians choose to take on 2019 to 2024. Beginning in 2026, there is a 0.25 percent annual update
under the Medicare Access and CHIP Reauthorization Act, to payment rates for MIPS physicians and a 0.75 percent update for
hospitals Medicare revenue could drop by $250 billion by those in APMs. This scenario would produce a projected $22 billion
2030 or it could increase by $32 billion, according to a study published decline in hospital Medicare revenues.
in Health Affairs.
Scenario 4: High-strength incentives. This scenario assumes the
The study estimates the effect of MACRA on physician and hospital majority of physicians in APMs are in high-financial risk models like the
Medicare revenue under various scenarios using the RAND Corpo- Next Generation ACO. Compared to the baseline, physician revenue from
rations Health Care Payment and Delivery Simulation Model. Unfor- Medicare would decline $106 billion from 2015-2030. Hospital Medicare
tunately for physicians the outlook is less favorable their Medicare revenue is projected to decline by $250 billion under this scenario because
revenue is expected to drop by billions of dollars in all scenarios.Phy- physicians would be more likely to respond to the strong incentives and
sicians Medicare revenue will decline between $35 billion and $106 try to reduce the use of hospital services, according to the report. n
billion from 2015 to 2030, according to the study.
The researchers examined three MACRA scenarios based on how
much risk providers choose to take on under the laws alternative
payment model track. These three scenarios were compared against
Study: High Prices Not
a counterfactual pre-MACRA baseline, which was the control group
of sorts; it projected spending as if MACRA did not exist and sustain- Necessarily Indicative of Better
able growth rate fixes continued. Each of the three MACRA scenarios
assumed APM participation rates over the projection period (2015 to Quality for Outpatient Services
2030) by extrapolating current ACO participation rates. Using this
method, by 2030, 40 percent of physicians would be participating in By Kelly Gooch

H
some type of APM, while the remaining 60 percent would be in the
other track, the merit-based incentive payment system. igh prices for outpatient services at physician
practices do not necessarily guarantee better
Here is how Medicare spending would change under each of the sce- care quality and efficiency, suggests a new study
narios presented by the study. published in Health Affairs.
Scenario 1: Pre-MACRA baseline. Under this scenario, the For the study, researchers identified high- or low-price
study authors project that physician Medicare revenue would increase physician practices using commercial claims data. They
from $81 billion in 2014 to $109 billion in 2030. Hospital Medicare said they also examined 2013 fee-for-service Medicare
revenue would grow from $223 billion to $413 billion in 2030. CAHPS survey data and linked 20112012 Medicare
Scenario 2: Low-strength incentives. This scenario assumes claims to compare high- and low-price physician prac-
the bulk of physicians participating in APMs are participating in pa- tices in the same geographic area based on care quality,
tient-centered medical homes, such as the Comprehensive Primary utilization and spending.
Care Plus model. These models are considered low-strength because The study, which included a sample of roughly 31,200
they do not require providers to take on downside financial risk. Un- survey respondents, found high-price physician practic-
der this scenario, physician Medicare revenue would decline by $35 es received an average of $84.45 for an outpatient visit,
billion from 2015-2030 compared to the baseline. However, hospital up 36 percent compared with the average of $62.06 for
revenue is projected to increase by $32 billion. low-price physician practices.
Scenario 3: Medium-strength incentives. This scenario as- As far as care quality, patients who visited high-price phy-
sumes physicians participate in a mix of APMs, the majority in PCM- sician practices reported significantly higher scores on
Hs, some in models similar to the Medicare Shared Savings Program some measures of care coordination and management,
Track 2 ACO model, and a minority in high-risk models like the Next according to the study. However, patients who visited
Generation ACO. For example, by 2030, the medium-strength scenar- high-price physician practices and patients who visited
io assumes 4 percent of physicians are in Next Generation ACO-like low-price physician practices did not differ meaningful-
models, 12 percent are in models similar to MSSP Track 2 ACOs and ly with their overall care ratings, physician ratings and
24 percent are in PCMHs. The remaining physicians are in the MIPS access to care, receipt of preventive services, acute care
track. Compared to the baseline, this scenario would mean physician use or total Medicare spending, the study notes.
Medicare revenue would decline by $47 billion from 2015-2030. Most
of the decline would happen in the second half of the study period This suggests an overall weak relationship between
because of the way payment rates are structured under the law. From practice prices and the quality and efficiency of care
2015 to 2019, the law prescribes a 0.5 percent nominal payment rate and calls into question claims that high-price provid-
increase. Then from 2020 to 2025, there is no nominal payment rate ers deliver substantially higher-value care, the studys
increase. However, APMs have the opportunity to earn lump sum bo- authors concluded. n
nuses that could increase Medicare payments by up to 5 percent from
Executive Briefing 17
18 Executive Briefing

Sponsored by:

Avoiding Friction in the Age of High-Deductible Health Plans: How


Innovative Solutions Can Help Providers Succeed

T
he consumer-driven healthcare era has transformed the Recent Congressional Budget Office data found the average
role of the patient. Today, patients are more informed premium for a 21-year-old will total $5,100 under the ACA and
about their treatment options and what they will have $3,900 under the AHCA in 2026. A 64-year-old will pay an av-
to pay out-of-pocket. Driven by a desire to obtain affordable erage premium of $15,300 under the ACA and $19,500 under
healthcare, patients seek providers that align with their overall the AHCA in 2026. Any escalated premiums will likely create
needs without compromising care. more price-sensitive consumers who seek a relatively seamless
process in all aspect of care, including the payment process.
As higher premiums and deductibles propel healthcare orga- Therefore, hospitals and providers will need to employ the right
nizations into more consumer-facing interactions, hospitals and tools to make this process as painless as possible.
health systems today understand they can no longer solely fo-
cus on the clinical side of care. They must also be upstanding Limiting friction in the payment process
in the revenue cycle management process and ensure patients When providers fail to effectively manage claims and obtain
have the information they need to follow through on payments. the necessary information from patients to avoid payer denials,
they risk creating diversions in the payment process that can
Healthcare's transformative business model harm the patient-provider relationship and create friction. Mr.
The evolution of the healthcare business model corresponds Law defines friction as any irregularity to an otherwise smooth
to the development of the payment process. What once was a payment process.
business-to-business transaction has been replaced by some-
thing more complex and difficult to navigate a business-to-busi- For instance, a provider could obtain an inappropriate denial
ness-to-consumer model. In a business-to-business model, a prac- from an insurance company, which raises a slew of questions
tice would file a claim to the insurance company who would then including whether the administrative team received all the cor-
adjudicate the claim and pay the provider for services rendered. rect information from the patient. This could be a product of a
staff member failing to verify a patient's information or a patient
"That was the easy money," says T. Scott Law, founder and CEO hastily writing down their information and making an error in
of Zotec Partners, a leading provider of revenue cycle manage- the process. Nonetheless, friction occurs and this is a phenom-
ment services to multi-specialty practices and health systems. enon providers want to avoid in their RCM process.
"The transaction was electronic; you were dealing with a busi-
ness. You had rules to comply with but it was pretty straight- Mr. Law cites data that found almost 30 percent of all claims are
forward with reasonable technology." either inappropriately denied or inappropriately paid. Of that
30 percent, half of claims are not followed up on. In those cases,
In the business-to-business-to-consumer payment model, pro- a provider is essentially walking away with nothing.
viders have to send the insurance company a bill and get it ad-
judicated. The insurance company may well come back to the "If a patient calls and complains, that's friction in the process,"
provider saying a patient owes the deductible, so the provider Mr. Law explains. "We measure the amount of friction, which
then bills the patient for that deductible. After billing the patient depends on how clean the data is, how the carrier processes
for the deductible, a provider has to get that money adjudicat- the claims, the ability of a patient to pay... Friction is any excep-
ed by the insurance company and only then can the provider tion to the payment process."
bill the patient and collect for the services rendered.
Zotec's technology has the ability to predict the likelihood of
This model has taken shape due to rising deductibles and copay- friction on a per-patient basis. Technology can assess several
ments. In 2016, covered employees had an average deductible of factors to determine this value, including a patient's propensity
$1,478 for single coverage, up from $1,318 in 2015, according to to pay, as well as the insurance company's likelihood of deny-
data from the Kaiser Family Foundation. Additionally, many covered ing or filing inappropriate denials and the provider's consisten-
workers have copayments. Sixty-seven percent of covered workers cy in relaying accurate insurance or payment information to the
have a copayment for a primary care visit. For primary care, the patient. However, all of this information must be 100 percent
average in-network copayment totaled $24 in 2016. An InstaMed correct because inaccurate information can completely alter a
study found the number of consumer payments to healthcare pro- specific patient's estimated friction.
viders increased 193 percent between 2011 and 2014.
"We have statistic modeling tools we use under the umbrella
All facets of the healthcare industry are waiting to see if Re- of big data. The most important thing we've found is you have
publicans' healthcare bill, the American Health Care Act, will to be able to track these events with a great deal of certainty so
pass, as reform legislation may increase premiums for some you come up with the proper conclusion," Mr. Law says.
and lower rates for others depending on their age and health.
Executive Briefing 19

How technology can reduce friction text message informing them that Zotec filed the claim and the
If providers successfully employ technology to determine an patient should be aware they will likely owe a certain amount of
estimated amount of friction, they can then fine-tune the best money. In the text, Zotec tells patients they will be notified once
next steps to boost a patient's likelihood of paying. Zotec caters the insurance company adjudicates that claim.
its technological solutions to each patient to ensure they use
the platform that best suits their needs and preferences. "The big problem with consumers is the surprise," Mr. Law says.
"They get a bill for $5,000 and they didn't even know. They are
"We personalize patients profiles based on what they are most getting billed for an entire deductible maybe in the first en-
likely to appreciate in terms of collection methods," Mr. Law counter they have [with a provider]. That's a big surprise for
says. "If a patient is a millennial, they may want a text telling $5,000 that they don't have and for [care] they don't think they
them to pay online. If a patient is 70, they may want to receive a need. Who is going to make that choice?"
text because their grandkids are texting, but they may still want
to hand-write a check and mail that in." Being transparent with consumers is increasingly important, and
having an open dialogue about the estimated cost of care will
Through its individualized platforms, the payment process is eas- often translate to reduced friction. Healthcare payments do not
ier for patients and will likely translate to a higher propensity for work the same way as other industries. If an individual fails to
patients to follow through on bills. As the industry continues to make a credit card payment repeatedly, this will affect their Fed-
trend toward the consumer, providers cannot forgo the impor- eral Insurance Contributions Act (FICA) score. If a patient does
tance of minimizing friction, particularly because value-based not make a payment for a healthcare service they received, this
outcomes and patient satisfaction scores dictate payments. will not impact their FICA score, making it exceedingly difficult
for providers to exercise disincentives when collecting payments.
Employing a third-party revenue cycle management partner
can empower healthcare organizations to reduce the friction "I don't have a hammer to affect people's credit ratings," Mr. Law
with patients and help providers bolster their bottom line by says. "[Instead], we introduce things earlier in the process by edu-
increasing collections. cating patients on their deductible and why they owe this money.
We do it through technology, versus the old days, where you'd
A 2017 Navicure survey found 51 percent of providers say it send two or three payments and hope patients paid them."
takes an average patient more than three months to pay their
full balance. However, only 18 percent of patients claim it took Zotec offers a portal that allows patients to stay updated on
them longer than three months to pay their last balance, indi- their insurance information and set up payment plans through a
cating a lack of consensus between the two parties on this topic. text or integrated voice response system. Texting is a preferred
method of communication for a large portion of patients, and
Whether a lapse in communication or varying perspectives on using a platform that bodes well with patients will fare well for
payment dates, many providers and patients are not on the providers in receiving payments.
same page regarding payments and their timeliness. Using
a third party vendor is becoming more commonplace in the "Text messaging is by far the [most popular] thing when you
industry, especially as healthcare executives are increasingly get into the consumer space," Mr. Law says. "We have to meet
adopting more responsibilities, such as improving infection consumers in spaces they understand in order for them to ap-
control protocols or meeting CMS' reporting requirements. preciate the exchange."
Letting the patient billing experience fall to the wayside may
cost a provider significant amounts of money, which is where a Technology can also minimize the likelihood of a denial due
revenue cycle management partner comes into play. to inaccurate or incomplete information. Equipped with editing
engines, Zotec has solutions that compare a claim to a patient's
Black Book projected the market for outsourced revenue cycle policy information to ensure there aren't any discrepancies that
management services is likely to increase at a compound an- would prohibit a provider from receiving payment in full. Ad-
nual growth rate of 26.5 percent in the next two years, reach- ditionally, Zotec does eligibility checks and verifies statements
ing $9.7 billion by 2018. On a micro-level, hospital executives prior to sending those to patients. "We wouldn't send a bill for a
understand the benefits a revenue cycle management partner high-dollar amount without that [the verification]. Those are the
can offer. The survey found almost 50 percent of hospital CFOs ones that cause the most friction," Mr. Law notes.
acknowledged outsourcing has become a more viable alterna-
tive to in-house management in 2017. With technology, providers can avoid friction that impedes a
successful payment process. Zotec was aware of the consumer-
Zotec works with providers around the United States to improve ism shift within healthcare nearly five to seven years ago and has
the payment process so practices and hospitals can focus on other been creating solutions to address this trend. Providers that fail
areas, such as clinical delivery. Mr. Law says Zotec brings patients to prioritize the consumer will fall behind their competitors, both
into the mix much earlier in the process, which helps eliminate in terms of reputation and finances, as patient satisfaction is a
some of the missteps that can occur along the way with payments. core component of the value-based healthcare era. With the rise
of high-deductible health plans, patient-focused care is here to
The company will file a claim to the insurance company on be- stay and providers should prepare to thrive in this landscape. n
half of a practice. Once completed, Zotec will send the patient a

Zotec Partners is an industry leader in revenue cycle and practice management services for physicians and health systems, managing in
excess of 70 million medical encounters annually. The company is committed to the continual pursuit of excellence, delivering effective
solutions through its proprietary technology, personalized service and measurable client results. Currently, Zotec Partners serves more
than 8,000 physicians in all 50 states.
20

230 Hospital Benchmarks | 2017


By Ayla Ellison and Jessica Kim Cohen

H
ospitals across the nation compete in a 13. Median time before patient received an tional Survey Results December 2016, the latest
number of ways, including on quality electrocardiogram: 7 minutes available data for these measures.
of care and price, and many use bench-
marking to determine the top priorities for Lower extremity joint replacement patients Overall hospital rating
improvement. The continuous benchmarking 14. Rate of complications for hip/knee replace-
ment patients: 3 percent 29. Patients who gave the hospital a rating of
process allows hospital executives to see how nine or 10: 72 percent
their organizations stack up against regional Stroke patients
competitors as well as national leaders. 15. Who received fibrinolysis within three 30. Patients who gave the hospital a rating of
hours after symptoms started: 87 percent seven or eight: 21 percent
For the sixth year,Beckers Hospital Reviewhas
collected benchmarks related to some of the Blood clot patients 31. Patients who gave the hospital a rating of
most important day-to-day areas hospital ex- 16. Who were discharged on a blood thinner six or lower: 7 percent
ecutives oversee: quality, patient satisfaction, medicine and received written instructions
staffing, utilization, finance, affiliations, com- Patient recommendation
about that medicine: 93 percent 32. Patients who said, yes, they would definitely
pensation and health IT.
Colonoscopy patients recommend the hospital to friends and family:
Quality and process of care 17. Who received appropriate recommenda- 72 percent
Source: Hospital Compare, HHS, Complica- tion for follow-up colonoscopy: 80 percent
tions-National Averages December 2016 and 33. Patients who said, yes, they would probably
Timely and Effective Care Measures-National 18. Percentage of patients with history of pol- recommend the hospital to friends and family:
Averages December 2016, the latest available yps who received follow-up colonoscopy in the 23 percent
data for these measures. appropriate timeframe: 87 percent 34. Patients who said, no, they probably or
Hospital-acquired conditions Flu vaccination definitely would not recommend the hospital
The following represent the average percentage of 19. Preventive care patients assessed and given to friends and family: 5 percent
patients in the U.S. who experienced the conditions. flu vaccination: 94 percent Cleanliness
1. Collapsed lung due to medical treatment: 20. Healthcare workers who received flu vacci- 35. Patients who said their room and bathroom
0.41 percent nation: 86 percent was always clean: 74 percent

2. A wound that splits open on the abdomen or Pregnancy and delivery care 36. Patients who said their room and bathroom
pelvis after surgery: 2.32 percent 21. Mothers whose deliveries were scheduled was usually clean: 18 percent
one to two weeks early, when a scheduled de- 37. Patients who said their room and bathroom
3. Accidental cuts and tears from medical treat- livery was not medically necessary: 2 percent
ment: 1.43 percent was sometimes or never clean: 8 percent
Emergency department care Noise
4. Serious blood clots after surgery: 5.31 per- 22. Average time spent in the ED before patient
cent 38. Patients who said the area around their
is admitted to the hospital as an inpatient: 279 room was always quiet at night: 62 percent
5. Serious complications: 0.9 percent minutes
39. Patients who said the area around their
6. Bloodstream infection after surgery: 10.21 23. Average time patient spent in ED after the room was usually quiet at night: 29 percent
percent physician decided to admit as an inpatient but
before leaving the ED for the inpatient room: 40. Patients who said the area around their
7. Infections from a large venous catheter: 0.17 99 minutes room was sometimes or never quiet at
percent night: 9 percent
24. Average time patient spent in the ED before
8. Developed a blood clot while in the hospital sent home: 140 minutes Physician communication
and did not get treatment that could have pre- 41. Patients who said their physicians always
vented it: 2 percent 25. Average time patient spent in the ED before communicated well: 82 percent
seen by a healthcare professional: 22 minutes
Heart attack patients 42. Patients who said their physicians usually
9. Median time to fibrinolysis: 28 minutes 26. Average time patient who came to the ED communicated well: 14 percent
with broken bones had to wait before receiving
10. Median time to transfer to another facility pain medication: 52 minutes 43. Patients who said their physicians some-
for acute coronary intervention: 58 minutes times or never communicated well: 4 per-
27. Percentage of patients who came to the ED cent
Outpatients with chest pain or possible heart with stroke symptoms who received brain scan
attack results within 45 minutes of arrival: 69 percent Nurse communication
11. Who received aspirin within 24 hours of 44. Patients who said their nurses always
arrival or before transferring from the emer- 28. Percentage of patients who left the ED be- communicated well: 80 percent
gency department: 96 percent fore being seen: 2 percent
45. Patients who said their nurses usually
12. Who received drugs to break up blood clots Patient satisfaction communicated well: 16 percent
within 30 minutes of arrival: 59 percent Source: Hospital Compare, HHS, HCAHPS Na-
21

46. Patients who said their nurses sometimes 65. Hospitals with 200 to 299 beds: 1,192 98. Hospitals with 300 to 399 beds: 4,182
or never communicated well: 4 percent
66. Hospitals with 300 to 399 beds: 1,727 99. Hospitals with 400 to 499 beds: 5,710
Pain control
47. Patients who said their pain was always 67. Hospitals with 400 to 499 beds: 2,562 100. Hospitals with 500 or more beds: 10,236
well controlled: 71 percent 68. Hospitals with 500 or more beds: 5,005 Average outpatient visits per year
48. Patients who said their pain was usually Averages include both hospital and nursing
Average part-time staff home units.
well controlled: 22 percent 69. Hospitals with six to 24 beds: 50
49. Patients who said their pain was some- 101. Hospitals with six to 24 beds: 23,780
70. Hospitals with 25 to 49 beds: 81
times or never well controlled: 7 percent 102. Hospitals with 25 to 49 beds: 45,249
71. Hospitals with 50 to 99 beds: 132
Explanation of medicines 103. Hospitals with 50 to 99 beds: 66,154
50. Patients who said staff always explained 72. Hospitals with 100 to 199 beds: 263
medicines before administering: 65 percent 104. Hospitals with 100 to 199 beds: 135,975
73. Hospitals with 200 to 299 beds: 453
51. Patients who said staff usually explained 105. Hospitals with 200 to 299 beds: 212,085
medicines before administering: 18 percent 74. Hospitals with 300 to 399 beds: 567
106. Hospitals with 300 to 399 beds: 271,538
52. Patients who said staff sometimes or 75. Hospitals with 400 to 499 beds: 835
never explained medicines before adminis- 107. Hospitals with 400 to 499 beds: 415,662
76. Hospitals with 500 or more beds: 1,341
tering: 17 percent 108. Hospitals with 500 or more beds: 667,839
Utilization
Assistance from hospital staff Source: American Hospital Association Hospi- Average outpatient surgeries per year
53. Patients who said they always received tal Statistics report, 2017 Edition. Averages include both hospital and nursing
help as soon as they wanted: 69 percent home units.
Average admissions per year
54. Patients who said they usually received 77. Hospitals with six to 24 beds: 394 109. Hospitals with six to 24 beds: 663
help as soon as they wanted: 23 percent
78. Hospitals with 25 to 49 beds: 922 110. Hospitals with 25 to 49 beds: 1,040
55. Patients who said they sometimes or
never received help as soon as they wanted: 79. Hospitals with 50 to 99 beds: 2,098 111. Hospitals with 50 to 99 beds: 1,708
8 percent
80. Hospitals with 100 to 199 beds: 5,779 112. Hospitals with 100 to 199 beds: 3,417
Recovery plan
81. Hospitals with 200 to 299 beds: 11,011 113. Hospitals with 200 to 299 beds: 5,528
56. Patients who said staff provided informa-
tion about what to do during their recovery at 82. Hospitals with 300 to 399 beds: 16,133 114. Hospitals with 300 to 399 beds: 6,934
home: 87 percent
83. Hospitals with 400 to 499 beds: 20,410 115. Hospitals with 400 to 499 beds: 9,364
57. Patients who said staff did not provide in-
formation about what to do during their recov- 84. Hospitals with 500 or more beds: 33,623 116. Hospitals with 500 or more beds: 15,124
ery at home: 13 percent
Average length of stay Finance
Care plan at discharge 85. Hospitals with six to 24 beds: 4.5 days Average adjusted expenses per inpatient day
58. Patients who strongly agreed they under- Source: Kaiser State Health Facts, accessed in
86. Hospitals with 25 to 49 beds: 5.1 days 2017 and based on 2015 data.
stood their care when they left the hospital: 52
percent 87. Hospitals with 50 to 99 beds: 5.5 days Adjusted expenses per inpatient day include all
59. Patients who agreed they understood their 88. Hospitals with 100 to 199 beds: 4.6 days operating and nonoperating expenses for reg-
care when they left the hospital: 43 percent istered U.S. community hospitals, defined as
89. Hospitals with 200 to 299 beds: 4.7 days public, nonfederal, short-term general and other
60. Patients who disagreed or strongly dis- hospitals. The figures are an estimate of the ex-
agreed they understood their care when they 90. Hospitals with 300 to 399 beds: 4.9 days penses incurred in a day of inpatient care and
left the hospital: 5 percent have been adjusted higher to reflect an estimate
91. Hospitals with 400 to 499 beds: 5.1 days
of the volume of outpatient services.
Staffing
92. Hospitals with 500 or more beds: 5.5 days
Source: American Hospital Association Hospi- 117. Nonprofit hospitals: $2,413
tal Statistics report, 2017 Edition. Average inpatient surgeries per year
Averages include both hospital and nursing 118. For-profit hospitals: $1,831
Full- and part-time staff averages are for the
home units. 119. State/local government hospitals: $2,013
hospital unit only and do not include separate
nursing home units. 93. Hospitals with six to 24 beds: 90 Key ratios
Average full-time staff 94. Hospitals with 25 to 49 beds: 200 Source: Moodys Investors Service, U.S. Not-for-
61. Hospitals with six to 24 beds: 99 Profit Hospital 2015 Medians report, Septem-
95. Hospitals with 50 to 99 beds: 480 ber 2016.
62. Hospitals with 25 to 49 beds: 176
96. Hospitals with 100 to 199 beds: 1,419 The medians are based on an analysis of audited
63. Hospitals with 50 to 99 beds: 286 2015 financial statements for 340 freestanding
97. Hospitals with 200 to 299 beds: 2,893
hospitals, single-state health systems and multi-
64. Hospitals with 100 to 199 beds: 646
22

state health systems, representing 81 percent of 148. EBIDA margin: 13.3 percent A rating
all Moodys rated healthcare entities. Childrens 177. Days cash on hand: 182.5
hospitals, hospitals for which five years of data AA- rating
are not available and certain specialty hospitals 149. Operating margin: 3.5 percent 178. Days in accounts receivable: 49.1
were not eligible for inclusion in the medians. 150. Operating EBIDA margin: 10.4 percent A- rating
120. Maintained bed occupancy: 64.3 percent 179. Days cash on hand: 156.6
151. Excess margin: 6.4 percent
121. Operating margin: 3.4 percent 180. Days in accounts receivable: 46.2
152. EBIDA margin: 12.7 percent
122. Excess margin: 6.1 percent BBB+ rating
A+ rating 181. Days cash on hand: 148.7
123. Operating cash flow margin: 10.3 percent 153. Operating margin: 4.1 percent
182. Days in accounts receivable: 47.6
124. Return on assets: 4.8 percent 154. Operating EBIDA margin: 10.3 percent
Health IT
125. Three-year operating revenue CAGR: 5.8 155. Excess margin: 5.6 percent HIMSS Analytics EMR Adoption Model,
percent 156. EBIDA margin: 12.3 percent which runs from Stage 0 to Stage 7
Source: HIMSS Analytics, EMR Adoption Mod-
126. Three-year operating expense CAGR: 5.5 A rating el, fourth quarter of 2016, the latest available
percent 157. Operating margin: 3.6 percent data for these measures.
127. Days cash on hand: 211.8 days 158. Operating EBIDA margin: 10.6 percent 183. Stage 7 providers: 4.8 percent
128. Annual operating revenue growth rate: 7.5 159. Excess margin: 5.2 percent 184. Stage 6 providers: 30.5 percent
percent
160. EBIDA margin: 11.1 percent 185. Stage 5 providers: 34.9 percent
129. Annual operating expense growth rate: 6.6
percent A- rating 186. Stage 4 providers: 10.2 percent
161. Operating margin: 2.9 percent
130. Total debt-to-capitalization: 33.7 percent 187. Stage 3 providers: 13.9 percent
162. Operating EBIDA margin: 9.5 percent
131. Total debt-to-total operating revenue: 34.5 188. Stage 2 providers: 2.3 percent
percent 163. Excess margin: 3.9 percent
189. Stage 1 providers: 1.4 percent
132. Current ratio: 2.0x 164. EBIDA margin: 10.8 percent
190. Stage 0 providers: 1.9 percent
133. Cushion ratio: 20.6x BBB+ rating
165. Operating margin: 0.8 percent Affiliations
134. Annual debt service coverage: 5.2x Source: American Hospital Association Hospi-
166. Operating EBIDA margin: 6.8 percent tal Statistics report, 2017 Edition.
135. Maximum annual debt service coverage:
4.8x 167. Excess margin: 3.4 percent Part of a group purchasing organization
191. Hospitals with six to 24 beds: 67 percent
136. Debt-to-cash flow: 2.7x 168. EBIDA margin: 8.7 percent
192. Hospitals with 25 to 49 beds: 69 percent
137. Capital spending ratio: 1.1x Days cash on hand and days in accounts re-
ceivable by credit rating group 193. Hospitals with 50 to 99 beds: 66 percent
138. Accounts receivable: 48.4 days Source: S&P Global Ratings U.S. Not-For-Profit
Health Care System Median Financial Ratios 194. Hospitals with 100 to 199 beds: 72 percent
139. Average payment period: 64.3 days
2015 vs. 2014 report, September 2016. 195. Hospitals with 200 to 299 beds: 77 percent
140. Average age of plant: 11 years
AA+ rating 196. Hospitals with 300 to 399 beds: 82 percent
Hospital margins by credit rating group 169. Days cash on hand: 426.2
Source: S&P Global Ratings U.S. Not-For-Profit 197. Hospitals with 400 to 499 beds: 86 percent
Health Care System Median Financial Ratios 170. Days in accounts receivable: 45.8
2015 vs. 2014 report, September 2016. 198. Hospitals with 500 or more beds: 93 per-
AA rating cent
AA+ rating 171. Days cash on hand: 292.9
141. Operating margin: 6.2 percent Part of a health system
172. Days in accounts receivable: 49.9 199. Hospitals with six to 24 beds: 46 percent
142. Operating EBIDA margin: 13.1 percent AA- rating 200. Hospitals with 25 to 49 beds: 55 percent
143. Excess margin: 8.4 percent 173. Days cash on hand: 258.2
201. Hospitals with 50 to 99 beds: 67 percent
144. EBIDA margin: 14.8 percent 174. Days in accounts receivable: 48.8
202. Hospitals with 100 to 199 beds: 75 percent
AA rating A+ rating
145. Operating margin: 4.9 percent 175. Days cash on hand: 200.3 203. Hospitals with 200 to 299 beds: 74 percent

146. Operating EBIDA margin: 10.6 percent 176. Days in accounts receivable: 46.2 204. Hospitals with 300 to 399 beds: 77 percent

147. Excess margin: 7.2 percent 205. Hospitals with 400 to 499 beds: 75 percent
206. Hospitals with 500 or more beds: 75 percent
23

Compensation

Finally...
Source: Integrated Healthcare Strategies 2016 National Healthcare Lead-
ership Compensation Survey.
Average base salary for independent hospital executives
207. CEO: $487,000
208. CFO: $227,900
209. COO: $323,000
Average total cash compensation for independent hospital ex-
ecutives
210. CEO: $553,400
211. CFO: $305,000
212. COO: $357,800
Average base salary for subsidiary hospital executives
213. CEO: $387,500
214. CFO: $276,000
215. COO: $304,700
Average total cash compensation for subsidiary hospital exec-
utives
216. CEO: $462,000
217. CFO: $309,300
218. COO: $349,200
...a messaging
Average base salary for independent health system executives
219. CEO: $826,500
solution physicians
220. CFO: $453,300 will want to use.
221. COO: $503,100
Average total cash compensation for independent health system
executives
222. CEO: $1.04 million
by
223. CFO: $538,400
224. COO: $606,300
Average base salary for subsidiary health system executives A Powerful,
Secure
225. CEO: $699,500
226. CFO: $406,800
227. COO: $376,800 Messaging
Average total cash compensation for subsidiary health system
executives Solution
228. CEO: $866,300
229. CFO: $478,400
230. COO: $430,300 n

Created
by Physicians,
for Physicians
www.mdinterconnect.com/evolve
24

Truven Names 15 Top Health Systems for 2017


By Ayla Ellison

T
ruven Health Analytics, a healthcare Large health systems (total operating ex- Mission Health (Asheville, N.C.)
data and analytics solutions provider, pense of more than $1.75 billion)
released its ninth annual list of the na- Parkview Health (Fort Wayne, Ind.)
tions 15 top health systems. Mayo Foundation (Rochester, Minn.)
Small health systems (total operating ex-
Mercy (Chesterfield, Mo.) pense of less than $750 million)
CEO/STRATEGY

To identify the top 15 health systems, Truven


analyzed data from 337 health systems based Scripps Health (San Diego) Asante (Medford, Ore.)
on the following five performance domains:
inpatient outcomes, process of care, extended Spectrum Health (Grand Rapids, Mich.) Lakeland Health (St. Joseph, Mich.)
outcomes, efficiency and patient experience.
St. Lukes Health System (Boise, Idaho) Lovelace Health System (Albuquerque, N.M.)
When compared to their peers, this years
top 15 health systems achieved higher sur- Medium health systems (total operating ex- Maury Regional Health (Columbia, Tenn.)
vival rates, released patients from the hospi- pense of between $750 million and $1.75 bil-
lion) Roper St. Francis Healthcare (Charleston,
tal sooner, had fewer readmissions, shorter S.C.)
emergency department wait times and higher HealthPartners (Bloomington, Minn.)
patient satisfaction scores, according to Tru- The 15 Top Health Systems study is part of
ven Health. Kettering Health Network (Dayton, Ohio) Truvens 100 Top Hospitals program. n

Here are the Truven Health 15 Top Health Mercy Health Southwest Ohio Region (Cin-
Systems, organized by system size. cinnati)

Cleveland Clinic President and CEO Dr. HCA to Change Its


Toby Cosgrove to Step Down in 2017 Name Again
By Alyssa Rege By Ayla Ellison

T N
oby Cosgrove, MD, president and CEO of Cleveland Clinic, re- ashville, Tenn.-based HCA Holdings
vealed plans to transition out of his executive roles later this year. board of directors voted to rework the
He will reportedly continue on in an advisory role to the Cleve- companys name, CEO Milton Johnson
land Clinic. said on a May 2 earnings call.
Dr. Cosgrove served as president and CEO of the system for roughly The companys new name is HCA Healthcare
13 years. The Clinics board of directors and board of governors plan to as of May 8.
jointly select Dr. Cosgroves successor by the end of 2017. Officials will
search for another practicing physician to lead the organization. Regarding the change, Mr. Johnson said, Our
new name is more reflective of our mission
Under his leadership, the Cleveland Clinic launched a number of major and the broad spectrum of care we provide
wellness initiatives for patients, employees and communities, including to our communities and the dedication of our
a same-day medical appointment policy, the cessation of smoking on caregivers to our patients in our vast network
all Cleveland Clinic campuses, weekly farmers markets at the Clinic in of inpatient and outpatient facilities across our
the fall and winter months and free memberships to Weight Watchers 42 U.S. markets and the U.K.
and various exercise facilities for all employees, among other programs.
The company will continue to trade under the
Prior to his executive roles with the Cleveland Clinic, Dr. Cosgrove prac- ticker symbol HCA after the change takes ef-
ticed as a cardiac surgeon for nearly 30 years. fect.
It is an honor and a privilege to be a part of an extraordinary and for- HCA has reworked its name several times over
ward-thinking organization that puts patients at the center of everything the years. Prior to HCA Holdings, the compa-
we do, Dr. Cosgrove said in a statement. Cleveland Clinics world-class nys names included HCA Inc., Hospital Corpo-
reputation of clinical excellence, innovation, medical education and re- ration of America and Columbia/HCA Health-
search was created and will be maintained by the truly dedicated care- care. n
givers who work tirelessly to provide the best care to our patients. n
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jcole@beckershealthcare.com
26

Governor Orders 6 Tips for Working With Someone


New Hampshire Who Isnt a Team Player
Hospital CEO Bob By Tamara Rosin

MacLeod to Resign W
orking with someone who isnt a team player is not only
frustrating, it can impair the entire teams performance. In
CEO/STRATEGY

healthcare, where team-based care is central to efforts to


Over Staffing improve coordination and collaboration among providers, the reper-
cussions can be severe for both patients and hospitals.

Deficiency Heres how to work with a colleague who isnt carrying his or her
weight as a team player, according to a recent article in the Harvard
Business Review.
By Anuja Vaidya
1. Dont make assumptions. Before jumping to conclusions and

T
he governor of New Hampshire asked Con- attributing a coworkers poor teamwork to their personality or work
cord-based New Hampshire Hospital CEO Bob style, do some exploration. Its possible the individual is dealing with
MacLeod to step down from his post, accord- a personal stressful situation that is contributing to distraction or
ing to a Concord Mirror report. diminished performance at work, according to the report. Or per-
haps they are dealing with work pressures you dont know about.
Here are nine things to know: Its important to avoid dismissing the person as a slacker or coming
1. New Hampshire Gov. Chris Sununu asked Mr. Ma- up with your own explanations for their behavior, especially if it in-
cLeod to resign after state officials found that Leba- volves attributing bad motives to them, said Allan Cohen, PhD, a
non, N.H.-based Dartmouth-Hitchcock has been vi- professor of management at Babson College in Babson Park, Mass.,
olating its staffing contract. and author of Influence Without Authority, according to the report.

2. In September 2016, New Hampshire officials ap- 2. Talk to the individual. Start a dialogue with the team member in
proved Dartmouth-Hitchcocks proposal to take over question, but approach him or her with friendly questions, not accu-
staffing for the state psychiatric hospital. sations. Helpful questions that indicate your support for the individual
could include: What else are you working on right now? or What
3. However, state officials discovered that only 10 psy- motivates you the most? according to the report.
chiatrists are currently providing care at NH Hospital,
even though the contract requires a total of 12 psy- 3. Be inclusive. The issue of a disengaged team member could be-
chiatrists. come exacerbated if the team decides to shun the person who isnt
carrying his or her weight, according to the article. To promote better
4. The two positions fell vacant after the psychiatrists cohesion, ask the person out for coffee or lunch and try to get to know
were promoted to leadership roles. The positions were him or her better, and bring a few other coworkers along.
not filled.
4. Clarify the teams mission. An uncooperative team member
5. State officials also discovered that the staffing re- may indicate that something is off with the group. Perhaps the
ports they have been receiving from the hospital were teams approach isnt working or the mission isnt clear enough.
incorrect. The reports show the benchmark for staff- Revisit the groups shared vision and mission and clarify best meth-
ing levels as 10, when it should be 12. ods for fulfilling them.
6. Dartmouth-Hitchcock received a notice of 5. Clearly define team members roles. Dont assume everybody
non-compliance from the state. The health system has knows exactly what their contribution is supposed to be, said Dr. Co-
five days to provide a response. hen. Its possible the person who hasnt been acting as a team player
simply does not understand what he or she is meant to do.
7. Additionally, the New Hampshire Department of
Health and Human Services is considering an inves- 6. Create new opportunities to motivate. An employee may seem
tigation into whether the staffing deficiency affected withdrawn from their work because they desire new opportunities to
care quality at NH Hospital. grow and develop their skills, according to the report. If that seems to
be the case, see if there is a more suitable role for this individual on
8. Gov. Sununu has asked the state Attorney Gener-
the team. Its also possible to give them other informal roles to better
als office to review the states contract with Dart-
showcase their skills or offer new learning opportunities, according to
mouth-Hitchcock to explore what additional action
the report. n
could be taken, according to the report.
9. Gov. Sununu asked Don Shumway, former CEO of
Greenfield, N.H.-based Crotched Mountain Hospital,
to take over as CEO of NH Hospital. n
27

Be Professionally Blunt 4 OSU Wexner CEO Resigns


Tips for Developing a Great Over Faculty Concerns
Leadership Team About Leadership
By Brian Zimmerman By Anuja Vaidya

D C

CEO/STRATEGY
rafting and managing a successful leadership team is a soft science with olumbus-based Ohio State University Wexner
no fixed blueprint. However, beyond measuring organizational achieve- Medical Center CEO Sheldon Retchin, MD,
ments, the experience of being part of a successful leadership team can resigned in May following complaints about
perhaps best be surmised by the colloquialism:I know it when I see it. his leadership from the faculty. He is also stepping
down from his position as executive vice president
A hospital CEO must rely on his or her team of leaders to promote the long- of health sciences at the medical center.
term vision and culture of an organization, while also completing essential
day-to-day duties. These relationships require trust and diligent upkeep. Twenty-five Ohio State University College of Medi-
cine physicians and professors signed a letter of "no
During the Beckers Hospital Review 8th Annual meeting in Chicago April confidence" in Dr. Retchin and his executive team at
19, Steven Little, president and CEO of Agnesian Healthcare in Fond du Lac, the beginning of May. The letter notes 100 faculty
Wis.; Parveen Chand, COO of Indiana University Health Academic Health members from the college of medicine express ed
CenterAdult Hospitals in Indianapolis; Christopher Weaver, MD, senior vice the same sentiments; however, not all signed it due
president of clinical effectiveness at Indiana University Health in Indianapolis; to fear of retaliation.
and Julie Blatnik, senior director of clinical operations with Medtronic, dis-
cussed leadership culture and the keys to establishing a great leadership team. Soon after, five senior members of the medical cen-
ter's neurological institute also penned a letter de-
Here are four tips panelists offered during the discussion. tailing concerns about the leadership team.
1. Leverage the entire team for daily and long-term goals. The two letters include a number of complaints.
Speaking about his 3-year tenure as COO of Indianapolis-based Eskenazi They both allege Dr. Retchin and his executives are
Health, Mr. Chand discussed the importance of leveraging the entire team in unsupportive of physicians, leading to low morale
terms of long-term strategy and daily tasks. among staff members and loss of talented physi-
Part of our work was really segmented in terms of leveraging our entire team, cians. Additionally, one letter contends Dr. Retchin's
so deciding the specific roles of the chief nursing officer, the chief strategy leadership strategies are driving a wedge between
officer, the CFO and deciding who is going to execute [which strategy] ... we the medical center and the OSU Comprehensive
leveraged our team to do both long-term strategy and daily operations. Cancer Center, where Michael Caligiuri, MD, serves
as leader. Ultimately, Dr. Retchin's leadership is hurt-
2. Develop trust and eliminate territorial mentality. ing the academic mission of the hospital and med-
During the discussion, Dr. Weaver spoke about the importance of having lead- ical college, the physicians wrote, according to The
ers who are interested in team goals beyond the scope of their particular field. Columbus Dispatch.
Trust is the biggest key for our team, said Dr. Weaver. Weve had great suc- In a statement issued by The Ohio State University,
cess in working together and crossing into each others area[s] ... Were not officials thanked Dr. Retchin for his work at the med-
territorial at all and I think thats important ... to truly function as a team. Its ical center and noted some of his accomplishments,
about keeping an eye on the same prize. including the opening of the Jameson Crane Sports
Medicine Institute. The statement also addressed
3. Know when to ask for help. the letters.
Ms. Blatnik suggested team members should feel comfortable relying on one
another for assistance, which can be integrated into the organizational culture "Although allegations raised in letters sent to the
by a shared vision. news media this week were untrue, these letters
may have damaged important relationships neces-
If we share the same vision and engage, identify and respect each others sary for continued future success, and Dr. Retchin
diverse talent, we have to know when something is outside of [our] expertise has chosen to move on in the best interests of the
[and] reach out, said Ms. Blatnik. university, himself and his family," the statement
4. Be professionally blunt. reads.
During the panel discussion, Mr. Little spoke about the importance of con- Dr. Retchin also issued a statement via the universi-
structive disagreement to optimize the decision-making process. ty, where he states that the allegations in the letter
We make better decisions when we dont agree, respectfully and profession- are not true. "These baseless accusations have dam-
ally, about why we should be moving in one direction or another, but in the aged me and the university I love. I cannot allow this
end recognizing that the majority is going to rule, said Mr. Little. Its about to continue and so I have decided that it is in the
being professionally blunt and straightforward with each other and not candy best interest of the institution and me and my family
coating difficult issues ... We have difficult problems in the industry. We better to step aside, effective immediately." n
step up and face them and work together in a collaborative way. n
28

University of Utah Health Care CEO Dr. Vivian Lee Steps


Down Post-Cancer Center Conflict
By Emily Rappleye

V
ivian Lee, MD, PhD, stepped down Throughout the ordeal, Dr. Lee declined to pub- media over the past two weeks, has been dis-
from her roles as senior vice president licly comment on the matter. I am aware too turbing, especially to the younger members
for health sciences, medical school that more than a few have felt there should be of our family in this close-knit community in
CEO/STRATEGY

dean and CEO of University of Utah Health some sort of reply to the very strong criticisms Utah we have come to call home. She added,
Care in Salt Lake City, after a high-profile con- of leadership and actions, directed especially at I am hoping my decision today will help in
troversy involving the director of the universi- me, she wrote in her resignation announcement putting that completely in the past.
tys cancer center. to faculty and staff. This absence is not because
of a lack of strongly held alternative viewpoints During her six-year tenure leading the health sys-
Dr. Lee announced the news to faculty and and substantive positions, but rather a clear sense tem, Dr. Lee emerged as a leader in driving val-
staff April 28: Taking account of the events of that the best interests of our university and of our ue-based outcomes and investigating the costs of
the last two weeks, I believe the best interests entire community are to collegially embrace one care. Under her leadership, the university recruit-
of the university are now served by the deci- another and all move forward together. ed 400 new faculty members and launched ini-
sion I am taking today. tiatives in neuroscience, diabetes, global health,
Mr. Hunstman said he did not regret Dr. Lees precision medicine and genomic sequencing,
The feud erupted when Mary Beckerle, PhD, resignation and called her a one-person wreck- among others, according to a statement from
director and CEO of the Huntsman Cancer ing crew, according to KSL.com. He also called University President David Pershing, PhD.
Institute was fired over email on April 17. Dr. her integrity into question in relation to the ap-
Becklerle, who has led the cancer center for 11 plication of a $12 million donation from Patrick She has been described by her colleagues as a vi-
years, claims no reason was given for her remov- Soon-Shiong, MD, which is currently under sionary leader who maintains high standards for
al. Billionaire philanthropist Jon Hunstman Sr., review by the state Office of the Legislative Au- herself as well as others, Dr. Pershing said in the
who helped found the institute, called the move ditor General, according to KSL.com. statement. Dr. Lee has led a remarkable transfor-
a power grab, threatened to sue the university, mation of our academic and research operations
took out full-page ads in two local newspapers Dr. Lee responded to the criticisms of her and has been at the forefront of innovations in
protesting her firing and threatened to withhold character in her resignation statement: In a healthcare delivery at the national level.
a $250 million donation, according to KSL.com. more private way, it is fair to say that some of
Dr. Beckerle was reinstated April 25. the strong invective directed at my integrity Dr. Lee plans to stay on at University of Utah
and character, which was carried in the news as a radiology professor. Dr. Pershing plans to
announce her interim replacement soon. n

Study: Executives Who Flatter CEOs Most Also Develop Greatest


Resentment for Them
By Emily Rappleye

W
hile CEOs may like to hear includes survey information from 3,895 to journalists, such as the board is
their top executives sing CEO and top manager pairs from large picking up the slack or that the CEO
their praises, a recent study to mid-sized companies that bring in at recognizes their lack of experience.
suggests they may want to be wary of least $50 million in annual sales.
managers who never voice dissenting They found the correlation between
opinions. They found ingratiation which may in- flattery and resentment was strong. So
clude flattery, compliments and opinion strong, in fact, that an increase in com-
Researchers found when top execu- conformity is often used by top man- pliments by one standard deviation
tives ingratiate themselves with the agers to build social capital with CEOs, was associated with a one and half to
CEO, the process can ultimately lead to potentially gaining board appointment two point increase in resentment on
resentment and result in the same ex- recommendations or insider informa- a five-point scale. The correlation was
ecutives making negative comments to tion. However, this type of ingratiation even stronger when white men report-
the press about the CEO. Unfortunate- can be demeaning for the executives ed to a CEO who was female or a racial
ly, researchers found an even stronger who make the comments and lead to minority, according to the report.
correlation between flattery and re- behaviors that damage their target
sentment when the CEO was female such as making negative comments to [O]ur findings suggest that the CEOs
and/or a minority and the top manag- the press about the CEO. who tend to receive high levels of flattery
ers were white males. and agreement from their managers are
The researchers found negative com- particularly prone to being socially un-
The study, published in the journal ments were both direct and indirect. In dermined by those very same individu-
Administrative Science Quarterly and their article for HBR, the study authors als, the authors concluded for HBR. n
featured in Harvard Business Review, gave examples of negative comments
29

Words From the C-Suite: Advice From 4 Executives


By Alyssa Rege

Team-based collaboration is 'First get started, then get smarter'


essential to the future of our
functioning healthcare system A mong the numerous business lessons he has learned over the
course of his career, one C-suite veteran said seizing opportu-
nities as they come instead of waiting until youre prepared has

F or one C-suite executive, the intersection of technology and med- helped him become a successful entrepreneur.
icine will become a crucial part of the healthcare industry in the
In a conversation with CNBC, Jeff Lawson, CEO of Twilio, a software
next few years, if not sooner. To use that technology effectively, med-
development company that allows apps to contact users directly, high-
ical professionals from all disciplines must learn to work together for
lighted the importance of taking initiative and taking advantage of op-
the benefit of the patient.
portunities as they come. As entrepreneurs, youre expected to fail at one
Larry Chu, MD,is the executive director ofMedicine X, an initiative ex- point or another; how you respond to that failure is what counts.
ploring how emerging technologies will advance the practice of medicine,
No one is going to just teach you exactly [what you need to know].
improve health and empower patients to become active participants in
Life is not a paint-by-number sort of deal. We have to figure it out
their own care. Dr. Chu said through his work as a professor of anesthesi-
My grandfather, during the Depression was working in a factory
ology, perioperative and pain medicine at Stanford (Calif.) University, he
and he wanted to make more money He went to the owner and he
witnessed inefficiencies in students ability to interact and problem-solve
said, I need to make more money, how do I do that? The guy said
together. He said the issue is especially problematic, since an individuals
I dont have any other jobs. The only job I have is driving the truck.
health is an amalgamation of various provider recommendations. If each
Do you know how to drive the truck? My grandfathers answer was,
medical professional isnt aware of the recommendations their colleagues
give me the keys and he got this job and made more money. But
provide, the patient is the one that loses out in the end.
heres the thing he never told his boss: He had never driven a truck
Inter-professional, interdisciplinary, team-based collaboration is es- before in his life its a lesson that Ive internalized and brought into
sential to the future of our functioning healthcare system[,] and we our company its like, you know what, well figure it out. And if we
cant get there if were not learning and teaching together. In health- dont, someone else will The best way to learn something new is to
care, we learn in silos. Medical doctors train in medical school, and commit yourself to doing it. n
we dont know anything about pharmacists. Pharmacists train at
pharmacy school [and] tend not to know anything about nurses. Algorithms will drive future
Nurses train at nursing school [and] dont know anything about
occupational therapists. Yet when were all done, were expected to health gains
work together [We need to spend time] in our curriculum to un-
derstand the misperceptions that arise between the patient persona
and the provider persona, so that we can uncover the roadblocks to L loyd Minor, MD, dean of the Stanford (Calif.) University School
of Medicine, believes further advances in medicine and health
will be tied to medical professionals ability to interpret massive
honest conversation that get in the way of participatory healthcare
decisions. We cant have honest conversations if we dont have trust, amounts of data.
and we dont have trust in our relationships because we dont under- Since taking over as dean of Stanfords medical school, Dr. Minor has
stand each other.," Dr. Chu told Becker's Hospital Review via email. n established a department of biomedical data science within the medical
school and announced a partnership with Google. He said his efforts
Bill Gates hopes Trump will be are part of a larger belief that the future of medicine lies in personalized
pragmatic about foreign health aid health, which focuses on prediction and prevention. Dr. Minor recent-
ly sat down with The Wall Street Journal to discuss the how the medical
school is integrating data science and medicine to mitigate hospital infec-
B illionaire philanthropist and Microsoft Founder Bill Gates said
he is counting on President Donald Trump to be pragmatic
when it comes to U.S. foreign health aid.
tions transmitted through poor hand washing.
We know that a lot of hospital infections are transmitted by our hands
and hand washing can be tedious, but it is extremely important. So we
In an interview with Bloomberg, Mr. Gates said President Trumps recent
began a project with the folks in computer science to develop an [artifi-
proposal to significantly cut the nations foreign aid budget may affect
cial intelligence]-based system that can look at the hand-washing stations
how much money other nations contribute to fund foreign health efforts.
outside of an ICU room and determine when a person has washed their
He speculated that because President Trump recently reversed his posi-
hands. The interlock on the patients room is only opened and triggered
tion on a number of economic pledges, a frank discussion with the presi-
when a person has gone through the appropriate hand washing. Now, it
dent may help him see the importance of continuing to fund such efforts.
can be overridden if there is an emergency. But if it is overridden it gets
Ive talked to [President Trump] about HIV and how the U.S. should recorded and there needs to be an explanation of why it was overridden. I
be proud of our work [to combat the virus]. This dialogue is important: was skeptical at first. I thought you could fool it by not actually rubbing
Youve seen his pragmatism on a number of things and Im certainly your hands. Well, it turns out to be pretty darn good [the technology]
hoping that these health-related budgets receive some of that atten- is being piloted in the ICUs but not yet driving the opening and closing of
tion Trump wants to be a leader, he wants to have things that hes doors. The technology is validating that the hand washing is taking place
actually accomplished. It means talking to him and giving him some and we are getting feedback from others on how it works. n
background that he might not have had through his past work. n
30 Executive Briefing
Executive Briefing 31

Sponsored by:

The Real Reason Loyalty Lacks in Healthcare


By Brian Wynne, Vice President and General Manager, NRC Health

H
ealthcare systems have long been relatively successful Customer Confusion = Lost Opportunities
at attracting and retaining customers with the if you The more frequently consumers visit their healthcare provid-
build it, they will come mentality or perhaps more ers, the more frustrated they become. According to a report by
accurately, if you build it, they must come. Prophet and GE Healthcare Camden Group, 81 percent of cus-
tomers are unsatisfied with their healthcare experience.
Yet with the meteoric rise of healthcare consumerism within the
past few years, most people have an unprecedented number Whats more, 75 percent of those who frequently use health-
of choices of provider and care options, including opting out of care services three or more times a year and 48 percent of all
care altogether. As a result, creating loyalists in todays health- other healthcare consumers say theyre frustrated.
care industry is nearly impossible without the right insight into
the wants, needs and expectations of those whom we in the For people to fully engage with their healthcare, its imperative
healthcare industry hope to serve. that they understand the process, their coverage and what to
expect from their providers.
The Demand for a Personalized Experience
Consumers are scrutinizing the quality and cost of their health- Research shows that when consumers first embark on a health-
care, and theyre more apt and able to look elsewhere when care journey, confusion is the primary emotion felt. The reasons
their providers dont measure up to their expectations. Ac- for this are intuitive: out-of-pocket costs are a mystery, con-
cording to a report by Accenture, 7 percent of customers have sumer reviews of care providers remain strangely elusive, ex-
switched healthcare providers due to a subpar experience, periences are inconsistent from one care provider or facility to
which could add up to more than $100 million in lost annual another, hospital consolidations are increasing each year, and
revenue per hospital. consumers are unsure of inter-hospital relationships and affilia-
tions. And yet, so few organizations ask their customers, How
This number will climb. The value equation in healthcare is al- can we make your experience less confusing? or, How can we
ready out of balance. Higher out-of-pocket expenditures for ex- reduce the frustration you feel?
tremely personal and in many cases life-changing encoun-
ters bring with them extremely high expectations for service
and care delivery; in fact, a recent study by NRC Health found
that 82.3 percent of consumers said hospitals and healthcare
systems should consistently meet or exceed their expectations. Most healthcare systems lack a
When these expectations are unmet, the switch economy, pre-
viously seen in all other consumer-driven industries, develops. comprehensive understanding of who
Since both the risks and the costs of healthcare are high, con-
sumers insist that healthcare systems with which they engage
their customers are, what they need and
understand their preferences and offer experiences to satisfy
their needs perhaps even delight them. Consumers demand how they want to access care.
that their healthcare be designed and delivered in the same
way that other industries they consume and experience are, like
retail, hospitality and consumer electronics. A $100-Million Blind Spot
According to the U.S. Census Bureau, the average lifetime val-
Still, few healthcare executives I know would say their services ue of an individual healthcare consumer is $1.4 million or $4.3
offer an experience akin to that of a luxury hotel or boutique million for a family of four.
spa. Although we know that high cost means high expectation,
there is still hesitance in healthcare to base design on models With this much potential spend at stake, the value equation
proven to work in other consumer-driven industries. comes under scrutiny. As mentioned earlier, when the cost of a
service outweighs the experience it delivers, it sets the stage for
Why? Because most healthcare systems lack a comprehensive consumers to become switchers.
understanding of who their customers are, what they need and
how they want to access care. As a result, those systems are un- Not only are consumers finding new providers in these cases,
able to consistently provide personalized and coordinated care theyre increasingly seeking care from non-traditional care pro-
experiences throughout their consumers healthcare journeys viders, such as chain pharmacies offering primary care and test-
and when the experience doesnt meet the expectation, loyalty ing services, borderless digital e-visit providers and alternative
becomes an unrealistic and unattainable goal. medicine and holistic-healing practitioners. Healthcare systems
need to make a deliberate commitment to offer high-quality,
32 Executive Briefing

cost-transparent, and easily accessible healthcare services if Studies show that once customers know what they can expect
they want to remain a viable option for todays consumer. from the healthcare system, they continue to purchase the same
products, purchase across product lines, and are more willing
Healthy Consumers, Healthy Bottom Line to pay for value-added products and services.
Naturally, healthcare systems that understand the value of loy-
alty and take steps to build trusted relationships at every touch- Since they are confident in the care they receive, theyre less
point of the customer journey reap financial benefits, but the likely to look for other providers, and their lifetime value in-
quality of care and the consumers well-being improve as well. creases. Theyre also more willing to make referrals on their pro-
In fact, people who have a primary-care physician rather than a viders behalf which is almost always a surefire way to attract
specialist as their personal physician have a 19 percent lower more consumers.
mortality rate and 33 percent lower annual healthcare spend-
ing, according to a study in the Journal of Family Practice. Creating Loyalists Takes Time. Start Here.

Population health efforts are impacted by loyalty as well. Pa- 1. Create an easy and exceptional experience
tients who are treated regularly by the same physician visit
the emergency room and are hospitalized less frequently than The customer journey starts the moment consumers start
those who frequently switch providers, a UCLA study found. searching for a provider. Between search, social media, ap-
pointment booking, personal encounters, feedback surveys,
What Loyalty Really Looks Like and billing, there are countless opportunities to make the expe-
Healthcare is notorious for using patient satisfaction scores, rience easy and extraordinary.
temporary volume growth of a service line, or NPS performance
as definitive ways to measure loyalty. When healthcare systems are accessible, are transparent with
quality and cost, and consistently meet or exceed expectations,
Although these all indicate loyalty, they represent different lifelong loyalty among consumers, their families and the peo-
points throughout the customer journey and fail to provide a ple they influence is achievable. To meet their expectations, you
complete understanding of who customers really are and what must ask, analyze, and design.
they need. Despite lead generation, customer experience, strat-
egy, the customer-acquisition process and execution are also 2. Get real-time feedback whenever possible
often fragmented, which leaves voids throughout the journey. It is imperative to get a 360-degree understanding of custom-
With a Net Promoter Score of a mere nine percent, the health- ers not as a demographic, but as real people. Their experience
care industry pales in comparison to other industries. Retail (23 is not limited to what happens within the four walls of an exam
percent) and financial services (27 percent) are perennially near room or a hospital. Providers must understand customer expe-
the top. One of the reasons for this is that healthcare is inconsis- riences and feelings, both inside and outside of the care setting.
tent and unreliable for example, the experience a consumer The only way to truly have that level of insight is to constantly
has with a hospital in New York City may be drastically differ- ask for feedback from care providers and the customers they
ent from the experience he would receive in upstate New York, serve. Modern methods of short-form outreach provide care-
even within the same healthcare system. givers and customers with a chance to tell their stories every
Loyalty demands more. According to loyalty expert James step of the way, empowering the health system to implement
Kane, loyalty in any industry follows upon positive answers to meaningful changes at key moments along their journeys.
three questions: 3. Right insight at the right time
1. Do you make my life safer? Market and consumer research has little or no value when its
2. Do you make my life easier? only used to confirm what we already know and patient feed-
back has little or no power to change care delivery when its
3. Do you make my life better? collected weeks after an encounter. Research is a powerful tool,
but only when used proactively to identify opportunities for im-
True consumer loyalty means that customers not only seek out provement and to understand what matters most to those you
care, but are willing and eager to take their care providers ad- hope to serve. Timely, actionable and rich insights will help you
vice, because the relationship is already built on trust. stop wondering and start understanding.
Loyalty fosters a sense of belonging, and when customers are If building loyalty is a strategic imperative at your organization
actively engaged in their healthcare, the outcomes are pro- and I hope it is its time to assess the quality of the insights you
found. When consumers are loyal, they choose to receive every have about the wants, needs, expectations and experiences of
single aspect of their care from a single health brand. those who provide and receive care in your system. n

For 35 years, NRC Health has been committed to achieving human understanding. We enable healthcare or-
ganizations to know the people they care for with greater clarity, immediacy, and depth. Our partners are able
to illuminate and improve the key moments that define an experience and build trust. Guided by our uniquely
empathic heritage, proprietary methods, skilled associates, and holistic approach, we help our partners design
experiences that exceed expectations, inspire loyalty, and improve well-being among patients, residents, phy-
sicians, nurses, and staff.
Executive Briefing 33
34

Epic, Cerner Hold 50% of Hospital EMR Market Share:


8 Things to Know
By Anuja Vaidya

I
n 2016, Epic and Cerner led the EMR 2. All other EMR vendors held 10 percent or larger organizations; as well as an increased
market space for acute care hospitals in less of the market share. interest in athenahealths new offering.
the United States, with Meditech follow-
ing close behind, according to the "KLAS US 3. Thirteen of 23 contracts for integrated 6. However, customers did complain about
Hospital EMR Market Share 2017." delivery networks (multi-hospital organiza- the lack of customization capabilities in both
tions) went to Epic. Epic and Cerner platforms.
The data in this study is based on acute care
EMR purchasing activity that occurred in the 4. Small community hospitals with less 7. While Cerner proved to be the most pop-
U.S. from Jan. 1 to Dec. 31, 2016. than 200 beds drove EMR purchasing de- ular vendor among small hospitals in 2016,
cisions in 2016, accounting for 80 percent of athenahealth grew the most.
Here are eight things to know: all hospital EHR decisions in the country.
8. The number of hospitals that contract-
1. Epic held 25.8 percent of the U.S. acute care 5. The increase in EMR adoption by small ed with athenahealth more than doubled in
hospital market share, with Cerner (24.6 per- hospitals was fueled by the community-spe- 2016, and one-third of the new hospitals had
cent) and Meditech (16.6 percent) coming in cific platforms from Cerner and Epic; acqui- more than 25 beds. n
CIO / HEALTH IT

a close second and third. sition and EMR-standardization activity of

Athenahealth CEO Jonathan Vanderbilt University Medical


Bush: Trump, High Center Begins IT Overhaul,
Deductibles Played Role in Epic Implementation
Disappointing Q1 By Anuja Vaidya

N
By Jessica Kim Cohen ashville, Tenn.-based Vanderbilt University
Medical Center haslaunchedits 18-month IT re-

A
thenahealth shares dropped 17 percent on April 28 placement project called Epic Leap. The medi-
after the company posted its 2017 first quarter finan- cal center is replacing its current IT system with software
cial results, according to theBoston Business Journal. from Epic.

In its financial results, athenahealth opted to adjust its full- The overhaul will involve implementing Epic technol-
year revenue projections based on its lower-than-expected ogy for a greater part of the medical centers clinical,
first quarter performance. The company reported $285.4 administrative and billing services. The staff and facul-
million in revenue with a net loss of $1.4 million, due to low ty will switch to Epic software for numerous processes
claims and collections revenues and a lack of new clients. such as medical record-keeping, hospital scheduling
and admissions, nursing documentation, outpatient
During an April 23 conference call, athenahealth CEO and prescribing, medication administration and hospital
Co-Founder Jonathan Bush suggested the companys disap- billing by November 2017.
pointing first quarter was also partially attributable to uncer-
tainty in the healthcare industry. He noted people are unsure Eventually, patients will also engage with their health-
how President Donald Trump will change federal healthcare care at VUMC via Epic software. The software will
laws,Boston Business Journalreports. allow patients to interact with their healthcare pro-
viders, schedule visits online and receive compre-
Another factor negatively affecting business is high-deduct- hensive bills, rather than separate bills for hospital
ible health plans preventing consumers from accessing med- and professional services.
ical care, according to Mr. Bush.
Were going to be really well prepared. And important-
Deductibles every year having materially larger share ben- ly, were going to look at how we can improve our pro-
eficiaries with high deductibles have an increasingly higher cesses of workflow as we install, so that everything is in
share of the covered base, and so theyre increasingly sheep- sync, said Jeff Balser, MD, PhD, president and CEO of
ish about going to the doctor, particularly in [the first quarter] VUMC and dean of the Vanderbilt University School of
when everybodys deductibles are refreshed, Mr. Bush said Medicine, at the project launch. n
in the call, according toBoston Business Journal. n
35

The 16 Tech Companies Trump Establishes American


Paying Interns Most Technology Council
By Emily Rappleye By Jessica Kim Cohen

S P
tudents are raking in the Here is the median monthly pay resident Donald Trump on April 28signedan ex-
cash at tech company in- for the top 15 tech internships and ecutive order to establish the American Technol-
ternships, earning more how much an annual salary would ogy Council.
than the average American work- be if that paycheck were earned
er, according to a report from over a full year. The councils mission is to promote the secure, efficient
Glassdoor. and economical use of information technology, accord-
1. Facebook $8,000medi- ing to the executive order. The ATC will strategize the
Tech companies hold 16 of the top an monthly pay (equivalent of federal governments use of IT and offer advice related
25 paying internships this year $96,000 annual salary) to IT policy decisions and processes, among other tasks.
on Glassdoors list. The monthly 2. Microsoft $7,100($85,200)
median pay for these internships, Americans deserve better digital services from their
when extrapolated, tops that of the 3. Salesforce $6,450($77,400) Government, the executive order reads. To effectu-
average full-time American work- 4. Amazon $6,400($76,800) ate this policy, the Federal Government must transform
er who earns a median of $51,350, and modernize its information technology and how it
5. Apple $6,400($76,800)

CIO / HEALTH IT
according to Glassdoors data. uses and delivers digital services.
Compare that to pay at Facebook, 6. Yelp $6,400($76,800)
The ATC will comprise 19 members, including the U.S.
the highest paying company for 7. Yahoo $6,080($72,960)
chief technology officer, Vice President Mike Pence and
internships. There, interns earn 8. VMWare $6,080($72,960) President Trump, who will serve as chairman. The act-
median monthly pay of $8,000,
9. Google $6,000($72,000) ing president will also designate a director, who will be
which is the equivalent of an an-
an employee of the executive office.
nual salary of about $96,000, ac- 10. NVIDIA $5,770($69,240)
cording to Glassdoor. 11. Intuit $5,440($65,280) The executive order and ATC will terminate on Jan.
20, 2021. n
Data in the report is based on 12. Juniper Networks
self-reported income from interns $5,440($65,280)
who are currently in or have com-
pleted programs within the past
year. Glassdoor only used compa-
13. Workday $5,440($65,280)
14. Adobe $5,120($61,440)
Report: 3 Cyberthreats
nies with at least 25 reports. For or-
ganizations with the same median
15. MathWorks
$5,120($61,440)
Make Up 81% of Healthcare
monthly pay, Glassdoor used the
number of reports as a tie-breaker.
16. Qualcomm
$5,040($60,480) n
Breaches
By Jessica Kim Cohen

CIOs Greatly Underestimate


T
here were 296 confirmed data breaches in the
healthcare industry last year a substantial por-

How Many Cloud Apps Their tion of which were perpetrated by insiders, ac-
cording to Verizons 10th annual Data Breach Investi-

Organization Use
gations Report.
The following three IT security threats made up 81 per-
By Jessica Kim Cohen cent of confirmed healthcare breaches in 2016.

O
1. Insider misuse, or the unauthorized use of organiza-
rganizations are using far more cloud apps than their tional resources
CIOs think, according to SymantecsInternet Security
Threat Report. 2. Miscellaneous errors, or unintentional mistakes that
directly compromise data security
While organizations used an average of 928 cloud apps each
last year, most CIOs said their organizations only used be- 3. Physical theft and loss, which encompasses any inci-
tween 30 to 40. This pattern is worrisome, since a lack of con- dents where items with data went missing
crete policies around cloud usage may lead to risky IT security
practices, according toSymantec. In 2016, ransomware also accounted for 72 percent
of all malware incidents in the healthcare industry, ac-
The number of cloud apps organizations use has steadily in- cording to the report. However, these incidents were
creased over the past few years. In 2016, the average number not counted as breaches, since investigators are often
of cloud apps was 841. In 2015, the average was only 774 unable to confirm whethercyberattackers access data
cloud apps. n after encrypting it. n
36

Why Do Women, Minorities Leave Tech Companies?


4 Study Insights
By Jessica Kim Cohen

A
new studyby the Kapor Center for sion to leave their job. Underrepresented men fair treatment, tech companies lose an es-
Social Impact explores what fuels of color were most likely to leave due to un- timated $16 billion each year in workforce
voluntary turnover in the technolo- fair treatment (40 percent) out of all minority replacement costs. Moreover, 25 percent of
gy industry. groups surveyed. respondents said they would be less likely to
recommend others use products and services
For the national study partially funded by 2. Unfair experiences differed across from their former employer.
the Ford Foundation Harris Poll surveyed demographic groups. Although 78 per-
2,006 U.S. adults who left a technology job cent of all employees reported experiencing 4. A comprehensive diversity strat-
within the last three years. unfair treatment, these experiences varied by egy can reduce turnover. Companies
race, gender and sexual orientation. One in with a comprehensive diversity and inclusion
Here are the researchers four main take- 10 women, for example, reported receiving strategy in place rather than a single, one-
aways. unwanted sexual attention. In general, ste- off initiative had less unfair treatment than
1. Among respondents of all back- reotyping and bullying were associated with other workplaces. Sixty-two percent of em-
grounds, unfairness was the most shorter length of employment. ployees said they would have stayed at their
CIO / HEALTH IT

frequently cited reason for quit- company if leaders had taken additional steps
3. This turnover has a financial im- to create a respectful work environment. n
ting. Thirty-seven percent of respondents pact. When considering the percentage of
said unfair treatment or mistreatment in the technology employees who leave due to un-
workplace was a major factor in their deci-

47% of Organizations Say Lifespan Notifies 20k Patients of


Virus Bypassed IT System Privacy Breach From Stolen Laptop
Designed for Malware By Jessica Kim Cohen

P
By Jessica Kim Cohen rovidence, R.I.-based Lifespan notified patients on April
21 about a potential breach of personal information, in-

O
ne in four organizations reportedly suffered cluding names, medical record numbers, demographic
cyberattacks that bypassed all of their securi- information and medication prescriptions.
ty solutions, according to a Barklyreport.
The privacy breach occurred when a Lifespan employees car
To determine what cybersecurity solutions succeed was broken into on Feb. 25. Several items were stolen, including
and fail at blocking malware, Barkly surveyed IT a MacBook laptop the employee used for work purposes. The
managers and administrators at small and medi- employee immediately contacted law enforcement and report-
um-sized businesses about their experiences with ed the theft to Lifespan, which launched an investigation and
software viruses. changed the employees Lifespan system credentials.

Barkly found 47 percent of organizations said mal- Investigators found the stolen laptop was unencrypted and not
ware had entered their system. Of this proportion, password protected, meaning the employees work emails were
79 percent said the malware was able to execute. potentially accessible. These emails did not include patient So-
Sixty-eight percent of these remaining organizations cial Security numbers, financial information or medical records.
said the malware successfully infected their IT sys-
Lifespan notified about 20,000 affected patients, according to a
tems, and more than half of these organizations (56
statement emailed toBeckers Hospital Review.
percent) said they were unable to recover from the
attack. To date, Lifespan has no indication that any patient informa-
tion has been accessed or used by anyone as a result of this
Unfortunately, the point at which the largest per-
incident, according to the statement. Lifespan is committed to
centage of organizations saw their protection fall
protecting the security and confidentiality of our patients infor-
down was at the pre-execution stage, according
mation, and we deeply regret this incident occurred.
to the report. Once malware was on a device, the
solutions they had in place werent always able Lifespan established a call center for patients to reach out with
to stop it from executing. n questions or concerns. The health system is also re-educating
its employees and updating its policies related to MacBook
security. n
37

HIMSS Analytics Unveils 2018 Health IT


EMR Adoption Model Criteria Regulations Are
By Jessica Kim Cohen
Too Burdensome
HIMSS Analytics established a new set of criteria for its EMR Adoption Model, set to take
effect Jan. 18, 2018. for Physicians, Says
The eight-stage EMR Adoption Modelmeasuresthe degree to which a hospital or health
system utilizes its EMR functions. The last time HIMSS Analytics updated its EMR Adop-
Price
tion Model criteria was in 2014, HIMSS Analytics Global Vice President John Daniels By Jessica Kim Cohen
tellsBeckers Hospital Review.

H
The new model contains a major focus on cybersecurity, with privacy and security stan- HS Secretary Tom Price, MD,
dards integrated into Stage 2 through Stage 7. To meet Stage 2 criteria, organizations must addressed the Trump admin-
now establish policies regarding device encryption, mobile security and antivirus soft- istrations long-term plans for
ware, among other standards. health IT guidance during an April 27
speech at the Health Datapalooza con-
Another update involves moving digital imaging criteria into Stage 1, since pretty much ference in Washington, D.C., reports
every organization has a digital [picture archiving and communication system] capability theWashington Examiner.

CIO / HEALTH IT
for radiology and cardiology, says Mr. Daniels. In the current EMR Adoption Model,
digital imaging for radiology is a requirement to reach Stage 5 and digital imaging for He said the Trump administration will
cardiology is a requirement to reach Stage 7. focus on interoperability and work to
reduce the burden health IT regula-
In 2018, HIMSS Analytics will also ask hospitals and health systems vying for Stage 7 des- tions place on physicians.
ignation about two more benchmarks: anesthesia information systems and smart infusion
pumps. However, healthcare organizations will not be scored on these two additions. Data is absolutely crucial, dont misun-
derstand me, Dr. Price said, according
Were looking at these capabilities, but were not scoring them, Mr. Daniels says. Were to the Washington Examiner. But we
letting the industry know, at some point in the future, these will become Stage 7 require- need our physicians to be patient-fac-
ments. We want to make sure we give the industry plenty of time to begin to plan for and ing, not computer-facing, which is what
implement these capabilities. n many of them feel they are right now. n

Cerner Impersonation Scheme Leader Sentenced to 12 Years in


Prison
By Anuja Vaidya

A
lbert Davis, the leader in a fraud scheme that estab- Mr. Davis lawyers argued that his fierce sense of pur-
lished a fake company impersonating Cerner, was pose and drive caused him to fly far off the track and
sentenced to 12 years in federal prison, according into the realm of fraudulent criminal conduct, according
to aKansas City Starreport. Mr. Davis was also ordered to to the report. They even pointed to the fact that Mr. Da-
pay part of the restitution costs. vis is a West Point Military Academy graduate as a testa-
ment to his character. They asked for a lesser sentence
In October 2016, Mr. Davispledguilty to his involvement of eight years.
in the scheme. His co-conspirators include Christina Bry-
ant, Richard Bryant, David Hernon and David Tayce. The Prosecuting attorneys, however, countered that Mr. Da-
individuals created a fake company, calling it Cerner LLC. vis had leveraged his West Point degree to gain peoples
They opened a bank account, bought an internet domain trust.
and also produced fake documents, agreements and in-
voices for Cerner LLC. Additionally, they created fictitious Like his West Point degree, this defendant knew that
employees, even using names of real Cerner employees. Cerner Corporations reputation in the medical commu-
nity would open doors otherwise unavailable to him,
Before being discovered, the conspirators managed to sell prosecutors noted in a written memorandum, according
an MRI to a Texas hospital, created fake invoices and re- to the report. n
ceived more than $1 million from the hospital. When the
hospital contacted Cerner for assistance with system instal-
lation, they found out that the real Cerner had not been
involved at all.
38

8 Things to Know About Nurse Bullying


By Alyssa Rege

T
he nursing profession has consistently ranked No. 1 in Gallups 5. Some researchers speculate that because nursing is generally a fe-
annualpollof Honesty and Ethical Standards in Professions for male-dominated profession, competition plays a role in pitting nurses
the past 15 years which makes therampant bullying and haz- against one another. Theories suggest that age-old female competition
ing that persists among nurses that much more surprising. [in the medical field] has shifted from competing over a man to compet-
ing over status, respect and position in the nursing environment, said Dr.
Judith Meissner, RN, MSN,coinedthe phrase nurses eat their young Thompson. The same behaviors once witnessed between two women
in a 1986 article to describe the hostility young nurses face at the hands fighting over a man are the ones witnessed today in the behavior of bullies.
of their more experienced coworkers. In a follow-up article published
13 years later, Ms. Meissner said students, new graduates and even 6. Given the apparent pervasiveness of the issue, how do hospitals and
experienced new hires still suffered intense bullying. administrators begin to combat incivility and bullying? Nurses should,
first and foremost, document any type of harassment inflicted upon
According to a 2017blog postby Pittsburgh-based Select International them, Dr. Thompson said. If you are being bullied, start a documen-
Healthcare, roughly 85 percent of nurses have been abused by a fellow tation trail. Keep a small notebook with you and write down dates,
nurse and approximately one in three nurses have considered quitting times, witnesses, verbatim comments and any behaviors you believe
the profession due to bullying. undermine a culture of safety and a professional work environment,
Here are eight things to know about nurse bullying. shesaid. Keep growing this documentation trail until you are at the
point where you can file a formal complaint.
1. Forty-five percent of nurses have been verbally harassed or bullied by
other nurses, according to a 2017 survey by employment agency RN- 7. Nurse managers also play a vital role in recognizing and preventing
network. Forty-one percent of those surveyed said they have been ver- bullying. According tosome experts, its up to the nurse manager to
bally harassed or bullied by managers or administrators. Some nurses [share] information about incivility and its harmful effects and [to]
(38 percent) even reported having been verbally harassed or bullied by take the lead in establishing civility charters, co-creating norms of de-
physicians. More than half of the nurses who reported work harassment sired behavior, implementing policies and rewarding civility because
indicated they were considering leaving the profession all together. their actions set the tone for the types of professional interactions that
are expected in the workplace.
2. While some forms of bullying nurses experience are overt, like ver-
bal harassment, threats or physical violence, other forms are more sub- 8. Additionally, hospital executives and nurse leaders can imple-
tle. Researchers refer to this subtle harassment as incivility, a form of ment protocols outlined under the acronym L.I.S.T.E.N to address
bullying commonly brought upon young nurses by their more expe- nurse bullying. Those protocols include beginning to investigate the
rienced counterparts. Renee Thompson, DNP, RN,saidincivility can situation as soon as a complaint is issued and to never share their own
take on many forms, including sabotage, withholding information, ex- opinion on the issue with any of the participants to remain unbiased. n
cluding others, unfair assignments or downplaying accomplishments.

CDC Director Calls C. Auris


3. For some nurses, incivility can wreak havoc not only on their self-es-
CMO / CARE DELIVERY

teem, but on the health and well-being of their patients. In an interview


forMarie Claire, 27-year-old Christi who declined to provide her
last name to the publication said about four months into her job
as an intensive care unit nurse at a North Carolina hospital, a group
Fungus a Catastrophic Threat
of nurses refused to help her care for a patient who had suddenly lost By Heather Punke
consciousness. A week after stabilizing the patient on her own, a friend

I
told Christi not to go into her locker and to call a manager. Christi n an interview with STAT, Anne Schuchat, MD, act-
said she opened her locker and, after lifting her clothes with a tongue ing director of the CDC, pointed to the deadly fun-
depressor, discovered a bloody syringe. gusCandida aurisas a catastrophic threat to society.
My first thought was, This could be attempted murder because I C. auris is an emerging, deadly, drug-resistant yeast.
didnt know what was on the needle that I would have contracted if it Some strains are resistant to all three major classes of an-
stuck me, she told the publication. tifungal drugs, making it of particular concern.
4. Nurses who have historically faced bullying or harassment in the The first domestic cases ofC. aurisinfections in the U.S.
workplace often do not report their concerns. If they do report the werereported in November 2016and as of April 13, 61
bullying, managers may do little to remedy the situation. During a infections have been reported in six states,according to
September 2016discussionhosted by the Association of periOperative the CDC.
Registered Nurses and streamed live on Facebook, Linda Groah, MSN,
RN, CEO of AORN,citeda survey in which only 38 percent of man- The threat of C. auris should spur officials to attempt to
agers said they attempted to address complaints of bullying brought better contain the fungus and other superbugs, according
to their attention. Christi toldMarie Claireshe asked management to to Dr. Schuchat.This is a big threat and a wake-up call, Dr.
investigate the situation involving her locker. She said management re- Schuchat toldSTAT. It was a problem for Ebola. It was a
fused, stating they [couldnt] fire 14 people for one nurse, according problem for SARS. Its a problem for drug resistance.
to the report. Christi said she decided to leave the health facility af-
The CDCrevised its guidelinesto control C. auris in Feb-
ter management did not allow her to change shifts or transfer depart-
ruary.n
ments, according to the report.
39

KentuckyOne to Cancel Contracts With 25 Employed


Physicians
By Alyssa Rege

L
ouisville-based KentuckyOne Health In a statement to theCourier-Journal, officials As a result, we anticipate minimal disruption
will dissolve its employment contracts said physicians impacted by the cuts have in patient care as a result of this decision.
with approximately 25 physicians as ear- all been notified and will continue with Ken-
ly as July, according to theCourier-Journal. tuckyOne through the term of their contract. The news follows the organizations decision
Individual physicians are making decisions on in April to lay off nearly 150 employees, or
Officials said the cuts were the result of chal- how they will continue practicing, caring for 1 percent of its workforce, to reportedly im-
lenges in the changing healthcare environ- current and future patients and what level of prove operational efficiency and decrease
ment and the recent decline in patient vol- staff support is needed. costs. n
umes in several areas, according to the report.

Trump Appoints Nurse to Serve Survey: 70% of Nurses Report


as Acting Surgeon General Burnout in Current Position
By Emily Rappleye By Brian Zimmerman

R W
ear Adm. Sylvia Trent-Adams, PhD, RN, was installed hile the number of nursing jobs increased by 6
as acting surgeon general April 21 after the Trump percent from 2012 to 2016, and is poised to in-
administration asked Vivek Murthy, MD, to resign, ac- crease an additional 7 percent from 3.6 million
cording toThe New York Times. positions in 2017 to 3.9 million positions in 2021, the nurs-
ing skills gap is also growing, according to a market analy-
Dr. Trent-Adams is one of the first nurses to be appointed sis conducted by CareerBuilder.
surgeon general and is the first non-physician to be ap-
pointed. During the Bush administration, the surgeon gen- In an analysis of job postings, CareerBuilder found 1.7
eral Richard Carmona, MD was both a physician and a million registered nurse job postings in the first quarter
nurse, according to the report. of 2017. However, among these postings, only 178,586
were unique, meaning each unique posting was upload-
Dr. Murthy was asked to resign after assisting with the ed an average of 10 times, which is indicative of a highly
transition between the Obama and Trump administra- competitive job market. With employers struggling to

CARE DELIVERY
tions, an HHS spokeswoman toldThe New York Timesin fill nursing job vacancies with qualified candidates, the
an emailed statement. However, Alice Chen, MD, Dr. Mur- workload for staffed nurses has increased, which may
thys wife, told the newspaper he was asked to resign, re- contribute to burnout.

CMO /FINANCE
fused and was fired. OnFacebook, Dr. Murthy said, Many
have asked why I chose not to resign as Surgeon General Asurveyinvolving more than 3,000 private sector employ-
when I was asked to do so. My reason was simple: be- ees, including 93 nurses, conducted by Harris Poll on be-
cause I would never willfully abandon my commitment to half of CareerBuilder, found 7 in 10 respondents reported
my Commissioned Corps officers, to the American peo- burnout in their current roles. Still, despite high levels of
ple, and to all who have stood with me to build a healthier emotional stress, nurses are largely satisfied with their jobs
and more compassionate America. overall. Seventy-six percent of nurse respondents report-
ing job satisfaction and 33 percent reported dissatisfaction
Dr. Trent-Adams is the right person to step into this role, he with their career progress.
added. Dr. Trent-Adams was serving as Dr. Murthys deputy
prior to her appointment as acting surgeon general. She Nurses, the backbone of U.S. healthcare, often handle life
has dedicated the past 30 years to our nation serving in the or death situations, so this high level of stress may come as
Army and in the U.S. Public Health Service. Her deep wealth no surprise,saidRosemary Haefner, chief human resources
of experience is matched only by the immense size of her officer at CareerBuilder. However, high levels of stress sus-
heart, Dr. Murthy wrote on Facebook. tained over a long period of time can be a major detriment
to ones health. Employers must ensure their nurses are get-
Prior to her role as deputy surgeon general, Dr. Trent-Adams ting the support they need, such as flexible schedules, ex-
served as CNO of the U.S. Public Health Service Commis- panded headcount or tools to deal with stress.
sioned Corps, according to herprofileon the HHS website.
Before that, she was deputy associate administrator for the The American Nurses Association designated this
HIV/AIDS bureau of the Health Resources and Services Ad- yearsNational Nurses Week held May 6 to May 12 the
ministration. She served as a nurse officer in the U.S. Army Year of the Healthy Nurse with a theme of the balance
and a research nurse at the University of Maryland in Balti- between mind and spirit to place an emphasis the health
more, where she earned her PhD. n and well-being of these essential frontline providers. n
40

CDC Issues New Dr. Peter Pronovost: This Unnecessary


Prevention Guidelines for Regulation Doesnt Benefit Patients
Surgical Site Infections: and Costs $500M Each Year
5 Things to Know By Heather Punke

T
he federal government re- Despite robust data supporting
By Brian Zimmerman quires preoperative testing this conclusion, the tests contin-
before cataract surgery, ue to be required by the federal

T
he CDC published its long-awaited update on recommen- which costs the healthcare system government and accrediting or-
dations for the prevention of surgical site infections on May $500 million annually but has no ganizations before every cataract
3 inJAMA Surgery. positive effect on patient health, surgery and other low-risk elective
according to a blog post in The procedures, Dr. Pronovost wrote.
The new guidance supplants the agencys previous SSI prevention
Wall Street Journal.
guidelines issued in 1999. Instead of performing the cost-
Peter Pronovost, MD, senior vice ly tests on every cataract patient,
Here are five things to know about the new guidelines. president with Baltimore-based those who need it can be identi-
1. The CDCs Sandra Berros-Torres, MD, served as the lead au- Johns Hopkins Medicine and di- fied with a checklist, he noted.
thor of the guidelines. rector of the Armstrong Institute
Dr. Pronovost wrote the require-
for Patient Safety and Quality,
ment may not be the only regu-
2. Researchers conducted a review of more than 5,000 studies wrote the piece published in April.
lation that could be revamped or
published from 1998 through 2014. Among these studies, 896
He cited a17-year-old studyinThe scrapped entirely without jeopar-
underwent full-text review. Of the 896 studies, 170 studies were
New England Journal of Med- dizing patient safety. For instance,
named eligible and were fully analyzed.
icine that found preoperative CMS recently eliminated a regula-
3. The research team separated recommendations into categories medical testing before cataract tion preventing nutritionists from
based on the quality of the evidence supporting the advisory. The surgery does not measurably in- writing diet orders.
categories include 1A, strong recommendation supported by high to crease the safety of the surgery.
Wise regulations have accom-
moderatequality evidence; 1B, strong recommendation supported Dr. Pronovost and his colleague
plished much good in healthcare,
by low-quality evidence; 1C, strong recommendation required by state Oliver Schein, MD, an ophthalmol-
he concluded. Still, CMS should
of federal regulation; category II, a weak recommendation supported ogist, alsowrote a studytitled, A
establish a process to identify,
by marginal evidence which would likely result in the clinical benefits Preoperative Medical History and
evaluate and revise or remove
and harms; and no recommendation signaling an unresolved issue. Physical Should Not Be a Require-
regulations that corset clinicians,
ment for All Cataract Patients,
4. New recommendations include, but are not limited to: increase costs and place burdens
published in theJournal of Gener-
CMO / CARE DELIVERY

on patients without clear benefits


al Internal Medicinein March.
 dvising patients to complete a full-body shower the
A to safety or quality. n
night before surgery
 dministering antimicrobial prophylaxis prior to inci-
A


sion during cesarean delivery
 pplying an alcohol-based agent to the skin prior to sur-
A
2 in 3 Medicare Clinicians Exempt

gery in most cases
 orgoing the use of plastic adhesive drapes as they are
F
From MIPS
unnecessary for SSI prevention By Emily Rappleye

T
 efraining from the application topical antimicrobial
R
agents to the incision he majority of clinicians who bill Medicare will not have to com-
ply with the Medicare Access and CHIP Reauthorization Act's
 ot withholding blood transfusions as an SSI prevention
N
Merit-based Incentive Payment System this year, CMS said.
method
The agency mailed roughly 280,000 letters to physician prac-
5. In an invited commentary discussing the guidelines also pub-
tices in May indicating the MIPS participation status for each
lished inJAMA Surgery, Pamela Lipsett, MD, a professor of surgery
clinician associated with the practices' Taxpayer Identification
at Johns Hopkins Medicine in Baltimore, wrote the new guidelines
Number. CMS said 806,979 clinicians do not have to participate
are useful to every surgeon because it distinguishes between what
in the MIPS track of the program, while 418,849 clinicians will be
surgeons should to do to prevent SSIs and what remains unknown
required to participate.
about SSI prevention.
Exempt physicians may not meet the minimum threshold for the
How do guidelines help us in practice? When their development program treating 100 Medicare Part B beneficiaries and billing at
is rigorous, experts are used to systematically review the evidence least $30,000 in Medicare Part B allowed charges per year. Others
and tell us what we can do (or not do) for most patients, wrote exempt from MIPS may qualify to participate in MACRA's alterna-
Dr. Lipset. The guidelines by [Dr.] Berros-Torres et al do exactly tive payment model track, which offers potentially greater financial
that, and they show us the way forward. n rewards for taking on more risk. n
41

50 Cities With the Largest, Smallest Gender Wage


Gaps for Physicians
By Emily Rappleye

F
emale physicians earn 26.5 percent less areas with the largest physician gender wage Here are the 25 metro areas with the smallest
than their male counterparts on average, gap, according to the data. gender wage gap, according to Doximity data.
according to new data from Doximity, a 1. Charlotte, N.C. 33 percent 1. Sacramento, Calif. 19 percent
medical social network whose membership
2. Durham, N.C. 31 percent 2. Minneapolis 20 percent
includes 70 percent of the nations physicians.
3. Orlando, Fla. 30 percent 3. Portland, Ore. 21 percent
In a Doximity survey of more than 36,000
4. Pittsburgh 30 percent 4. Rochester, N.Y. 21 percent
physicians across 48 specialties in the U.S.,
female physicians reported an annual average 5. Bridgeport, Conn. 29 percent 5. Phoenix 21 percent
shortfall of $91,284 compared to their male 6. Louisville, Ky. 29 percent 6. Indianapolis 21 percent
counterparts. Women did not earn more than 7. Houston 29 percent 7. Ann Arbor, Mich. 22 percent
men in any specialty.
8. New Orleans 29 percent 8. Hartford, Conn. 22 percent
The data also shows the magnitude of the gen- 9. Charleston, S.C. 29 percent 9. Milwaukee 22 percent
der pay gap varies significantly based on where a 10. Atlanta 28 percent 10. Boston 23 percent
physician lives. However, what is striking is that
gender parity in pay does not exist in any of the 11. Nashville, Tenn. 28 percent 11. Riverside, Calif. 23 percent
metropolitan areas included in the survey. 12. Columbus, Ohio 28 percent 12. San Francisco 23 percent
13. Kansas City, Mo. 27 percent 13. Dallas 23 percent
For example, Sacramento, Calif., boasts the
smallest gender wage gap. However, female 14. New York City 27 percent 14. Baltimore 24 percent
physicians in Sacramento earn 19 percent less 15. Birmingham, Ala. 27 percent 15. Cincinnati 24 percent
than male physicians in Sacramento on aver- 16. San Jose, Calif. 27 percent 16. Providence, R.I. 24 percent
age, according to Doximity, which comes out
to about $63,283 per year. On the flip side, 17. Jacksonville, Fla. 27 percent 17. San Diego 24 percent
female physicians in Charlotte, N.C., are los- 18. Cleveland 27 percent 18. Austin, Texas 24 percent
ing out on about twice as much money each 19. Chicago 27 percent 19. New Haven, Conn. 25 percent
year than female physicians in Sacramento. 20. Detroit 27 percent 20. San Antonio 25 percent
In Charlotte, the wage gap is 33 percent, and
female physicians earn an average of $125,035 21. Seattle 27 percent 21. Miami 25 percent
less than their male counterparts each year, 22. Denver 27 percent 22. Salt Lake City 25 percent

CARE DELIVERY
according to the data. 23. Washington, D.C. 27 percent 23. Philadelphia 26 percent
Doximity broke down the wage gap by ma- 24. Tampa, Fla. 26 percent 24. Virginia Beach, Va. 26 percent

CMO /FINANCE
jor metropolitan area. Here are the 25 metro 25. Los Angeles 26 percent 25. Las Vegas 26 percent n

Resignation of 3 Physicians Sparks Great Concern in Small Iowa


Community
By Emily Rappleye

R
esidents of Akron, Iowa, are fighting to keep three calls for Mercy and Akron Health Care, the entity that owns
local family medicine physicians from Akron (Iowa) the clinic, to terminate the clinic building lease and cede
Mercy Medical Clinic in business, according to a re- control. That will enable the Akron clinic to return to local
port from theSioux City Journal. control so we can keep the doctors we know and love in our
community, the petition reads.
The physicians submitted their resignations March 14 to
Mercy Medical Center Sioux City (Iowa), the facility that Two of the three physicians Cynthia Wolff, MD, and David
leases the clinic, according to the report. They plan to work Wolff, MD opened the clinic in 1991, and the third physi-
through the end of their contracts, which expire June 30. cian Allison Schoenfelder, MD, joined the practice in 2006,
according to the report.
However, when news of the resignations hit the town of
1,464, petitions began to circulate at local businesses, as A Mercy spokesman told theSioux City Journalthe medical
well as online, according to the report. The online peti- center plans to continue to operate a clinic in Akron and
tiongarnered more than 250 signatures as of early May. It staff it with highly qualified physicians. n
42

How Identifying High-Value PCPs 10 Best and Worst


Can Improve Profitability States for Nurses
By Morgan Haefner By Ayla Ellison

P W
roviders and health plans are constant- ings to calculate performance rates for PCP isconsin is the best state
ly searching for ways to improve their outcomes. Ms. Way writes in her blog post for nurses, according to
bottom line without slashing benefits while these measure sets are reported at the ananalysisby WalletHub.
or increasing premiums. health plan level to the National Committee
for Quality Assurance andCMS, the logic to To identify the best and worst
One opportunity lies in networking with produce these results can be implemented at states for nurses, WalletHub ana-
high-value primary care physicians, says the provider level. lysts compared the 50 states and
Karen Way, health plan analytics and con- the District of Columbia based on
sulting practice lead at NTT DATA Services 3. Estimate the yearly cost per pa- 18 metrics that speak to the op-
based in Plano, Texas. tient for each provider. Ms. Way says portunities for nursing jobs in each
since cost can be defined in several ways, its market. Each metric was graded on
In a Februaryblog post, Ms. Way referenced helpful to use existing methodologies like
astudyby The Peterson Center on Healthcare a 100-point scale, with 100 repre-
QRURs or relative value units to calculate senting the most favorable condi-
and the Clinical Excellence Research Center annual cost per patient for each provider.
at Stanford (Calif.) Medicine that analyzed tions for nurses.
Relative value units are measures Medicare
how steering patients toward high-value PCPs uses to determine reimbursement under its Here are the 10 best states for nurs-
can aid providers and health plans in cost con- physician fee schedule. Once the method- es based on the analysis.
trol. The study found high-quality PCPs that ology is chosen, Ms. Way says hospitals and
implement a team approach to care helped 1. Wisconsin score of 59.55 out
health plans have to look at risk adjustments
prevent hospitalizations and other complica- of 100
for the population and each patient.
tions affecting chronically ill patients.
2. New Mexico 58.61
You want to compare apples to apples when
If you can identify and increase the num- you look at the cost data, because a physi- 3. Iowa 58.49
ber of high-value primary care teams in your cian who treats older diabetic patients with
network, you can control costs without com- co-morbidities is going to have a much high- 4. Texas 57.98
promising benefits, Ms. Way writes. er annual cost per person than a physician
5. Colorado 56.55
Ms. Way spoke with Beckers Hospital Re- who has a population of younger, healthier
view about four specific steps providers patients, she wrote in her blog post. 6. North Dakota 56.23
and health plans can take to find and use 4. Rank PCPs by quality and cost 7. Delaware 55.75
high-quality PCPs. per patient.Ms. Way says this final step
CMO / CARE DELIVERY

involves taking all the information from 8. Utah 55.62


1. Attribute members to provid-
ers. When assessing quality and value of steps one through three and collating it.
9. Arizona 55.18
PCPs, providers have to look at it through The high-value PCPs will be the ones with
slightly different lens, Ms. Way says. Al- the highest quality scores and the lowest 10. Washington 55.12
though there are several methodologies cost. Ms. Way says there may not be a large
number of high-value PCPs, but allof the Here are the 10 worst states for
to help healthcare organizations attribute
data give providers a bell curve of who is nurses.
members to a high-value PCP, Ms. Way
recommends using CMS Quality and Re- doing well and who is not doing well. Pro- 1. District of Columbia 27.56
source Use Reports. The 2015 QRURs detail viders can then say, Lets go talk to PCPs
how group practices and practitioners in the that are doing really well and engage them 2. Hawaii 36.18
U.S. performed in 2015 on certain quality in a value-based contract.
3. New York 36.45
and cost measures, identifying practices and Ms. Way advises providers and health
practitioners by their Medicare-enrolled tax- plans seeking high-value PCP arrange- 4. Louisiana 38.89
payer identification number. While hospitals ments to look at the capabilities you have
and health plans should sort specialists from 5. Alabama 43.03
in-house. If you dont have any [capabil-
PCPs when using QRURs, Ms. Way also ad- ities] in-house, look for a vendor, tool or 6. Alaska 43.65
vises providers hold on to the list of special- a combination of the two that can help
ists to look for high-value opportunities in analyze the data. Its going to impact your 7. New Jersey 43.78
that area. bottom line, she says.n 8. Ohio 44.98
2. Quantify performance rates for
clinical outcome measures. Ms. Way 9. Georgia 45.61
says hospitals and health plans can use 10. Nevada 46.15 n
Healthcare Effectiveness Data and Infor-
mation Set or Medicare Advantage Star rat-
Executive Briefing 43

Because one-size-fits-all,
really doesnt.
Your business needs are unique. Thats why weve designed revenue cycle
management services to address the complex challenges of managing
your revenue cycle operations.

As health care shifts from volume to value, we help organizations like yours
prepare for regulatory changes so you can optimize reimbursements while
maintaining high-quality care and controlling cost to collect.

Denial mitigation

Clinical documentation
improvement Culture adoption
Claims
processing
Analysis of technical
and clinical denials
Accurate payer
Monthly reimbursement
reporting

Build a healthier bottom line.

Visit cerner.com/revworks
2016 Cerner Corporation
44 Executive Briefing

Sponsored by:

Keys to Painless Conversions: Transition Services and Best Practices to


Prevent Disruption and Return to Baseline

P
reparing for a conversion of any kind is no small task. But conversion], so its a juggling act between maintaining current
coordinating a conversion that involves transitioning patient operating performance and standing up this new system thats
accounting systems must include specific fiscal, cultural and going to replace all the current workflow, Mr. Koons said.
operational considerations. When these arent accounted for ear-
ly in the preparation process, organizations can run into cash flow This juggling act between systems can reduce productivity and in-
problems later that set collection rates back by several months. troduce opportunities for financial information to slip through the
cracks. Missing claims, missed revenue capture and late patient
However, with the proper fiscal planning, staff engagement billing can result in fewer collections and slower collection rates.
and executive support, healthcare organizations can minimize Hospitals with particularly bumpy conversions can see baseline
their financial risk and more quickly return to, or exceed, base- collections fall 195 percent below baseline performance equiv-
line performance. alent to two months worth of collections within nine months of
implementation, according to a 2016 Crowe Horwath study.
Few know this better than conversion-veteran Joe Koons, man-
aging director of revenue cycle for Centra Health, a regional Even hospitals with middle-of-the-road conversions have seen
nonprofit system in Lynchburg, Va. Since August, Mr. Koons has noteworthy disruption to revenue cycle operations, according
led efforts to prepare Centras revenue cycle departments for to the Crowe Horwath study. Hospitals average benchmarks for
conversion to Cerners patient accounting system, slated to go- key performance metrics within one month of implementation
live March 2018. included: a 10 day increase in days in accounts receivable, from
52 days to more than 62; an 86 percent increase in days-not-
Centras size has made planning a conversion particularly com- final-billed; and a 21 percent decline in collection rates.
plex. Centra provides medical services to patients across a geo-
graphic area roughly the size of New Jersey. Its diverse portfo- Although these metrics may appear discouraging, there are
lio spans the full continuum of care, including four acute care four key actions hospitals can take to mitigate and possibly
hospitals, more than 50 ambulatory and long-term facilities, a eliminate the negative financial consequences of conversion,
freestanding ER and a 300-physician medical group. The health Mr. Koons said.
system recorded $1.1 billion in net revenue in 2016. Centra also
oversees a burgeoning health plan covering more than 45,000 1. Create a revenue cycle governance structure.
residents in south-central Virginia. To minimize disruption, Mr. Koons recommended organizations
establish a governance framework to ensure revenue cycle KPIs
The amount of resources behind a conversion of that size is continue to meet pre-conversion benchmarks.
daunting, Mr. Koons said. The complexity of the system is at
the degree where there are lots of different bill formats and For example, Centra established a reporting structure consist-
unique requirements that have to be considered ... and coordi- ing of three management tiers to monitor day-to-day opera-
nated with the different clinical workflows. tions as well as high-level strategic progress.

Many hospitals pursue IT conversions to enhance system interop- Centras first process management tier the revenue cycle
erability, improve workflow efficiencies and gain tools to manage action team consists of directors from revenue cycle depart-
a more complex care environment. Although C-suite leaders gen- ments as well as project leaders from Cerner. The action team
erally agree the long-term benefits of conversion outweigh the is responsible for monitoring a laundry list of performance met-
short-term challenges of implementation, a mismanaged conver- rics at a granular level, such as gross and net days in A/R, cash
sion can have severe financial consequences that limit an organi- as a percent of net revenue, DNFBs, denials, partial denials and
zations capacity to function, and may even affect patient care. A/R aging by 90 days by payer, among others. If KPIs deviate
from the expected rates, the action team notifies second tier
Having realistic expectations of how a conversion will affect management and executes corrective measures to get the de-
day-to-day processes can help revenue cycle leaders take ini- partment back on track.
tiative to mitigate financial risk, Mr. Koons said. This article ex-
amines the potential financial effects of a conversion, as well The second and third tiers the revenue cycle finance steering
as four key steps Centra Health took to address and minimize committee and revenue cycle advisory committee, respectively
financial disruption. examine and discuss high-level implementation strategies and
initiatives to ensure a smooth transition. For instance, the adviso-
Tactics to mitigate financial disruption during conversions ry committee considers and monitors costs associated with con-
A patient accounting system (PAS) conversion involves the version scope, ensuring the project doesnt overrun its budget.
gradual transitioning of workflows from a legacy system to the
current system while maintaining day-to-day operations. The framework is in place to ensure the scope of the conver-
sion doesnt balloon to the point where it jeopardizes or puts
The internal operation has to continue to move forward [during the project, or the organization, at risk, Mr. Koons said.
Executive Briefing 45

2. Increase cash on hand. Cerners team also plays an important role in helping staff learn
Another way organizations can minimize financial disruption is best practices in the new system. RevWorks teams work side-
to augment cash reserves and enhance revenue cycle perfor- by-side with [hospital] staff to help them both understand new
mance prior to conversion. workflows and learn how to use the system at its full capacity,
Ms. Kay said. For instance, as hospitals undergo a software con-
Initially, some organizations may struggle with cash collections version, hospital IT and revenue cycle staff may have a general
after transitioning between patient accounting systems, per Ju- idea of how to use the new system to complete a particular task,
lie Kay, vice president of revenue cycle services at Cerner. This but they may not know system best practices. Cerner experts
can happen when an organization begins to focus on complet- can recommend alternative workflows that take full advantage
ing work in the new system and inadvertently lets legacy A/R of the IT systems efficiencies.
work slide, which can lead organizations to suffer a cash crunch
or issue with their reserves. Although an IT vendor is likely to have unmatched knowledge
of its product, value-added resellers, consultants and other
You have to set the expectation that there is going to be a business education and training companies are also worth con-
short-term decline in cash unless certain steps are taken to pro- sidering for employee training and support services, according
tect cash flow and prevent billing delays, Ms. Kay said. To mit- to Mr. Koons.
igate financial risk during conversion, Ms. Kay recommended
organizations optimize revenue cycle processes and take steps [Centra] also partnered with a company to build the training
to increase cash on hand. Working down days in A/R, reducing content and curriculum for staff system conversion, he said.
DNFB to around four days and enhancing charge capture pro-
cesses are effective ways organizations can create a financial 4. Engage staff in the conversion process.
cushion to mitigate any dip during the conversion. System conversions present as many cultural challenges as they
do technical difficulties. People are creatures of habit, which can
Having a very rigorous project plan in place is important, not just lead to resistance to change among employees. It is no differ-
for converting, but also for managing and maintaining accounts re- ent in a field as disciplined and regimented as medicine, where
ceivable and knowing how many days of cash on hand you need healthcare professionals are often uncomfortable with aban-
should something happen during implementation, Ms. Kay said. doning ingrained practices in favor of new, unfamiliar ones.
3. Counter productivity issues by adding support staff. The importance of anticipating and addressing cultural chal-
Enlisting the support of a third-party to augment revenue cycle lenges during a PAS implementation cannot be understated.
staff can be invaluable during a conversion, when hospital re- Change is very uncomfortable and awkward for staff, Mr.
sources are stretched thin, Mr. Koons said. Koons said. We want frequent communication to the organiza-
tion and inclusion as much as we can from a high level down to
Some organizations choose to outsource all legacy A/R work alleviate any fears that the change will be overwhelming.
during a conversion so internal staff can focus entirely on stand-
ing up the new system. This abrupt transition, although intend- Knowing that a patient accounting system implementation will
ed to help staff learn the new system more quickly, can end up cause complications for staff, an organizations implementation
overwhelming employees and harming office morale. teams must find ways to boost morale. To foster a culture of
change among revenue cycle employees, Centra presented
Gradually introducing staff to new workflows while they wind- the conversion as an enterprisewide movement for improved
down legacy A/R can help employees feel more comfortable connection and unity.
and confident with change. Internal staffs expertise is in the
legacy system, Ms. Kay said, meaning internal employees are We called Cerner Unison, or the Unison Project to generate ex-
often the most productive and efficient at working the legacy citement among staff, Mr. Koons said. Weve held a number of
system. As a result, organizations that gradually shift workflows events to kickoff the Unison Project and scheduled town halls
may see a less marked impact on productivity levels as employ- where weve demonstrated the system to employees in advance.
ees gain competence in the new system.
Conclusion
To further ensure productivity remains consistent during con- The fact that change has become a near constant in healthcare
version, health systems should enlist supplemental office does not make navigating transformation any easier for em-
support. Weve partnered with Cerners RevWorks for sup- ployees or administrators. Engaged and effective leadership
plemental staffing, known as transition services, to bridge our and a well-established implementation management team are
productivity gap during conversion and ensure performance key to leading an organization through times of instability.
remains consistent while our internal staff gain efficiency on the
Cerner system, Mr. Koons said. Hospital leaders tend to become fixated on the technical con-
version, Ms. Kay said. But Centra is doing a fantastic job of
Specifically, RevWorks team of experts focuses on refining preparing their organization for change on all fronts, from em-
work processes in the Cerner system as employees work down ployee engagement to executive leadership. They understand
legacy accounts. By setting up and smoothing out processes in the culture of their staff, their physicians, their community and
the platform before the office fully converts, RevWorks ensures thats what makes a difference. n
the transition is as seamless as possible.

Cerners health information technologies connect people, information and systems at more than 25,000 provider facilities world-
wide. Recognized for innovation,Cernersolutions assist clinicians in making care decisions and enable organizations to manage
the health of populations. The company also offers an integrated clinical and financial system to help health care organizations
manage revenue, as well as a wide range of services to support clients clinical, financial and operational needs. Cerners mission
is to contribute to the systemicimprovement of health care delivery and the health of communities. Nasdaq: CERN. For more
information aboutCerner, visitcerner.com, read our blog atblogs.cerner.com, connect with us on Twitter attwitter.com/cern-
erandonFacebookatfacebook.com/cerner.
46 Executive Briefing

Debunk the myth:


Outsourcing RCM doesnt
mean youll lose control.
Shifts in payer mixes and reimbursement structure are not slowing down.
More and more organizations are seeking help managing the complexity
of the revenue cycle. You dont have to do it alone.

Three good reasons


to outsource RCM
Improves viability, sustainability
1 and profitability The regulatory environment
Placing the burden of staff training and retention today is pretty onerous, a lot
on a partner increases efficiency, and leads of organizations struggle to
to faster reimbursement and a more stable get staff up to a particular
cash flow skill level, know solutions
appropriately and stay
2 Lessens administrative burden ahead of market growth.
An RCM partnership
Reducing human error and inefficient, manual
processes can free up providers to focus on becomes an attractive
patient care alternative because of the
size and scale a partner
Increases preparedness for can offer.
3 industry change
Jason Rawlings
Vice President
Cerner RevWorks
Keeping up with regulatory mandates, adapting
to new payment models and preparing for
tomorrows trends leads to future flexibility

Build a healthier bottom line.


To learn more about the benefits and best practices of outsourcing all or part
of your RCM operations, download the Partnering for Success whitepaper at
cerner.com/partneringforsuccess.
47

150 Hospital and Health System CFOs to Know | 2017


By Kelly Gooch, Eric Oliver, Alyssa Rege and Anuja Vaidya

B
eckers Hospital Review is pleased to release the 2017 edition of by $500 million during his 20-year tenure with University of North Car-
its 150 Hospital and Health System CFOs to Know list. olina Health Care. He has experience developing new revenue streams
for hospitals and implementing cost containment initiatives.
The men and women on this list help their organizations navigate
healthcares financial challenges. Dara Bartels. CFO of Gundersen Health System (La Crosse, Wis.).
Ms. Bartels has more than 16 years of experience serving in various
To develop this list, the Beckers Hospital Review editorial team re- health systems and public accounting firms. She joined Gundersen in
ceived nominations and conducted an editorial review process. 2010 as director in finance and was promoted to system controller in
2011 before becoming executive director of finance two years later. She
Note: Individuals cannot pay for inclusion on this list. Names are became interim CFO in September 2015 and took on the role perma-
presented in alphabetical order. nently in April 2016. Prior to joining Gundersen, Ms. Bartels spent
Clint Adams. Executive Vice President and CFO of Ardent Health more than three years as controller at Moline, Ill.-based Trinity Regional
Services (Nashville, Tenn.). Mr. Adams, a certified public accountant, Health System, now UnityPoint Health Trinity, and six years at West Des
has more than 20 years of experience in the financial and healthcare Moines-based UnityPoint Health.
sectors. Before joining Ardent Health Services in 2003, he served as an Jill Batty. Senior Vice President and CFO of Cambridge (Mass.)
audit senior manager for accounting firm EY and controller for Brent- Health Alliance. Ms. Batty has more than 20 years of experience as a
wood, Tenn.-based PathGroup, a comprehensive anatomic, clinical and financial executive and healthcare consultant. She joined Cambridge
molecular pathology services provider. Health Alliance in January 2014 as the organizations senior vice pres-
Kedrick Adkins Jr. CFO of Mayo Clinic (Rochester, Minn.). Mr. Ad- ident and CFO. Before beginning her tenure with CHA, Ms. Batty was
kins has been CFO of Mayo Clinic since 2014. He joined Mayo from Li- senior vice president of finance and CFO of Cheshire Medical Center/
vonia, Mich.-based Trinity Health where he was president of integrated Dartmouth-Hitchcock Keene (N.H.) where she helped the organization
services for six years. From 1976 to 2007, he held various positions at transition from fee-for-service to population health management.
consulting firm Accenture, including global chief diversity officer and Gregg Beeg. CFO of Oaklawn Hospital (Marshall, Mich.). A veteran of
country managing director. the industry, Mr. Beeg maintains more than 27 years of experience in the
Michael Allen. CFO of OSF Healthcare System (Peoria, Ill.). Mr. Allen healthcare and financial sectors. He was appointed CFO of the hospital
has more than 25 years of business and healthcare experience, including in 2014. Prior to joining Oaklawn Hospital, he held numerous leadership
eight years in public accounting and more than 18 years as CFO of var- positions at health systems across Michigan. Mr. Beeg began his career in
ious health systems. He joined OSF HealthCare in 2015 after serving as finance as an accountant at Michigan Medicine in Ann Arbor.
CFO of La Crosse, Wis.-based Gundersen Health System for two years. Chris Bergman. Vice President and CFO of Dayton (Ohio) Childrens
Jennifer Alvey. Senior Vice President and CFO of Indiana University Hospital. Mr. Bergman is responsible for leading Dayton Childrens
Health (Indianapolis). Ms. Alvey joined Indiana University Health in Hospitals accounting, revenue cycle and medical records departments.
2011 and currently serves as senior vice president and CFO. Her previ- Prior to joining Dayton Childrens, he served in executive leadership po-
ous positions with the health system include treasurer and vice president sitions at Cincinnati-based Christ Hospital and Sparrow Health System,
of revenue cycle services. She spent five years with the Indiana Finance a five-hospital health system in Lansing, Mich. He has more than 35
Authority, eventually serving as public finance director. years of healthcare experience.

Mark Anderson. CFO of Lane Regional Medical Center (Zachary, Ron Blaustein. CFO of Ann & Robert H. Lurie Childrens Hospital of
La.). In his current role, Mr. Anderson is responsible for overseeing Chicago. Mr. Blaustein joined Lurie Childrens in 2006 as the hospitals
all finance, accounting and revenue cycle functions for the medical first corporate comptroller. He was then appointed to associate CFO in
center. He has more than 18 years of executive leadership experience. 2010 before being promoted to CFO in 2014. In addition to his work
Prior to joining Lane Regional in 2011, Mr. Anderson was CFO of with the hospital, Mr. Blaustein has served as a board member for the
Danville (Va.) Regional Medical Center and Memorial Hospital of Near North Health Services Corporation and Almost Home Kids, which
Martinsville, Va., and Henry County, a member of Brentwood, Tenn.- provides transitional care for pediatric patients between the hospital and
based LifePoint Health. home. He currently serves on the boards of Accountable Care Chicago
and Lurie Childrens Health Partners Clinically Integrated Network.
Rhonda Anderson. Senior Vice President and CFO of Ascension
Healthcare (St. Louis). Before joining Ascension Healthcare in Octo- Kimberly Bones. CFO of Baylor Scott & White Medical Center-McK-
ber 2014, Ms. Anderson served as president of the business develop- inney (Texas). Ms. Bones helped open Baylor Scott & White Medical
ment division and CFO of Milwaukee-based Columbia St. Marys, roles Center-McKinney in 2012 and served as senior financial analyst for the
she had held since 2009. Her experience also includes 20 years at Balti- facility before being promoted to the CFO position two years ago. Previ-
more-based Saint Agnes HealthCare serving in the financial division. ously, she worked at The Heart Hospital Baylor Plano (Texas) and served
In her current role, Ms. Anderson works closely with CFOs across the as CFO of Baylor Scott & White Surgical Hospital at Sherman (Texas).
Ascension organization. Cara Breidster. CFO of IU Health Arnett Hospital (Lafayettte, Ind.).
Charles Ayscue. Senior Vice President of Finance and CFO of Mis- Ms. Breidster joined IU Health Arnnett Hospital's executive team in
sion Health (Asheville, N.C.). Before serving as senior vice president July 2012. She served as the health systems vice president of finance
of finance and CFO of Mission Health, Mr. Ayscue was CFO of Chap- and corporate controller before being named CFO. Prior to joining IU
el Hill-based University of North Carolina Health Care. He helped the Health, Ms. Breidster spent 17 years at Ernst and Young in healthcare
University of North Carolina Hospitals improve its overall cash balance and tax consulting.
48

Michael Browning. CFO of ProMedica (Toledo, Ohio). Mr. Browning president and CFO at Boston-based Tufts New England Medical Center
has more than 25 years of experience in healthcare finance. As CFO of for four years. A 20-plus-year industry veteran, Mr. Burke is also in-
ProMedica a role he took in August 2016 he is responsible for the volved with the Association of American Medical Colleges and the pro-
organizations finance department, including accounting, supply chain vider advisory board of Minnetonka, Minn.-based UnitedHealthcare.
management and financial planning. He is a member of the Healthcare
Finance Management Association and has experience in treasury, reve- Daniel Cancelmi. CFO of Tenet Healthcare (Dallas). Mr. Cancelmi
nue cycle, managed care and reimbursement. has spent numerous years in the financial and healthcare sectors. He first
joined Tenet as CFO of Philadelphia-based Hahnemann University Hos-
Colleen M. Blye. Executive Vice President and CFO of Montefiore pital, and later transitioned into leadership roles as controller of the health
Health System (New York City). Ms. Blye oversees the financial strat- system, principal accounting officer and senior vice president before be-
egy, reporting and investments for Montefiore Health System and New coming CFO in 2012. He began his career at PricewaterhouseCooper and
York City-based Albert Einstein College of Medicine, where she is also served in the companys national accounting and Securities and Exchange
responsible for revenue cycle and supply chain performance. Before be- Commission unit.
coming executive vice president and CFO of Montefiore in January 2016,
she served as executive vice president and CFO of Rockville Centre, N.Y.- Dan Carpenter. Senior Vice President and CFO of UnityPoint Health
based Catholic Health Initiatives of Long Island. She also has experience (West Des Moines, Iowa). Prior being promoted to senior vice presi-
in treasury management, financial reporting and information technology. dent and CFO of UnityPoint Health in January, Mr. Carpenter served as
CFO of UnityPoint Health-Dubuque (Iowa) at Finley Hospital. While at
Mark Bogen. Senior Vice President and CFO of South Nassau Com- Finley, he was responsible for creating a shared analytics and business
munities Hospital (Oceanside, N.Y.). With more than 35 years of expe- development team between the health systems Dubuque and Waterloo,
rience in healthcare and financial operations, Mr. Bogen is responsible Iowa, locations. He is a member of the American College of Healthcare
for the South Nassau Communities Hospitals financial planning related Executives and the Healthcare Financial Management Association.
to growth, financing and associated issues. He also coordinates the hos-
pitals relationship with auditors and investment bankers. In addition to Barbara Carveth. Vice President of Finance and CFO of University of
his leadership roles, Mr. Bogen, a certified public accountant, is a mem- Colorado Hospital (Aurora). Ms. Carveth joined the University of Col-
ber of the Healthcare Financial Management Association and Health orado Hospital in January 2013 and currently serves as vice president of
Care Compliance Association. finance and CFO. Her previous roles include CFO of St. Mary-Corwin
Medical Center in Pueblo, Colo., and CFO of St. Anthony North Hos-
Kevin Brennan. Executive Vice President of Finance and CFO of pital in Westminster, Colo. During her time with St. Mary-Corwin, she
Geisinger Health System (Danville, Pa.). In addition to his role as ex- oversaw the hospitals fiscal operations.
ecutive vice president and CFO of Geisinger Health System, Mr. Bren-
nan serves as treasurer of the Geisinger Health System Foundation. Paul Castillo. CFO of Michigan Medicine (Ann Arbor). Mr. Castil-
He is a member of the Geisinger Assurance Company board of direc- lo joined Michigan Medicine in November 2011 after serving as vice
tors and treasurer of Geisinger Insurance Corp.s board of directors. president of finance and CFO of Pittsburgh-based UPMC Presbyterian
Mr. Brennan was appointed voluntary secretary and treasurer of the Shadyside. As CFO of Michigan Medicine, Mr. Castillo is responsible for
Healthcare Financial Management Association for the 2016-17 term, the integrated financial and clinical operations at the health systems vari-
beginning in June. ous health centers, the Ann Arbor-based University of Michigan Medical
School and the universitys school of nursing, as well as the Michigan
Robert Broermann. Senior Vice President and CFO of Sentara Health- Health Corp.s shared administrative services.
care (Norfolk, Va.). Mr. Broermann was CFO of Tidewater Health Care
when it merged with Sentara in 1998. He was appointed senior vice presi- Steve Chen. Vice President of Finance and CFO of San Joaquin Com-
dent and CFO of Sentara Healthcare in 2001 and is responsible for 12 op- munity Hospital (Bakersfield, Calif.). Mr. Chen began his healthcare
erating divisions within the organization. He also belongs to the Virginia career as a financial management intern at a healthcare facility in Flor-
Beach Education Foundation, where he serves as treasurer, and is a fellow ida. He became CFO and senior finance officer of Adventist Hinsdale
of the Healthcare Financial Management Association. (Ill.) Hospital in 2000, a position he held until 2008 when he became
CFO of Porter Adventist Hospital in Denver. He then served as vice
Mike Browder. Executive Vice President and CFO of RegionalCare president at Denver-based Executive Health Resources for four years
Hospital Partners (Brentwood, Tenn.). Prior to joining RegionalCare before taking on his current role as vice president of finance and CFO of
Hospital Partners, Mr. Browder served as president and CEO of Essent San Joaquin Community Hospital.
Healthcare, a Nashville, Tenn.-based company that owned and operated
nonurban acute care hospitals before merging with RegionalCare Hos- Michael Coggin. Executive Vice President and CFO of LifePoint
pital Partners in 2011. He began his career at EY. He holds advanced Health (Brentwood, Tenn.). Mr. Coggin was hired as LifePoint Healths
membership to the Healthcare Financial Management Association and senior vice president and chief accounting officer in 2008, where he was
membership to the Financial Executives Institute. responsible for the health systems external financial reporting and cor-
porate accounting functions. He received a promotion to executive vice
Jim Budzinski. Executive Vice President and CFO of WellStar Health president and CFO in September 2016. Mr. Coggin began his profes-
System (Marietta, Ga.). Mr. Budzinski joined WellStar in July 2008 as sional career as an auditor with KPMG.
executive vice president and CFO. He helped the system shore up its fi-
nances and credit before overseeing consecutive years of strong financial Mike Connors. Senior Vice President of Finance and CFO of Cape
performance. He has previous experience as CFO of St. Johns Health Cod Healthcare (Hyannis, Mass.). A certified public accountant, Mr.
System in Springfield, Mo. now known as Mercy and Sparrow Connors joined Cape Cod Healthcare in March 2009. He previous-
Health System in Lansing, Mich. ly served as senior vice president and CFO of Brockton, Mass.-based
Signature Healthcare. Mr. Connors has also held leadership positions
Michael Burke. Senior Vice President, Vice Dean and Corporate CFO at Burlington, Mass.-based Lahey Hospital & Medical Center and Wey-
of NYU Langone Medical Center (New York City). Mr. Burke assumed mouth, Mass.-based South Shore Hospital.
his role as senior vice president, vice dean and corporate CFO of NYU
Langone Medical Center in 2008. He previously served as senior vice Thomas Corrigan. Executive Vice President and CFO of Christiana
49

Care Health System (Newark, Del.). Mr. Corrigan joined Christiana Area Chamber of Commerce and the Wisconsin Hospital Association.
Care Health System in October 2006 as executive vice president and
CFO. He has served as a member of the Visiting Nurses Association Lori Donaldson. CFO of UC San Diego Health. Ms. Donaldson joined
board of directors and chaired the health systems audit committee. UC San Diego Health in 1990 and served as comptroller before being
Before joining Christiana Care Health, Mr. Corrigan served as CFO of appointed to CFO in July 2010. In 2015, the San Diego Business Journal
ADP Brokerage Services Group and held a number of leadership posi- named her CFO of the Year. She is also an active member of the commu-
tions at Anheuser-Busch Companies, including vice president of finance nity and is a member of the Bannister Family House board of directors.
of Busch Entertainment. Bill Douglas. Senior Vice President, CFO and Treasurer (Riverside
Carol Crews. Senior Vice President and CFO of Tanner Health Sys- Healthcare, Kankakee, Ill.). Mr. Douglas has been senior vice president,
tem (Carrollton, Ga.). Ms. Crews joined Tanner Health System in 1991 CFO and treasurer of Riverside Healthcare since 2006. His previous roles
as a staff accountant and quickly made her way to senior accountant, with the health system include vice president of finance and director of
vice president of finance, senior vice president and CFO. In her current planning and operations. He is a member of the Healthcare Financial Man-
role, Ms. Crews is responsible for the health systems business-related agement Association and American College of Healthcare Executives.
activities, including budgets, audits and government filings. Christopher Dunleavy. Senior Vice President of Finance and CFO of
Michael Curran. Executive Vice President and Chief Administrative Brigham Health (Boston). Mr. Dunleavy brought more than 25 years of
and Financial Officer of MedStar Health (Columbia, Md.). Mr. Curran experience in financial management and healthcare to his role as senior vice
joined MedStar Health in 2002, bringing with him more than 20 years president of finance and CFO of Brigham Health in May 2016. Prior to join-
of senior healthcare leadership experience. Prior to his work at MedStar, ing Brigham, he held a number of executive roles with Vizient; USMD Hold-
he served as CFO and treasurer of Philadelphia-based Jefferson Health. ings, the parent company of Irving, Texas-based USMD Health; and Baylor
Mr. Curran previously sat on the board of directors for the American Jack and Jane Hamilton Heart and Vascular Hospital in Dallas.
Red Cross, Juvenile Diabetes Research Foundation and Elwyn Institute. Chris Ellington. President of UNC Health Care Network Hospitals
Conrad Deese. CFO of LifePoint Health Eastern Group (Brentwood, and Executive Vice President and CFO of UNC Hospitals at Chapel
Tenn.). Mr. Deese was appointed to CFO of LifePoints Eastern Group Hill. Before joining UNC in 2008, Mr. Ellington was vice president of
in April 2016. He began his career at LifePoint as the vice president of fiscal services and CFO of Appalachian Regional Healthcare based in
finance for the Eastern Group where he oversaw and directed the finan- Lexington, Ky. He is a member of the North Carolina Hospital Associa-
cial operations for LifePoint facilities in the Midwest, Northeast and tion board of directors and is also on the boards of UNC Health Care-af-
Southeast regions. Before joining LifePoint, Mr. Deese spent nine years filiated entities throughout the state.
at Health Management Associates, eventually serving as CFO and vice Dan Enderson. Senior Vice President and CFO of Centura Health
president of operations finance of the Florida-based system. (Englewood, Colo.). Centura Health named Mr. Enderson senior vice
Anthony C. DeFurio. Senior Vice President and CFO of UCHealth president and CFO in 2011. His previous experience includes time as
(Denver). Mr. DeFurio oversees UCHealths financial operations includ- CFO and senior vice president of Huguley Memorial Medical Center in
ing business development, investment and treasury management. He is Burleson, Texas, and regional CFO for the Southwest Region of Adven-
also responsible for UCHealths capital and debt structure as the systems tist Health System, based in Altamonte Springs, Fla.
senior vice president and CFO. Before taking on his current role, Mr. Jo Ann Escasa-Haigh. Executive Vice President and CFO of St. Jo-
DeFurio was vice president and CFO of University of Colorado Hospital seph Health (Irvine, Calif.). Ms. Escasa-Haigh joined St. Joseph Health
Authority. Earlier in his career, Mr. DeFurio served as the CFO of the in 2007, eventually serving as executive vice president and CFO of St.
University of Iowa Hospitals and Clinics in Iowa City. Joseph Health. After St. Joseph Health merged with Providence Health
Robert DeMichiei. Executive Vice President and CFO of UPMC & Services last year, Ms. Escasa-Haigh took on the additional roles of
(Pittsburgh). Mr. DeMichiei joined UPMC in May 2004 and is respon- executive vice president and interim CFO of the combined system, Prov-
sible for the $14 billion integrated health care delivery and finance sys- idence St. Joseph Health. Prior to joining St. Joseph, she spent 10 years as
tems operations. Prior to joining UPMC, Mr. DeMichiei was CFO of vice president of finance at PacificCare, now part of UnitedHealth Group.
GE Transportation Systems global service operations. He also spent 10 William Bill Fenske. CFO of Rice Memorial Hospital (Willmar,
years with PricewaterhouseCoopers in Pittsburgh. In addition to his Minn.). Mr. Fenske has been CFO of Rice Memorial Hospital for the
role at UPMC, Mr. DeMichiei is the finance committee chairman of the last 11 years. He has held similar positions at Agnesian HealthCare in
United Way of Allegheny County and is a member of the Greensburg, Fond du Lac, Wis., and Winona (Minn.) Health. He is involved with the
Pa.-based Seton Hill University board of trustees, among other boards. Healthcare Financial Management Association.
Andrew DeVoe. CFO of TriHealth (Cincinnati). Mr. DeVoe joined Steve Filton. Executive Vice President and CFO of Universal Health Ser-
TriHealth at the end of 2016 and oversees financial planning, account- vices (King of Prussia, Pa.). Mr. Filton was a longtime United Health Ser-
ing systems, budgeting, patient financial services and managed care vices employee when he was named executive vice president and CFO in July
contracting. He is also responsible for the external financing and invest- 2003. He was previously UHS vice president, controller and secretary. He
ments across the health system. Before joining TriHealth, Mr. DeVoe joined the health system in 1985 as a director of corporate accounting.
was senior vice president and CFO for Aria Health System in Philadel-
phia. He spent three years as the CFO of Philadelphia-based University Steven Fischer. CFO of Beth Israel Deaconess Medical Center (Bos-
of Pennsylvania Health System. ton). Mr. Fisher accepted the CFO position at Beth Israel Deaconess
Medical Center in October 2004. With more than 35 years of experi-
Jim Dietsche. Executive Vice President and CFO of Bellin Health ence in healthcare, Mr. Fisher previously held the CFO position at Bos-
(Green Bay, Wis.). Mr. Dietsche has more than 25 years of experience in ton-based Caritas Christi Health Care System, now known as Steward
the healthcare industry. He was named to Bellin Healths executive team Health Care System. He is a member of the Beth Israel Deaconess Med-
in 2005 where he is responsible for all the financial aspects of the health ical Centers board and serves on the standing committee on finance.
system as well as regional business development. He also serves on the
board of directors for Bellin-ThedaCare Healthcare Partners, Green Bay
50

Kenneth Fisher. Associate Vice President of Finance for UI Health Craig Goodrich. CFO of Virginia Mason Health System (Seattle).
Care and CFO of University of Iowa Hospitals and Clinics (Iowa Mr. Goodrich was promoted to CFO of Virginia Mason Health System
City). Mr. Fisher became associate vice president of finance for UI in June 2016. He has more than 30 years of experience in healthcare
Health Care in June 2007. He was consulting firm Navigants director and was previously the systems senior vice president for finance and ac-
before joining UI Health Care. With more than 40 years of healthcare counting. Before joining Virginia Mason, Mr. Goodrich was a principal
experience, he plans to retire July 1. at Arthur Anderson LLP in Seattle.
Larry Fitzgerald. Associate Vice President for Business Development Michael Gough. Executive Vice President and CFO of Norton Health-
and Finance for University of Virginia Health System (Charlottes- care (Louisville, Ky.). Mr. Gough joined Norton Healthcare in July 2000
ville). Mr. Fitzgerald joined the University of Virginia Health System in as vice president of finance and accepted the CFO position in September
1999 where he is currently responsible for management, oversight and 2003. In January 2017, Mr. Gough became Norton Healthcares execu-
financial resources coordination for the systems medical center. He is tive vice president and CFO. His previous experience includes six years
responsible for the health systems fiscal services, investments, access as CFO of Caritas Health Services in Louisville, Ky., and 11 years work-
and registration functions and contract management. Mr. Fitzgerald ing for Columbia/HCA Healthcare.
also manages funds to support the health systems current and future
operations and expansions. Joe Guarracino. Senior Vice President and CFO of White Plains
(N.Y.) Hospital. Mr. Guarracino has been in his position with White
Amy Floria. CFO of Goshen (Ind.) Health. Ms. Floria has been CFO Plains Hospital since January 2017. He also serves as an adjunct faculty
of Goshen (Ind.) Health formerly associated with IU Health for member at New Rochelle, N.Y.-based Iona College. Mr. Guarracino is
the past eight years. She has worked in the Goshen Health System since a past senior vice president and CFO of the Brooklyn Hospital Center
1999. During her tenure, the Goshen Health System hasnt reported a and Health Quest, a nonprofit family of hospitals and healthcare provid-
single layoff. Before her time at Goshen, she was an audit senior associ- ers headquartered in Lagrangeville, N.Y. He serves on the Iona College
ate at PricewaterhouseCoopers in South Bend, Ind. board of directors.
Henry Franey. Executive Vice President and CFO of University of Dana Haering. CFO of Lucile Packard Childrens Hospital Stanford
Maryland Medical System (Baltimore). Mr. Franey had more than 30 (Palo Alto, Calif.). Ms. Haering has spent more than 20 years in the fi-
years of healthcare experience when he took on his current role in Janu- nance industry, working primarily with healthcare clients. She was hired
ary 2009. He is responsible for the nine-hospital health systems financial as the controller of Lucile Packard in 2011 and was promoted to interim
services and is involved in the strategic financial and capital planning, CFO in 2013 before officially being named CFO the following year. Prior to
investment and debt management, rate setting and reimbursement and her tenure at Lucile Packard, Ms. Haering was a senior manager at KPMG.
financial reporting. Before accepting his current position, Mr. Franey
was the senior vice president and CFO for the Baltimore-based Univer- Don Halliwill. CFO of Carilion Clinic (Roanoke, Va.). Mr. Halliwill
sity of Maryland Medical Center. joined Carilion Clinic in 1997 and became CFO in 2013. He is guided by
three primary principles as CFO of Carilion Clinic: his resources are the
Lawrence Furnstahl. Executive Vice President and CFO of Oregon patients resources; the hospital must achieve financial success to ensure
Health & Science University (Portland). Mr. Furnstahl has more than sustainability; and the hospital must reduce cost to patients over time.
three decades of healthcare experience. He was chief financial and strat- Mr. Halliwill attributes his passion for the position to his deep ties to the
egy officer at the University of Chicago Medical Center for five years Roanoke community.
before joining Oregon Health & Science University as executive vice
president and CFO in 2011. Gail Hanson. CFO of Aurora Health Care (Milwaukee). Ms. Hanson
joined Aurora Health Care in January 2011 after a long career in govern-
Steven Glass. CFO and Treasurer of Cleveland Clinic. Mr. Glass ment and the healthcare insurance industry. Before joining Aurora, Ms.
joined Cleveland Clinic in 2002 as controller and chief accounting offi- Hanson was the State of Wisconsin Investment Boards deputy executive
cer; he became CFO three years later. He is responsible for the finances director and a senior vice president, treasurer and CFO for Blue Cross
of the entire Cleveland Clinic Health System, which includes 11 owned Blue Shield United of Wisconsin, which became Cobalt Corporation.
hospitals, 18 full-service family health centers and more than 3,000 phy- Ms. Hanson has an MBA from the University of Chicago.
sicians. Before joining the Cleveland Clinic, Mr. Glass was Columbia,
Md.-based MedStar Healths vice president of finance. Fred Hargett. CFO of Novant Health (Winston-Salem, N.C.). Joining
Novant Health in 2003, Mr. Hargett has progressed through the system
Robert Glenning. President of the Financial Services Division and before earning his current title of CFO. He previously served as senior
CFO of Hackensack Meridian Health (Edison, N.J.). In his current vice president of financial planning and executive vice president of fi-
role, Mr. Glenning is responsible for maintaining the Hackensack Me- nance. Before joining Novant, Mr. Hargett was the manager of health-
ridian Healths information systems and technology in addition to his care consulting at EY in Charlotte, N.C.
various financial duties. He previously served as the executive vice pres-
ident and CFO of Hackensack (N.J.) University Health Network. As a re- Scott Hawig. Executive Vice President of Finance, Treasurer and CFO
sult of his successful leadership of Hackensack-affiliated enterprises, Mr. of Froedtert & the Medical College of Wisconsin (Milwaukee). Mr.
Glenning was jointly appointed as an initial board of governors mem- Hawig joined Froedtert & the Medical College of Wisconsin in August
ber for the South Orange, N.J.-based Seton Hall-Hackensack Meridian 2012 in his current role. He also recently took responsibility for supply
School of Medicine and the Hackensack Alliance ACO. chain operations across the health network. Mr. Hawig came to Wiscon-
sin after serving as the executive leader over Durham, N.C.-based Duke
Greg Gombar. Executive Vice President and CFO of Carolinas Health- University Health Systems revenue cycle organization. While at Duke,
Care System (Charlotte, N.C.). Mr. Gombar joined Carolinas Health- he oversaw a hospital system with more than $2.8 billion in net revenue.
Care System in 1984 as controller and became CFO the next year. His
previous experience includes seven years as an audit manager and health- Mike Heather. CFO of Prime Healthcare Services (Ontario, Calif.).
care consultant for Arthur Anderson LLP. Mr. Gombar is a member of Mr. Heather arrived at Prime after serving as CFO of Prospect Medi-
several professional organizations, including the North Carolina Asso- cal Holdings, a company focused on coordinating regional healthcare
ciation of CPAs and the Healthcare Financial Management Association. services. During his time at Prime, Mr. Heather oversaw the companys
51

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52

initial public offering in 2005. He has a long history in finance serving as services for the health system. He joined CentraCare in 2008 after serv-
CFO and then becoming CEO of what is now known as Demand Media. ing as CFO and finance director for HealthPartners for 11 years.
Tim Heinrich. CFO of Thorek Memorial Hospital (Chicago). Mr. Vanessa Kochevar. CFO of St. Mary-Corwin Medical Center (Pueblo,
Heinrich has served as Thorek Memorial Hospitals CFO since Septem- Colo.). Ms. Kochevar joined St. Mary-Corwin Medical Center, part of
ber 2014. He has also served as the president of Heinrich & Associates, a Centennial, Colo.-based Centura Health, in August 2013. She was pre-
full-service accounting firm. viously the CFO at Deaconess Hospital in Oklahoma City and CFO of
St. Marys Regional Medical Center in Enid, Okla., Summerlin Hospital
Dennis Hesch. Executive Vice President and CFO of The Carle Foun- Medical Center in Las Vegas and Spring Valley Hospital Medical Cen-
dation (Urbana, Ill.). Bringing more than two decades of healthcare ter in Las Vegas. Community Health Systems awarded Ms. Kochevar its
experience with him, Mr. Hesch has served as the CFO of The Carle Outstanding Achievement Award in 2012.
Foundation since September 2006. At Carle, Mr. Hesch oversees a $1.9
billion, two-hospital integrated delivery system. Before assuming his Anne Krebs. CFO of Butler (Pa.) Health System. Ms. Krebs joined
current role, Mr. Hesch was a senior vice president and CFO for the Butler Health System in 2001. She was previously the vice president of
Carle Clinic Association. finance at the former St. Joseph Hospital in Kirkwood, Mo. She was also
the vice president of finance at Lurie Childrens Hospital in Chicago and
Pam Hess. CFO of Saint Vincents Healthcare (Jacksonville, Fla.). Ms. a senior auditor in KPMGs Chicago office.
Hess became market CFO of Saint Vincents Healthcare in July 2016.
She was previously with St. Thomas Health in Nashville, Tenn., where JoAnn Kunkel. CFO of Sanford Health (Sioux Falls, S.D.). As Sanford
she served as CFO of St. Thomas West Hospital and St. Thomas Mid- Healths CFO, Ms. Kunkel oversees finances for one of the largest health
town Hospital. Both St. Thomas and St. Vincent are members of St. systems in the country, with 45 hospitals and nearly 300 clinics. She
Louis-based Ascension. Ms. Hess has more than 20 years of healthcare joined Sanford Medical Center in 1995 and was appointed CFO of the
experience as an auditor, financial analyst and financial director. system in 2012. Sanford Health has 28,000 employees with more than
1,300 physicians.
Rick Hinds. Executive Vice President and CFO of UC Health (Cin-
cinnati). For the last seven years, Mr. Hinds has overseen finances at UC Angela Lalas. Senior Vice President of Finance for Loma Linda (Ca-
Health. In his role as executive vice president and CFO, he is responsible lif.) University Health. Ms. Lalas joined Loma Linda University Health
for the financial leadership of the system as well as the technology, le- in January 2006 and was promoted to senior vice president of finance
gal, human resources, marketing and supply changes. Before joining UC in January 2015. She has previous experience as a senior tax consultant
Health, Mr. Hinds was the interim CEO of Health Alliance of Greater at Deloitte and senior associate at McGladrey, now known as RSM, an
Cincinnati, UC Healths predecessor company. He is a life-long resident audit, tax and consulting services provider. Ms. Lalas has been an Amer-
of Cincinnati. ican Institute of CPAs and The Chartered Institute of Management Ac-
countants chartered global management accountant since June 2013.
Linda Hoff. Senior Vice President and CFO of Legacy Health (Port-
land, Ore.). Ms. Hoff joined Legacy Health in January 2014 after serving as Kathy Lancaster. Executive Vice President and CFO of Kaiser Foun-
CFO of Madison, Wis.-based Meriter Health Services now UnityPoint dation Hospitals and Health Plan (Oakland, Calif.). Ms. Lancaster
Health-Meriter and as president of Physicians Plus Insurance Corp., a joined Kaiser Permanente in 1998 and held several strategy and financial
healthcare insurer in Madison, Wis. She heads the $1.8 billion systems fi- planning roles before accepting the CFO position in 2005 after hold-
nancial department, which has an operating margin of 5 percent. ing senior leadership roles for Prudential Insurance Co. In her current
position, Ms. Lancaster oversees the controllers office, treasury, capital
Allen Johnson. CFO of Truman Medical Centers (Kansas City, Mo.). planning, enterprise shared services and financial operations.
Since 1999, Mr. Johnson has led financial operations of Truman Medical
Centers as CFO. Under his tenure, Truman Medical Center has seen a $208 Phyllis Lantos. Executive Vice President, Treasurer and CFO of
million revenue increase. He was previously director of reimbursement at NewYork-Presbyterian Hospital (New York City). Ms. Lantos is the
Hennepin County Medical Center in Minneapolis for four years and CFO executive vice president, treasurer and CFO of NewYork-Presbyterian
of Metropolitan Health Plan, a Minnesota-based HMO, for eight years. Hospital as well as CFO of the NewYork-Presbyterian system. Prior to
joining the system in 2000, Ms. Lantos served as deputy COO at Yale
Keith Kasper. Senior Vice President and CFO of University of Penn- University School of Medicine in New Haven, Conn., and vice presi-
sylvania Health System (Philadelphia). Mr. Kasper is responsible for the dent of financial management services at Montefiore Medical Center in
University of Pennsylvania Health Systems capital and operating budget Bronx, N.Y. She serves on the Healthcare Financial Management Asso-
process as vice president and CFO. He also provides financial support to ciations board of directors.
strategic and operating plans and leads the implementation and over-
sight of customer-focused financial processes and systems. He previously Dennis Laraway. CFO of Memorial Hermann Healthcare System
served as CFO of Hahnemann University Hospital in Philadelphia. (Houston). Mr. Laraway joined Memorial Hermann Healthcare System
as CFO in 2011. He oversees the finances of the systems 16 hospitals
Jim Kelley. CFO of Presence Health (Chicago). Mr. Kelley joined Pres- throughout the greater Houston area. Before his tenure at Memorial
ence Health as CFO in May 2016 where he is responsible for manag- Hermann Health System, Mr. Laraway was the vice president and CFO
ing Presence Healths finances. Mr. Kelly spent three years as the vice of St. Josephs Hospital in Phoenix. He is currently an adjunct professor
president of finance at Park Ridge, Ill.-based Advocate Lutheran General at Rice University in Houston.
Hospital and the 17 years before that as vice president of finance and
support services at Oak Lawn, Ill.-based Advocate Childrens Hospital. Ralph Lawson. Executive Vice President and CFO of Baptist Health
He also served on the board of directors for Rainbow Hospice, based in South Florida (Coral Gables). Mr. Lawson oversees the finances for
Mount Prospect, Ill., for 10 years. Baptist Health South Florida, a nonprofit healthcare organization. Pri-
or to his tenure at Baptist, he spent 17 years at professional services
Greg Klugherz. Senior Vice President of Finance and CFO of Cen- firm Deloitte, with eight years focused on healthcare. Mr. Lawson
traCare Health (St. Cloud, Minn.). As CentraCare Healths CFO and served as national chair of the Healthcare Financial Management As-
senior vice president, Mr. Klugherz, oversees finance and accounting sociation from 2012-2013.
53

Kevin Lenahan. Senior Vice President and Chief Finance and Ad- Tim Maurice. CFO of University of California Davis Health System (Sac-
ministrative Officer of Atlantic Health System (Morristown, N.J.). ramento). Mr. Maurice has overseen all financial operations of the Univer-
Mr. Lenahan joined Atlantic Health System in 1995. He was named vice sity of California Davis Health System as CFO since 2011. Before then, he
president of finance and CFO in June 2010 and then promoted to his was vice president and CFO of St. Johns Regional Medical Center in Ox-
current role in December 2015. Mr. Lenahan developed Atlantic Health nard, Calif., and St. Johns Pleasant Valley Hospital in Camarillo, Calif. He
Systems first risk-based contract, which took effect in 2015, and led the previously spent time as CFO of Good Samaritan Community Healthcare
team to develop the systems ACO, which was the first in New Jersey. in Puyallup, Wash., and Saint Joseph Mercy-Oakland in Pontiac, Mich.
M. Scott Lieberenz. Senior Vice President and CFO of Childrens Hos- Kenneth McGhee. CFO of Loretto Hospital. (Chicago). Prior to join-
pital Los Angeles. Mr. Lieberenz joined Childrens Hospital Los Angeles ing Loretto Hospital, Mr. McGhee was CFO of Pinnacle Hospital in
in 2016. His responsibilities include overseeing the hospitals account- Crown Point, Ind. He previously spent 10 years as the director of finance
ing, financial reporting, financial planning and budgeting. He previously for Chicago-based Michael Reese Hospital, which is now closed, and five
served as senior vice president of financial services for Greenville, N.C.- years as the director of finance Jackson Park Hospital in Chicago.
based Vidant Health where he led the systems ICD-10 implementation.
He is a member of the Healthcare Financial Management Association. Patrick McGuire. Executive Vice President and CFO of St. John Prov-
idence Health System (Warren, Mich.). Mr. McGuire has worked for
Darryl Linnington. CFO of McAlester (Okla.) Regional Health St. John Providence Health System, part of St. Louis-based Ascension
Center. Mr. Linnington, a certified management accountant, has more Health, since 1986. During his tenure, he has seen the health system
than two decades of experience in healthcare. Most recently, he served grow from one hospital into a five-hospital health enterprise with fa-
as CFO of facilities affiliated with Community Health Systems and Iasis cilities throughout five counties in southeast Michigan. He helped lead
Healthcare, both based in Franklin, Tenn., and Plano, Texas-based Triad Ascension Health Michigan Ministries through negotiations as a unified
Hospitals, which merged into CHS. group with Blue Cross of Michigan on a new three-year agreement.

Neil Lubarsky. Senior Vice President for Finance and CFO of Thomas Craig McKnight. Executive Vice President of Finance and CFO
Jefferson University Hospital (Philadelphia). Mr. Lubarsky, a certified of Phoenix Childrens Hospital. Mr. McKnight has served as CFO of
public accountant and chartered global management accountant, has held Phoenix Childrens since 2010. He has more than 30 years of healthcare
his position as CFO of Thomas Jefferson University Hospital for nearly financial management experience, previously serving as executive vice
two decades. In addition to his current role, he serves as treasurer of the president and CFO of Centennial, Colo.-based Centura Health.
Philadelphia International Medicine board. Earlier in his career, Mr. Lu- Jim McNey. Senior Vice President and CFO of North Kansas City
barsky served as a financial officer at other Philadelphia-area healthcare (Mo.) Hospital. Mr. McNey has served as CFO of North Kansas City
organizations and as a senior manager at PricewaterhouseCoopers. Hospital since 2004. Mr. McNey previously was senior vice president
Robert Lux. Vice President, Treasurer and CFO of Temple Universi- and CFO of Valley Baptist Health System, which has locations in
ty Health System (Philadelphia). Mr. Lux has been Temple University Brownsville and Harlingen, Texas. In addition to his current duties as
Health Systems vice president, treasurer and CFO since 1996. His pre- CFO, he is a board member for Kansas City-based Meritas Health and
vious positions include assistant controller, controller and associate vice Gashland Physicians Group.
president and CFO of Temple University Hospital. Mr. Lux has also served Mark Meyer. Executive Vice President and CFO of Grady Health Sys-
as head of the finance committee of health maintenance organization tem (Atlanta). Mr. Meyer joined Grady in 2012, after serving as vice pres-
Health Partners Plans of Philadelphia and as a member of the Hospital ident and CFO of Texas Health Presbyterian Hospital of Dallas. He previ-
Association of Pennsylvanias statewide committee on public payer policy. ously served as vice president of finance at Dallas-based Methodist Health
Richard Magenheimer. CFO of Inova Health System (Falls Church, System. He has more than 20 years of experience in healthcare finance.
Va.). Mr. Magenheimer joined Inova Health System in 1987 as vice pres- Jennifer Mitzner. Senior Vice President and CFO of St. Joseph Hoag
ident of financial operations and was promoted to CFO in 1992. Before Health (Irvine, Calif.). Ms. Mitzners duties as senior vice president
joining Inova, he was vice president of financial controls and director of and CFO of St. Joseph Hoag Health include overseeing financial per-
finance for West Coast operations of American Medical International, formance of the integrated care network that comprises numerous hos-
an investor-owned international hospital management company. pitals, urgent care centers and medical groups. She previously served as
senior vice president of corporate services and CFO of Hoag Memorial
Stacey Malakoff. Executive Vice President and Treasurer of Hospital
Hospital Presbyterian in Newport Beach, Calif. Additionally, she worked
for Special Surgery (New York City). Ms. Malakoff began her tenure at
in the healthcare advisory practice at KPMG in Orange County, Calif.
Hospital for Special Surgery in 1990 as director of reimbursement. Since
then she has been executive vice president, treasurer and CFO, as well as Dan Moncher. Executive Vice President and CFO of Firelands Re-
interim controller and interim vice president of finance with the nations gional Medical Center (Sandusky, Ohio). Mr. Moncher has spent
oldest orthopedic hospital. She previously served as a manager in the roughly 30 years in healthcare, the last 20 of which were spent at Fire-
audit division of EY. lands Regional Medical Center, where he now serves as executive vice
president and CFO. Previously, he was regional vice president and CFO
Peter Markell. Executive Vice President of Administration and Fi-
of Mercy Hospital in Tiffin, Ohio, and Mercy Hospital in Willard, Ohio.
nance, CFO and Treasurer of Partners HealthCare (Boston). Mr.
Markell joined Partners HealthCare in 1999, before which he served as a John Mordach. Senior Vice President of Finance and CFO of Rush
partner with EY in Boston. In his current role, Mr. Markell oversees the fi- University Medical Center (Chicago). Mr. Mordach has served as CFO
nances of the systems academic medical centers, community and specialty of Rush University Medical Center since 2011. Previously, he was senior
hospitals, a managed care organization, community health centers and a vice president, CFO and treasurer of Loyola University Health System,
physician network, among other entities in the Partners network. He cur- based in Maywood, Ill. His past positions include vice president of fi-
rently serves as vice chairman of the board of trustees at his alma mater, nance at the University of Chicago Medical Center and senior vice pres-
Boston College, and director with Eastern Bank in Boston. ident and CFO of Edward Health Services Corp., now Edward Hospital
& Health Services, in Naperville, Ill.
54

Daniel Morissette. Senior Executive Vice President and CFO of Dig- Jim Porter. CFO of St. Bernard Hospital (Chicago). Mr. Porter has
nity Health (San Francisco). Mr. Morissette serves as senior executive been CFO of St. Bernard Hospital since 2015. Previously, he served as a
vice president and CFO of Dignity Health, a nearly $15 billion health regional CFO for Chicago-based Presence Health, and CFO of the Saint
system. Before he joined Dignity Health last year, Mr. Morissette served Joseph and Saint Francis Hospitals within the system. He also has served
as CFO of Stanford (Calif.) Health Care. on the finance committee of Family Health Network, a nonprofit provid-
er-sponsored health plan based in Chicago.
Kenneth Morris. Senior Vice President, Treasurer and CFO of Duke
University Health System (Durham, N.C.). Mr. Morris joined Duke Scott Posecai. Executive Vice President and CFO of Ochsner Health
University Health System in 2000 and now serves as senior vice presi- System (New Orleans). Mr. Posecai joined Ochsner Clinic in 1987 and
dent, treasurer and CFO. His previous experience includes time as CFO became CFO in 1995. He was named CFO for the Oschner Clinic Foun-
of Mission Health in Asheville, N.C., and of Loyola University Health dation in 2001, after Ochsner Clinics merger with Alton Ochsner Medical
System in Maywood, Ill. Mr. Morris also previously served as assistant Foundation, and became CFO of the system in 2006. He is responsible
vice presidentfor finance at Loyola University Health System and at Tu- for accounting, financial planning and analysis, reimbursement, managed
lane University in New Orleans. care contracting and revenue cycle health information management.
Dominic Nakis. Senior Vice President, Treasurer and CFO of Advo- William Pugh. Senior Vice President and CFO of PinnacleHealth
cate Health Care (Downers Grove, Ill.). Mr. Nakis joined Evangelical System (Harrisburg, Pa.). Mr. Pugh joined PinnacleHealth in 2007.
Health Systems in 1995, the same year it merged with Lutheran General Throughout his tenure, he has played a role in the organizations pro-
HealthSystem to become Advocate Health Care. He was named senior posed affiliation with Pittsburgh-based UPMC and the acquisition of
vice president, treasurer and CFO of Advocate Health Care in 2006. He four hospitals from Franklin, Tenn.-based Community Health Systems.
previously worked in the healthcare practice at EY. Mr. Pugh has around three decades of CFO experience.
Brett Norell. Vice President of Finance and CFO of Holy Family Me- Connie Prewitt. CFO of Billings (Mont.) Clinic. Ms. Prewitt serves as
morial (Manitowoc, Wis.). Mr. Norell has spent 15 years in the health- CFO of Billings Clinic, Montanas largest healthcare organization. She is
care industry. He assumed his current position at Holy Family Memorial responsible for financial management of the organization, including pa-
in May 2015. Mr. Norell spent several years at Milwaukee-based Chil- tient financial services, accounting and budget. Throughout her career,
drens Hospital of Wisconsin before taking on his current role. He is an she has focused on providing strategic vision, project management and
American College of Healthcare Executives fellow. personnel management for both physician multispecialty groups and
hospital organizations.
John Orsini. Senior Vice President and CFO of Northwestern
Memorial HealthCare (Chicago). Mr. Orsini has more than three Edward Prunchunas. Executive Vice President of Finance and CFO of
decades of healthcare finance experience. He served as executive vice Cedars-Sinai Medical Center (Los Angeles). Mr. Prunchunas has held
president and CFO of Winfield, Ill.-based Cadence Health prior to its the CFO role at Cedars-Sinai for nearly 20 years. He previously served
merger with Northwestern Memorial HealthCare in 2014. He became as the academic medical centers director of finance and vice president
senior vice president and CFO of Northwestern Memorial HealthCare of finance. In the past, Mr. Prunchunas served as CFO of Northridge
when the merger closed. His previous positions include CFO of Chica- (Calif.) Hospital Medical Center and spent time with EY.
go-based Presence Health and corporate vice president of finance and
Michael Reney. Senior Vice President for Finance and CFO of Da-
treasurer for San Diego-based Scripps Health.
na-Farber Cancer Institute (Boston). Mr. Reney has held the CFO role
Todd Ostendorf. CFO of Childrens Hospitals and Clinics of Minne- since 2015. Prior to joining Dana-Farber, he was controller, executive
sota (Minneapolis). Mr. Ostendorf has more than 25 years of experience director of finance and CFO of Boston-based Brigham and Womens
in finance leadership. He was appointed CFO of Childrens Hospitals Hospital. He also spent time as senior vice president for finance and
and Clinics of Minnesota in 2016. Previously, he was CFO of Robbin- CFO of Boston-based Brigham and Womens Health Care and assistant
sdale, Minn.-based North Memorial Health Care and led two subsid- controller at Boston-based Massachusetts General Hospital.
iaries within Minnetonka, Minn.-based UnitedHealth Group as CFO.
Mark Rich. CFO of Steward Health Care System (Boston). Before tak-
Eric Peburn. Executive Vice President and CFO of Halifax Health ing on the CFO role, Mr. Rich was executive vice president for corporate
(Daytona Beach, Fla.). Mr. Peburn joined Halifax Health in 1996 and strategy at Steward. In this role, he led the health systems acquisition
became executive vice president and CFO of the system in 2007. Before efforts. Mr. Rich previously served as CFO of Boston-based Caritas
taking on the CFO role, he served as corporate controller, director of Christi Health Care. Private equity firm Cerberus Capital Management
finance and assistant administrator. He also previously served as an au- acquired Caritas Christi Health Care in 2010 and established Steward
ditor for EY. Health Care System the same year.

Blaine Petersen. CFO of Loyola University Health System (Maywood, Craig Richmond. Senior Vice President and CFO of The MetroHealth
Ill.). Mr. Petersen has more than three decades of leadership experience System (Cleveland). Mr. Richmond has roughly 20 years of healthcare
with healthcare organizations. He was named CFO of Loyola Universi- experience, and he joined MetroHealth in 2010. Mr. Richmond served
ty Health System in 2016. Previously, he served as CFO of Boise, Ida- as the systems vice president of revenue cycle and associate CFO before
ho-based Saint Alphonsus Health System and vice president of financial taking on his current position in 2014. During his tenure, he has headed
services for Catholic Health Initiatives, based in Englewood, Colo. a $10 million, systemwide implementation of Epics revenue cycle suite.

Alice Pope. Senior Vice President and CFO of HonorHealth (Scott- Chuck Robb. Senior Vice President of Finance and Administration
sdale, Ariz.). Ms. Pope has roughly 25 years of experience in finance, and CFO of Saint Lukes Health System (Kansas City, Mo.). Mr. Robb
with 20 years in healthcare finance specifically. Before taking on her cur- has served as CFO of St. Lukes Health System since 1999. He gained
rent role as senior vice president and CFO of HonorHealth, she served experience as CFO of Saint Lukes Hospital, the systems flagship facility.
as CFO of Wellmont Health System in Kingsport, Tenn. She previously Mr. Robb serves as a board member for the Missouri Society of Certified
served as senior vice president of finance, managed care and revenue Public Accountants, with his current term expiring June 30.
cycle at Wellmont, as well as vice president and CFO of Kingsport-based
Holston Valley Medical Center, a Wellmont hospital.
55

Kevin Roberts. Senior Vice President and CFO of BJC HealthCare Robert Shapiro. Executive Vice President of Finance and CFO of
(St. Louis). Mr. Roberts joined BJC HealthCare in 2008 as senior vice Northwell Health (New Hyde Park, N.Y.). Mr. Shapiro assumed the
president and CFO. He previously served as senior vice president and CFO position at Northwell Health in 2000. Before then, he was vice
CFO of University Hospitals in Cleveland and treasurer of Cleveland president of financial operations and director of finance/assistant ad-
Clinic Foundation for a total of roughly 20 years. ministrator of the health system. He is also an adjunct professor of
health system finance at New York City-based Hofstra University.
Richard Rothberger. Corporate Executive Vice President and CFO
of Scripps Health (San Diego). Scripps named Mr. Rothberger CFO Roger Sharma. Executive Vice President and CFO of Citrus Valley Health
in 2001. He is responsible for corporate financial and capital planning, Partners (Covina, Calif.). With more than 20 years of healthcare finance
payer contracting, revenue cycle, real estate and construction as well as experience, Mr. Sharmas most recent role prior to his current one was serv-
financial operations for the four-hospital nonprofit system. During his ing as senior vice president of financial operations for City of Hope, a can-
tenure, Mr. Rothberger played a key role in the systems financial turn- cer treatment and research center in Duarte, Calif. He has also previously
around beginning in 2000 through 2005. worked at St. Mary Medical Center in Long Beach, Calif., and California
Hospital Medical Center in Los Angeles. He is an inaugural fellow of the
Steve Roussel. CFO of Baylor Scott & White Medical CenterIrving Health Leadership program at Coro, a leadership training organization.
(Texas). Mr. Roussel joined Baylor Scott & White Medical CenterMcK-
inney in 2011, where he was responsible for financial planning and bud- Richard Silveria. Senior Vice President of Finance and CFO of Bos-
geting as well as directing and coordinating nursing and ancillary services. ton Medical Center. Mr. Silveria joined BMC in 2010. As senior vice
He was recently named to his current role as CFO of Baylor Scott & White president and CFO, he is responsible for the medical centers financial
Medical CenterIrving. Mr. Roussel has previous experience as senior framework including treasury and managed care. His previous roles in-
vice president of finance and compliance officer for Baylor Scott & White clude serving as corporate director of revenue finance for Boston-based
Medical CenterWaxahachie, where he helped improve hospital opera- Partners HealthCare and vice president of managed care finance for
tions through financial management and increased staff productivity. Lawrence (Mass.) General Health System.
William Rutherford. Executive Vice President and CFO of HCA Daniel Smith. Vice President of Finance and CFO of The Johns Hop-
Healthcare (Nashville, Tenn.). Mr. Rutherford joined HCA Healthcare kins Hospital (Baltimore). In addition to his current roles, Mr. Smith
in 1986 as a staff auditor and assumed his current position with the com- serves as senior vice president of finance for The Johns Hopkins Health
pany in 2014. He rose through the ranks, serving in a number of leader- System. He served as a healthcare consultant to Johns Hopkins in the
ship roles such as director of operations support and CFO for the Georgia 1980s and officially joined the staff in 1983. He previously served as se-
division. He left HCA from 2005 to 2008 to start a training and education nior director of finance at Johns Hopkins Bayview Medical Center in
company, where he gained experience in private equity ventures. Baltimore and CFO of Johns Hopkins Home Care Group.
Randolph Safady. Executive Vice President and CFO of Christus Shannon Sock. Executive Vice President of Strategy and CFO of Mercy
Health (Irving, Texas). Mr. Safady joined Christus in his current posi- Health (St. Louis).Mr. Sock came to Mercy in 1999 after working for con-
tion in 2011. Previously, he served as executive vice president and CFO sulting firm CSC Healthcare. Mercy named Mr. Sock to his current roles in
of Centennial, Colo.-based Centura Health for four years. At Centura, February 2014. He has overseen Mercy initiatives related to EHRs and virtual
Mr. Safady was instrumental in repositioning the health systems finan- care, as well as strategic planning, business development and innovation.
cial operations and its conversion to Meditech platforms. He previously
served as senior vice president and CFO of Adventist Midwest Health, a Eddie Soler. Senior Finance Officer of Adventist Health System (Al-
region of Altamonte Springs-based Adventist Health. tamonte Springs, Fla.). Mr. Soler serves as senior finance officer of Ad-
ventist Health System, where he oversees the systems three division CFOs
Fred Savelsbergh. CFO of Baylor Scott & White Health (Dallas). Mr. and works closely with Chief Clinical Officer Loran Hauck, MD. He was
Savelsbergh joined Baylor Health Care System in 1982 as a corporate previously executive vice president of finance at Adventist and CFO of
staff accountant. He assisted in the formation of Baylor Scott & White Orlando-based Florida Hospital and the systems Florida division.
Health, which was created by the merger of Scott & White Healthcare
and Baylor Health Care System, in 2013. He assumed his duties as CFO Anthony Tony Speranzo. Executive Vice President and CFO of As-
of the combined $8.4 billion system in 2014. cension (St. Louis). Prior to his current role as executive vice president
and CFO of Ascension, Mr. Speranzo served as senior vice president and
Donald Scanlon. Chief of Corporate Services and CFO of Mount Sinai CFO of Ascensions healthcare division. He joined Ascension Health in
Health System (New York City). Before Mr. Scanlon was appointed CFO 2002 after serving as managing director at U.S. Bancorp Piper Jaffray.
of Mount Sinai Health System in 2013, he served as executive vice presi- Earlier in his career, Mr. Speranzo spent 11 years at the St. Joseph Health
dent and CFO of Mount Sinai Medical Center for 10 years. Since taking System in Orange, Calif., serving as vice president of finance and opera-
on his current duties, he completed a $370 million financing for the Icahn tions before being promoted to senior vice president and CFO.
School of Medicine at Mount Sinai to support the Leon and Norma Hess
and Norma Hess Center for Science and Medicine. He previously served Bernadette Spong. CFO of Orlando (Fla.) Health. Ms. Spong has
as senior vice president of finance at NewYork-Presbyterian. served as CFO of Orlando Health since 2015. She previously served as
senior vice president and CFO of network hospitals for University of
Matthew Sells. CFO of Shenandoah (Iowa) Medical Center. Mr. Sells North Carolina HealthCare in Chapel Hill and CFO of UNC Rex Health
has served as CFO of the hospital since 2013. He is currently interim Care in Raleigh. The health systems bond rating has been upgraded from
president and CEO in addition to fulfilling his CFO duties. Mr. Sells pre- A3 to A2 by Moodys Rating Agency since Ms. Spong took over as CFO.
viously served as CFO of Brown County Hospital in Ainsworth, Neb.,
and spent time working at KPMG. Paul Staton. Senior Vice President of Finance and CFO of UCLA
Health (Los Angeles). Equipped with more than 28 years of experience
Lance Sewell. CFO of South Lake Hospital (Clermont, Fla.). Mr. in healthcare finance, Mr. Staton is senior vice president of finance and
Sewell has served in his current role since October 2007, prior to which CFO of UCLA Health System. After serving as the health systems con-
he was director of finance at the hospital. He previously served as assis- troller, he became CFO in 1996 and oversees financial operations for the
tant CFO of Ochsner Medical Center-Baton Rouge (La.), formerly Sum- health system, the UCLA Faculty Practice Group as well as the David
mit Hospital. South Lake Hospital is a part of Orlando Health, a $2.6 Geffen School of Medicine at UCLA.
billion nonprofit organization.
56

J. Dean Swindle. President of Enterprise Business Lines and CFO of BJCs home care and behavioral health service lines and 12 years as con-
Catholic Health Initiatives (Englewood, Colo.). Mr. Swindle joined troller and director of patient financial services with Childrens Medical
CHI in 2010. Before then, he spent more than 11 years at Winston-Sa- Center of Dallas. Mr. Vanderslice began his career on the audit staff of
lem-based Novant Health, including time as Novants executive vice Deloitte & Touche in Dallas.
president and CFO, and president of ambulatory services. Mr. Swindle
previously led Concord Medical Center in Baton Rouge, La., as CEO. Charles Chuck Weis. Executive Vice President and CFO of Si-
nai Health System (Chicago). Mr. Weis is a longtime employee of Si-
Michael Szubski. Senior Vice President and CFO of University Hospitals nai Health System; he began his tenure as executive vice president and
(Cleveland). Mr. Szubski has led financial operations at University Hospi- CFO in 1982. He is an adjunct faculty member in the University of Illi-
tals, an 18-hospital system, since October 2008. He previously served as the nois-Chicago School of Public Healths hospital administration program.
health systems COO, in addition to sitting on the Deans Advisory Council He is also a member of the Illinois Hospital Association Policy Council.
for Baldwin Wallace University School of Business, based in Berea, Ohio.
Gary Weiss. Executive Vice President, CFO and Treasurer of North-
J. Britton Tabor. Senior Vice President and CFO of Erlanger Health Shore University HealthSystem (Evanston, Ill.). Mr. Weiss joined
System (Chattanooga, Tenn.). Mr. Tabor has been Erlanger Health NorthShore in 2001 and was named CFO in 2007. He spent more than
Systems senior vice president and CFO since 1986. Before joining Er- two decades at Chicago-based Bank One, ending his time there as senior
langer, Mr. Tabor was an auditor for Chattanooga-based Hazlett, Lewis vice president of the commercial bank business line.
& Bieter, which merged with Atlanta-based Mauldin & Jenkins in 2013.
Throughout his career, Mr. Tabor has taught at Knoxville-based Uni- Jim Wentz. CFO of KentuckyOne Health (Louisville). Equipped with
versity of Tennessee and Chattanooga State Community College at the more than 30 years of experience in the healthcare industry, Mr. Wentz
undergraduate and master levels. was named CFO of KentuckyOne in August 2016. His previous expe-
rience includes five years as CFO at University of Mississippi Medical
Vincent Tammaro. Executive Vice President and CFO of Yale-New Center in Jackson and financial leadership roles with UT Southwestern
Haven (Conn.) Health System and CFO of Yale New Haven Hospital. Medical Center in Dallas and Oakland, Calif.-based Kaiser Permanente.
Mr. Tammaro joined Yale-New Haven Health System in 2002 as director
of financial reporting. He climbed the ranks and served as senior vice Ken Wheat. Senior Vice President and CFO of Eisenhower Medical
president of corporate finance for the health system for four years before Center (Rancho Mirage, Calif.). Mr. Wheat has been senior vice presi-
his promotion to executive vice president and CFO in April 2016. dent and CFO of Eisenhower Medical Center since 2013. He previously
served as vice president of operations and finance for Tenet Healthcares
Jeff Taylor. Senior Vice President and CFO of St. Lukes Health System 12-hospital Texas region and CFO of Desert Regional Medical Center,
(Boise, Idaho). Mr. Taylor has been with St. Lukes Health System since a 367-bed hospital in Palm Springs, Calif. He serves on the Rancho Mi-
1994, serving as director of finance and controller before his promotion rage Chamber of Commerces board of directors.
to senior vice president and CFO in 2008. Prior joining the health sys-
tem, he was a senior manager in Deloitte & Touches Boise office. Vinson Yates. Senior Vice President and CFO of OhioHealth (Co-
lumbus). Mr. Yates joined OhioHealth in 1987, serving as president of
Karen Testman, RN. CFO of MemorialCare Health System (Fountain OhioHealth Grant Medical Center in Columbus and vice president of
Valley, Calif.). Ms. Testman joined MemorialCare in 1998. She served finance at both OhioHealth Riverside Methodist Hospital in Columbus
as CFO of Orange Coast Memorial Medical Center in Fountain Valley, and OhioHealth Grant Medical Center. He was promoted to senior vice
Calif., and Saddleback Memorial Medical Center in Laguna Hills and San president and CFO of the system in 2013.
Clemente, Calif., as well as senior vice president of financial operations
for the health system, before being named CFO in 2013. Ms. Testman Laura Zehm. Vice President and CFO of Community Hospital of the
has previous professional experience in public accounting and nursing. Monterey (Calif.) Peninsula. Ms. Zehm joined the 286-bed Commu-
nity Hospital of Monterey in 1982 and became CFO in 1996. She also
Jonathan Tingstad. Vice President and CFO of Seattle Cancer Care serves as CEO of Central Coast Community Mutual Insurance Com-
Alliance. Mr. Tingstad has served as vice president and CFO of Seattle pany and Aspire Health Plan two insurance products she helped de-
Cancer Care Alliance, a network of health systems and hospitals for can- velop. She previously served as chairperson of the Healthcare Financial
cer research and care, since 1999. Before then, he was CFO at Medalia Management Associations board of directors.
Healthcare in Seattle. Mr. Tingstad began his career at KPMG in 1990.
Kris Zimmer. Senior Vice President of Finance for SSM Health (St.
Thomas Todorow. Executive Vice President and CFO of Childrens Louis). Mr. Zimmer joined SSM Health in 2003, after serving as CFO
Hospital of Philadelphia. Mr. Todorow was named executive vice presi- of Norton Healthcare in Louisville, Ky. He has also served as CFO of
dent and CFO of Childrens Hospital of Philadelphia in 2001. Previously, Mount Carmel Health System in Columbus, Ohio, and Southeastern
he was senior vice president and CFO of Wellesley, Mass.-based Harvard Ohio Regional Medical Center in Cambridge. He serves on the federal
Pilgrim Healthcare. advisory panel on hospital outpatient payment, which advises the HHS
secretary and CMS administrator.
Michael Tretina. Senior Vice President and CFO of Bayhealth (Do-
ver, Del.). Mr. Tretina has served as CFO of Bayhealth since November Bert Zimmerli. Executive Vice President and CFO of Intermountain
2013. He was previously vice president and CFO of Mary Greeley Med- Healthcare (Salt Lake City). Having joined Intermountain in 2003,
ical Center in Ames, Iowa, and senior vice president of finance for St. Mr. Zimmerli has provided financial oversight for the health system,
Vincents HealthCare in Jacksonville, Fla. Mr. Tretina is a fellow of the its health plans and business development strategies for more than a
American College of Healthcare Executives. decade. Previously, he was executive vice president and CFO of Hous-
ton-based Methodist Hospital System, oversaw various responsibilities
Doug Vanderslice. Senior Vice President and CFO of Boston Chil- with Memorial Hermann Healthcare System in Houston and worked as
drens Hospital. Mr. Vanderslice joined Boston Childrens in 2013 after a partner at EY's Houston office. n
spending nine years as vice president and CFO of St. Louis Childrens
Hospital, part of BJC HealthCare. He also spent three years as CFO of
Executive Briefing 57

Whats missing from your


GPO Partner Strategy?
58 Executive Briefing

Sponsored by:

Supply Chain Optimization: How Mercy Leaders Took an Idea on a


Napkin to $1B in Savings and Are Now Doing it for Others

D
ecreasing reimbursements amid ROi operates the end-to-end supply chain 2. Manufacturing and packaging operations
rising operational costs can activities including self-distribution and ROi implemented a self-distribution
threaten a healthcare organiza- logistics for the 43-hospital system on a model that allows the supply chain or-
tions bottom line. daily basis. Over the past 15 years, ROi has ganization to manufacture and distribute
helped Mercy save more than $1 billion, its own products at much lower costs, ac-
Supply chain costs continue to represent according to Mr. Firestone. cording to Mr. Firestone. Services include
the second largest operating expense for custom procedure trays, pharmaceutical
hospitals and health systems after labor, ROis first step to achieve these cost sav- repackaging, medical device reprocess-
according to a 2014 Market Realist report. ings was setting up its own consolidated ing, private label products and, most re-
Efforts to effectively allocate finances for service center to take control of Mercys cently, IV compounding.
supplies are challenged by pressure to supply chain.
satisfy physicians demands for prefer- There are many supplier companies that
ence items. A 2016 survey from Premier We felt like we could deliver the prod- do not manufacture their own products,
found 98 percent of C-suite leaders cite ucts to our own facilities in a more efficient which provides us the option to go di-
standardizing physician preference items manner, says Mr. Firestone. ROi also built rectly to the source of manufacturing to
as a major concern they expect to ad- its own self-contracting portfolio to better create our own private label at a substan-
dress in the near future. manage supply costs by building closer tially reduced cost.
relationships with industry suppliers.
Many healthcare executives are identify- Mr. Firestone says this helped ROi and
ing the supply chain as an area of strategic After working with Mercy for nearly a de- Mercy achieve a 10 to 30 percent cost re-
opportunity to cut costs and improve the cade, ROi has established a large breadth duction for supplies. We essentially re-
bottom line, but they dont always have of knowledge and first-hand experience turn a mass majority of these cost savings
the right tools to do so. Organizations of- by executing critical elements of the sup- over to our member facilities, he says.
ten lack the time, money and resources ply chain, says Mr. Firestone. Mercy and
necessary to standardize products, up- ROi commercialized their supply chain 3. Consulting
date ordering practices or find the most and GPO services in 2011 to help other ROi also offers GPO members supply
cost efficient items for their facilities. healthcare providers recognize similar op- chain optimization consulting free of
erational improvements and cost savings. charge, says Mr. Firestone. Consultants
A solution is born with extensive clinical and operational
In the late 1990s, leaders at St. Louis-based The accountable supply chain organization expertise visit provider locations in per-
Mercy set out on a quest for operational now provides multiple cost management son, helping them develop more efficient
efficiency. Their journey and the devel- and supply chain services to more than 240 inventory management processes within
opment of their supply chain organization hospitals and about 2,800 non-acute facili- their facilities and build collaborative re-
Resource Optimization & Innovation (ROi) ties across the country. Services include: lationships with physicians.
started with notes on the back of a napkin. 1. Contracting and sourcing If organizations are interested in setting
They envisioned a more strategic opera- ROi offers a very broad contract portfolio up a consolidated service center, weve
tional approach that internalized and inte- for its member organizations, with a special also gone in and shown them how to do
grated key functions within the supply chain emphasis on physician preference items. that after conducting a feasibility study,
and group purchasing process. Those These items represent 35 percent to 50 says Mr. Firestone.
dreams were recognized in 2002, when percent of total supply costs, depending
Mercy officially founded ROi as its own ac- Case study: Mercys custom procedure
on the health system, says Mr. Firestone. tray operations
countable supply chain organization.
Since Mercys size and scope drives a One of the best examples of ROis initial
From 2002 to 2011, ROi exclusively ran large demand for physician preference success with Mercys supply chain was its
Mercys supply chain and kept adding ser- items, ROi can commit to purchasing transformation of the health systems cus-
vices to its offering to help drive down costs a high volume of these products from tom procedure tray operations.
for Mercy, says Greg Firestone, vice presi- suppliers, which results in sustainable
dent of strategic customer relations for ROi. In 2007, each of Mercys hospitals man-
controlled costs. Our model has fostered aged its own unique pack program, yet
We found a lot of opportunity to increase highly collaborative relationships with
supply chain efficiencies and to improve there was no effective way to manage item
physician preference item suppliers that usage. The lack of structure and organi-
the quality and safety of care delivery. allow us to gain commitment from key zation contributed to a large amount of
stakeholders, says Mr. Firestone.
Executive Briefing 59

waste throughout the health system. After Mr. Firestone says ROi leverages best Mr. Firestone is so confident in ROis
conducting a Six Sigma project, ROi dis- practices in sourcing, contracting, stan- ability to transform a healthcare organi-
covered Mercy was losing about $30.71 dardization, utilization and supply chain zations operational supply chain struc-
per pack an average of six items per pack management developed at Mercy so its ture and inventory management, he feels
were thrown away without ever being used. member organizations can achieve the comfortable telling new ROi members
same level of success. upfront not only what theyll save in the
A year later, ROi built a 6,000-square-foot first year, but each and every year for the
custom procedure tray production facili- 2. Vertically integrated service offering duration of their partnership.
ty inside its existing consolidated service Unlike many other GPOs, ROi manufac-
center in Springfield, Mo. The supply tures its own custom procedure trays, IV We believe an organization should be
chain organizations strategic contracting compounding solutions and other prod- held accountable for what they say they
and sourcing team had to contract with ucts, including its own private label. By can deliver, he says. We are very com-
150 vendors to access 900 unique items leveraging its self-manufacturing capa- fortable putting ourselves at risk to offer
used in the packs. ROi standardized exist- bilities, along with strategically sourced guaranteed savings.
ing packs and created new packs tailored branded products, ROi offers member
to end users preferences to eliminate un- hospitals additional savings on lower 5. No fees for service
necessary waste. These improvements led cost products that still promote clinical ROi wants to be very transparent with its
to a 10 percent reduction in custom pro- value and efficacy. GPO costing model so members know the
cedure tray costs for Mercy. exact benefits theyll receive from day one
Were always looking for other opportu- and understand thats not going to change,
Prior to implementing its own custom nities to further vertically integrate, Mr. says Mr. Firestone, who likens fee-for-ser-
procedure tray operations, Mercy used Firestone says. Were always searching vice GPO models to extra airline fees.
93 unique custom packs about 90,000 for processes that generate a substantial
times annually. Now, ROi offers more than amount of spend for an organization so You buy your ticket, get on the flight and
600 unique custom packs used more we can attack those cost areas and start they charge you for an in-flight meal, he
than 500,000 times a year by Mercy and to reduce dollars. says. Nobody likes to be on the receiv-
other health systems across the country. ing end of that.
3. Clinically integrated supply chain
Most, if not all, of our commercial cus- ROi offers 11 service line committees ROi uses the simplest costing model pos-
tomers purchase packs from us, so that physicians, other clinicians or sup- sible, in which new members know exactly
theyre experiencing the same benefit as ply chain stakeholders from member what theyre going to get out of the part-
Mercy, says Mr. Firestone. hospitals can join to weigh in on the de- nership and are aware of the potential
cision-making process when looking at revenue generation and cost savings. The
The secret to a successful GPO supply and device contracts. The com- GPO also shares back a portion of collect-
In addition to greater customer savings mittees have monthly phone meetings to ed administrative fees with its partners and
on procedure trays, Mr. Firestone be- discuss not just the price at the pump, avoids any service or membership fees.
lieves ROis GPO members receive nu- but utilization and standardization op-
merous benefits from the organizations Conclusion
portunities for everything from med/surg The innovation behind ROis integrated
uniquely integrated structure and role in supplies to pharmaceuticals to capital
the healthcare industry. supply chain and group purchasing ser-
equipment, according to Mr. Firestone. vices is homegrown by a health system.
He highlighted five ways ROi ensures They also place a strong emphasis on That said, it offers substantial opportuni-
sustainable cost savings and satisfaction managing physician preference items ties for health systems to achieve supply
for its GPO members. and purchased services categories. chain efficiencies, eliminate waste and
We think clinical integration is critical lower costs, all while providing quality
1. Provider-owned perspective patient care.
Truven Health Analytics named Mercy throughout the decision-making process,
among the top five large health systems he says. Weve found if we involve physi- ROi hopes to keep up this level of innova-
in the country in 2016. After handling cians considerations from the very begin- tion with new service offerings and projects
the day-to-day supply chain operations ning, we get much better commitment on in its pipeline. Mr. Firestone says the com-
of such a large-scale, prominent health the purchases and better overall compli- pany is looking into offering clinical ana-
system for more than a decade, Mr. Fires- ance, which in turn drives lower pricing and lytics capabilities to aid hospitals in supply
tone says ROi is well positioned to share cost from a manufacturers perspective. chain decision-making. ROi is also building
its breadth of supply chain knowledge. 4. Guaranteed sustainable cost savings a 110,000-square-foot custom pack facility
ROis unique contracting and self-distri- to increase manufacturing capacity and ex-
We bring a real-life, practicable applica- pand the service across the U.S.
tion of running a supply chain, he says. bution strategy allows it to offer guaran-
We can take the lessons weve learned teed cost savings to its members, accord- We look at ourselves as a continuous im-
from running Mercys supply chain and ing to Mr. Firestone. provement engine, says Mr. Firestone. We
transfer it over to our members. constantly ask ourselves: How can we do
the same things today, better tomorrow? n

ROi believes in the power of provider collaboration to transform health care. A recognized leader in healthcare supply chain management through a vertically integrated
supply chain model, ROi was founded more than a decade ago by Mercy, one of the nations largest nonprofit healthcare systems. We now serve fellow providers across the
U.S. that share a passion for supply chain excellence. As a provider-owned accountable supply-chain organization, our insights and goals are uniquely aligned with todays
healthcare organizations that must find new ways to provide better care at lower cost. ROi works alongside fellow providers of all sizes to deliver a range of cost management
and end-to-end supply chain solutions with significant results. We are the only provider to be ranked by Gartner as a top 10 healthcare supply chain for eight straight years.
Delivering the 5 missing pieces
60 Executive Briefing

to complete the puzzle for a


Successful GPO Partner Strategy.

1 2 3
Provider-Owned, Operator Vantage Point Vertically Integrated Service Offering Clinically Integrated Supply Chain
We deliver much more than a traditional We leverage our self-manufacturing We integrate physicians and clinicians
GPO model. Drawing from our daily supply capabilities to provide our Members within our Service Line Contracting models
chain operator experience managing with additional savings through our that provide an evidence-based decision-
end-to-end supply chain activities (including custom procedure trays, private-label making process for the selection and
self-distribution and logistics) for both acute products and IV compounding solutions. utilization of products and services, with
and non-acute care for one of the nations ROi sources both branded products special emphasis on Physician Preference
largest non-profit health systems we assist and our own brand of private-label Items and Purchased Services categories.
our fellow provider Members in leveraging products, known as Regard, which Our clinical apps and advanced analytics
best practices in sourcing, contracting, provide lower-cost product alternatives offer valuable detail and intelligence into
standardization, utilization and supply without compromising clinical value cost per case and other clinical metrics
chain management. and efficacy. required to achieve a clinically integrated
supply chain.
4 5
Guaranteed Sustainable Cost Savings No Fees For Service
We employ a committed contracting We offer a completely transparent
strategy that delivers highly competitive pricing model providing full access Check out the case studies that
pricing and broad contract coverage, to an extensive, la carte menu of quantify the benefits of our service:
utilizing our proprietary benchmarking services with no hidden charges, and
model. Our model provides long-term no service or membership fees to roiscs.com/results
sustainable savings measured by the access our comprehensive contract
reduction in Supply Expense Per Adjusted portfolio or any other service offering.
Discharge (CMI) and supply chain expense
as a percentage of net operating revenue.

5
61

Remembering Chuck Lauer Chuck Lauer, in


By Scott Becker and Molly Gamble the Words of His
C Readers, Friends
huck Lauer, 86, was a legend in the healthcare arena. He passed
awayApril 30after a battle with leukemia. It is an understatement to

and Colleagues
say he will be greatly missed.
For 29 years, Chuck served as the publisher ofModern Healthcareand grew
that magazine into greatness. He oversaw the publications editorial direc-
By Kelly Gooch and Molly Gamble

PRACTICE MANAGEMENT
tion and served as vice president of publishing before he attempted to re-

T
tire fromCrain Communicationsin 2007. Retirement didnt work out well,
and Chuck soon rebounded to his business interests and community work. he healthcare industry said goodbye to a giant
on April 30 with the passing of Chuck Lauer,
As beloved as he was in healthcare, Chuck was first and foremost a de- 86, former publisher of Modern Healthcare.
voted family man. He tirelessly gave his time and prodigious energy to Here, readers, friends and colleagues share the ways
everyone and everything, but most of all his family his beloved wife, Chuck touched the industry, their work and their
Maggie, his children and his grandchildren. He always spoke of them lives.
with such love and pride.
Chuck was a natural, gifted communicator and
Chuck mentored so many people throughout his life. He was a longtime always ensured that all of us in this field stayed in-
unpaid mentor to Beckers Healthcare, and to many of us personally, until formed and connected.
we literally forced him to take a paycheck. He was always looking to help
more. His advice transcended generations and boundaries, from editorial Terry Akin, CEO of Cone Health (Greensboro,
to sales to healthcare and leadership of all sorts. As I watched Chuck work N.C.)
and relate to people into his 80s, I often thought, My God, I want to be Chuck was a kind, compassionate and thoughtful
Chuck Lauer when I grow up, says Publisher Scott Becker. leader. Through his writing, he frequently reminded
Throughout his career, Chuck wrote several books and hundreds, if not us that although healthcare is a business, our work in-
thousands, of articles. His moral fiber and decency was apparent in his volves the most vulnerable aspect of peoples lives and
writing, and he never failed to advocate for patients. Chuck also served we have a special obligation to be respectful in all we
as a corporal in the U.S. Army during the Korean War, and he devot- do. He will be greatly missed.
ed a great deal of his writing to lessons he learned and people he met Teri Fontenot, President and CEO of Womans
throughout his service. Hospital (Baton Rouge, La.)
Chuck, as publisher of Modern Healthcare and then a special writer Im not sure there are many in the healthcare indus-
for Beckers Hospital Review, understood healthcare as few really do try who dont know or know of, Chuck Lauer.He
the complexity, importance, the passion and the emotion, says Chris Van has been such an incredible influence to leaders
Gorder, president and CEO of San Diego-based Scripps Health. His edi- throughout the country, over many years.His quick
torials were challenging and yet supportive as only those on the inside of wit, his unapologetic quest for basic humanity, the
healthcare would understand. His writings demanded good leadership love he openly shared with all of us about his family
and management in healthcare, and he prided himself in recognizing dogs included his country, and those serving in
the good in healthcare leadership. Ill never forget the day he presented the military, his transparency about his own health-
me with a Beckers Leadership Award. I think he enjoyed presenting it as care experiences, always naming individuals and in-
much as I did receiving it. And I could tell he expected even more of me stitutions who exceeded expectations but never call-
going forward. Ill miss his writing as much as I will miss him. ing out publicly if someone did not, and his focus on
We cant remember Chuck without recalling his unique spirit and brand other-centeredness. It was not about Chuck, never
of energy. Chuck was a friend to all, and a generous one at that. An intro- was. Such a profound lesson.

THOUGHT LEADERSHIP
duction from Chuck Lauer was the golden pass to business relationships, I particularly enjoyed Chucks gift of the written lan-
said Mr. Becker. He loved his sports ice hockey and golf, particularly guage.I still have copies of many of his oldModern
and his kids sports. He enjoyed spending time with his family in the sun Healthcare columns, dog-eared as they may be, in-
ofNaples,Fla.He was a natural networker and a sight to be seen when cluding his last one, December 2008. Ill quote the
meeting people and introducing friends to one another. He was young at last two sentences:
heart and never without his sense of humor.
Please tell some people in your lives just how much
Having worked with Chuck for nearly a quarter century, I can say that the you love them and remember to laugh, think and
success he had never went to his head, says Todd Sloane, a former se- cry.Its all part of living a great life.
nior editor atModern Healthcare. He was one of the warmest people you
could meet and would go out of his way to help anyone who asked for it. And, indeed, a great life he has lived. Blessed to
know you, Chuck.
Like hundreds of others who knew him, we at Beckers Healthcare are so
grateful for the friendship we shared with the legendary Chuck Lauer. We Julie Manas. President and CEO of HSHS Sacred
are better for having known him, and he will be sorely missed. n Heart Hospital (Eau Claire, Wis.)
62

I had the honor of knowing Chuck Lauer for about 20 years. And, I will miss him dearly. He was a good friend, a thoughtful advisor and
during the past several, we met for lunch a couple times a year at vari- a very special human being.
ous Chicago area restaurants to catch up on our lives, swap stories and
discuss the status of healthcare in the U.S. He was a great mentor and Alan Channing, Former CEO of Sinai Health System (Chicago)
friend to my entire family, took my daughter Liz under his wing and Chuck, as publisher ofModern Healthcareand then a special writer
has been an incredible influence in her career in healthcare. forBeckers Hospital Review, understood healthcare as few really do
I could go on and on about the kindness and generosity of this great the complexity, importance, the passion and the emotion. His editori-
man. Instead, let me put it this way: In my 43 years in business, I have als were challenging and yet supportive as only those on the inside of
never met a more decent, credible and genuine person. He is a singular healthcare would understand. His writings demanded good leadership
Mt. Rushmore. and management in healthcare, and he prided himself in recognizing
the good in healthcare leadership.
Jack Querio, Senior Vice President of Sales, Entrotech Life Sciences
Ill never forget the day he presented me with a Beckers Leadership
I am very sad to learn of Chucks passing. His imprint on healthcare Award. I think he enjoyed presenting it as much as I did receiving it.
will never be forgotten, along with his contribution to making this And I could tell he expected even more of me going forward. Ill miss
world a much better place. I always looked forward to his role as mod- his writing as much as I will miss him.
erator for IDN Summits, in which he brought out the very best in the
healthcare leaders who would join him on stage. My condolences to his Chris Van Gorder, President and CEO of Scripps Health (San Diego)
family, and may he rest in peace. Chuck was a very close friend for more than 35 years. We both spent
Bob Acosta, Director of Business Development for Healthcare Ser- time together for years at Health Insights and HRDI, and supplement-
vices, Konica Minolta Business Solutions ed those relationships with many phone calls each month and some
rounds of golf. To say he was an icon in the healthcare industry does
His articles were both enlightening and humorous at times. His ded- not do justice to the respect others had for him. He was Mr. Modern
ication and emotional attachment to the healthcare field could be felt Healthcare, a pillar of integrity and a genuinely fine human being.
in every article he wrote. They were short, to the point and so valu-
able to us when we were just entering the healthcare field back in the With the passing of Chuck, I lost a very close and dear friend. Now I
1980s. I never personally met Mr. Lauer, but felt close to him just by must find strength in what remains behind.
the passionate method he so eloquently expressed in his articles con- Tony Alibrio, Corporate Officer and Division President at Marriott
cerning patient care. He was certainly one of a kind, and well all miss International
him dearly.
Chuck spoke at the Healthcare Planning, Marketing & Public Rela-
Rick J. Leinen, CFO of Montgomery County Memorial Hospital tion Professionals of
New Jersey Annual meeting in 2007. As the editor
(Red Oak, Iowa) ofModern Healthcarefor 29 years, Chucks column had a following. He
As a publisher and columnist, Chuck was old school. He believed in retired fromModern Healthcareprior to his talk at HPMSNJ, but his key-
journalism and the separation of church and state, meaning editorial note set attendance records for HPMSNJ that I think have still not been
was king and advertising was there to support it, with profit a result of broken. I went back through my notes and found his presentation.
doing great journalism. Here is an excerpt:
Having worked with Chuck for nearly a quarter century, I can say that Success is often understood to mean achievement in work - how high we
the success he had never went to his head. He was one of the warmest climb the career ladder. But that definition falls short. For success includes
people you could meet and would go out of his way to help anyone who all of life, and far more than what we do; it describes what we are. A suc-
asked for it. cessful person is not just productive but positive: not just a go-getter but
He loved life and loved healthcare. He knew everyone in the healthcare a giver. A successful person seeks excellence. Not only in the workplace
business and had legions of admirers in the industry. He worked right but in social, emotional, intellectual, physical and spiritual dimensions
up to the end of his life, even as he battled cancer, and kept his sense of as well. Nothing ranks higher than possessing a personal character than
humor all the way through. reflects time-tested virtues and values: honesty, resiliency, perseverance,
kindness and the full slate of other essential traits.
Todd Sloane, Former Senior Editor at Modern Healthcare
THOUGHT LEADERSHIP

We were better people after Chucks presentation. God bless you,


While I have a number of warm memories of Chuck, one stands out as Chuck. Thanks for all that you did for HPMSNJ and for inspiring us
a special experience. At a Beckers CEO Roundtable several years ago, as leaders.
Chuck was the moderator of a CEO forum. I approached the front of
the room to say hello and greet some of my former colleagues. I had re- Anthony C Stanowski, President and CEO of the Commission on
tired from my CEO role at Sinai Health System by then. Chuck looked Accreditation of Healthcare Management Association
up with Scott Becker, and they both said, You need to be on this panel! Chuck was a true icon who contributed enormously to healthcare and
As much as I resisted, they insisted. It turned out to be one of my most to many of our careers. He cared deeply about everyone and made you
enjoyable sessions. Chuck and I managed to get into a little humorous feel so welcome. I was truly honored to co-chair Beckers conferences
riff in the middle of a serious discussion on organizational manage- with this extraordinary leader who touched all our hearts and souls.
ment. Teasing each other in front of a crowd of CEOs and senior leaders There will never be another Chuck. He will be greatly missed.
echoed the warmth and charm that Chuck brought to all his friends and Rhoda Weiss, PhD, National Co-Chair, Beckers Healthcare Spring
acquaintances. And, by the comments from several in the audience, I and Fall Conferences
certainly was not alone in feeling that special connection with him.
63

What a class act. Chuck was the guy who knew everyone in the room I freelanced the main story forModerns Healthcare Hall of Fame is-
from the CEO of the largest healthcare system in the country to the sue while on leave from the Trib in 1986, briefly considered becoming
name of the waiter and he treated everyone the same, his yardstick was Chucks editor when the position became open and then returned to
respect and kindness. When Chuck would stop and speak with you, with the Trib before leaving journalism some years later to write a book and
the unmistakable Chuck Lauer radio voice, he would look you in the then go into full-time consulting and part-time academic endeavors.
eye and really listen; you felt like you were the only person in the room. Chuck and I still corresponded and sometimes saw each other.
Comparing notes over the years I discovered Chuck was a medic in the His energy, optimism and commitment to using his voice to make
Korean War, as was my father, and his love of his family and colleagues thingsbetter through books, articles, speeches, blogs and every oth-
was only rivaled by his love of his country. Interestingly enough if there er communication form known to man was an inspiration. Chucks
was the rare time we didnt see eye to eye on an issue he could also give me writings were filled with love whether for his country, his wife and
the look Id get from my own father signaling me to throw in the towel! kids, the latest in a series of loyal family dogs or the healthcare (one

PRACTICE MANAGEMENT
word, please!) industry. He will be missed.
Chuck will be missed but certainly not forgotten by a long shot. Hell
have a ripple effect on the healthcare industry for many years to come; Michael Millenson, President of Health Quality Advisors
he was our industrys LinkedIn.
The legacy left by Chuck Lauer is one of wisdom, insight and friend-
Neil Thorpe, Strategic Account Manager - U.S. at Halyard Health ship.I ran into Chuck a few years ago at a Beckers conference in Chi-
(Phoenix) cago. As we got on the elevator together at the Ritz Carlton, Chuck
had just finished readingThe Wall Street Journaland when he threw it
Chuck Lauer was a giant among healthcare journalists.He was a true down the trash chute at the hotel, he accidentally threw his cell phone
professional who had incredible insight and knowledge of the indus- with it.With the help of the staff at the Ritz, we recovered his cell phone
try. He was a prolific writer, public speaker and career coach who also but it was always a fun event to recall and brought us closer together.I
happened to be a great guy and a good friend. All those who knew will miss him for his laughter, his graciousness and his genuine love for
and worked with him will miss him greatly, but were buoyed by many life.Healthcare has lost a great leader and the nation has lost a great
fond memories. American.
Michael Dowling, President and CEO of Northwell Health(New Bill Sexton, CEO of Crossing Rivers Health (Prairie du Chien,
Hyde Park, N.Y.) Wis.)
I believe every industry, if you look hard enough, has a finite num- I had the privilege of participating in a panel discussion that Chuck
ber of sage, experienced leaders leaders with a passion and a heart moderated at last years Beckers conference. Chuck was an absolute
for making that industry and the world for that matter a better pleasure to team with, both in our preparation for the panel and the
place.Chuck Lauer was in my bookone of these people. Through a long discussion itself. He was on his game, asked us excellent questions, of-
career of service in healthcare, he inspired others to learn more and do fered wonderful insights, and was a true gentleman.
more. His objective was always to lift up others and help them fulfill their
vision and dreams.My interactions with Chuck were always filled with I will always have fond memories of his energy, enthusiasm, and pas-
kindness and respect, with uplifting remarks and encouragement.In the sion for healthcare! Our sincerest condolences to the Lauer family and
world of healthcare, he will be sorely missed.Thank you, Chuck, for your his many friends.
many contributions to our industry. May you rest in peace.
Don Barbo, Managing Director at VMG Health (Dallas)
Paul Stewart, President and CEO of Sky Lakes Medical Center
(Klamath Falls, Ore.) Much has been said about Chuck and all of it is true! It was my
privilege to call Chuck a friend and a colleague over several decades.
Imagine the old-fashioned speech cadence of radios Paul Harvey Whether it was professional advice or personal mentoring he always
combined with the hail-fellow-well-met brio of a man who wore the had pearls of wisdom that helped you think through the issue at hand.
badge of salesman with a pride that came from working to win over Those pearls captured in his many articles are still in my possesion and
the loyalty of every single customer. Then add in a lifetime of industry in many cases in my adult childrens possesion as I passed them along
knowledge and infuse it all with the genuine warmth and caring of to them.
a devoted family man who saw everyone in healthcare as part of his
extended family. That was Chuck Lauer. His most powerful pearl was in the calls he placed to me after my heart
attack. He said Let GoLet God.words I still live by sixyears later.

THOUGHT LEADERSHIP
Did I say healthcare? Really, it was hospitals that captured Chucks I was privileged to return those calls during his recent struggles. We
heart. Chuck was a key part of the transition of Modern Hospi- both loved hockey, golf and dogs, and I was delighted to have played
talsintoModern Healthcare. That was before my time, but when I met golf with him this past January in Naples. It was quite the group. Ed
Chuck back in the spring of 1982 as a Chicago Tribune financial re- Eckenhoff, Tony Alibrio, Chuck and myself.the laughter that day
porter whod had the healthcare beat unexpectedly thrust upon him, was the best medicine.
Chuck quickly tutored me in that and a great deal more industry
history. Crains, the publisher ofModern Healthcare, was based just a Thanks for all you did for us and this industry. It is good to know we all
few blocks away from the Trib, and Chuck and his then-editor, Don have another angel in heaven looking after us. God Bless you Chuck!
Johnson, served as mentors and, eventually, friends. It was an era of Brian Grissler, President and CEO of Stamford (Conn.) Health
colorful personalities, when congressmen, industry lobbyists and jour- System
nalists could take in dinner and a Las Vegas show together without
anyone batting an eye. Everyone was Chucks pal, though he was no The highlight for the many years that I subscribed toModern Health-
naif; privately, he knew exactly who was doing what with (or to) whom. care while Chuck served as editor was reading his editorial column.
More often than describing some temporary crisis in reimbursement
64

or latest startling statistic on hospital mortality from hospital acquired goodness and without intending to do so, led his life in a way to pro-
infections, Chucks articles were life lessons. I still recall his hockey sto- vide a measure against which you could assess your own commitment,
ries and his experience as a patient for his joint replacements. These ar- motivation and purpose. He was one in a generation and all of us who
ticles showed the depth of his experience and his observations of doing knew him were blessed beyond measure but all of us in healthcare,
life in Chicago. Chuck was close to many of the giants who built our irrespective of how well we may or may not have known him, were
health systems. He was loved by those of his builder generation. Final- blessed that he chose healthcare as his industry of focus. He made our
ly, Chuck understood his role. As a publisher, his primary job was as a profession and the individuals who comprise our industry better.
salesman for the publication. And sell it well, he did.Thanks Chuck for
all you brought to our industry and for helping us to not lose sight of Stephen Mansfield, PhD, President and CEO of Methodist Health
life as we worked to better healthcare in America. System (Dallas)

Tom Mallon, Co-Founder and Board Chairman of Regent Surgical Chucks amazing energy and constant eagerness to help others and
Health (Westchester, Ill.) connect with them made everyone a better person, with any interac-
tion, however brief. He had endless love for his wife Maggie, son and
Chuck Lauer was a leader in healthcare journalism and always willing daughter, daughter- and son-in-law, grandkids even his dog Yodi
to share his sage advice. He was supportive and encouraging to me and and the grand-dog, Remy. He was a gentlemans gentleman. His en-
countless others. He will be missed. thusiasm was endless, his passion contagious he was the most moti-
vating person I have ever met. Chuck was a walking legend, and I will
Kristin Baird, RN, BSN, President and CEO of Baird Group miss him very much.
Chuckhad the gift of making you feel significantthat what you did Jessica Cole, President and CEO of Beckers Healthcare n
mattered and that you mattered. He was always on the side of good and

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THOUGHT LEADERSHIP

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65

Raising the Nations Guts Quotient 5 Thoughts on


the Future of Healthcare From Cleveland Clinic CEO
Dr. Toby Cosgrove
By Tamara Rosin

W
hen Delos Toby Cosgrove, MD, Dr. Cosgrove said it also occurred to him that ing offered a position. Smoking is not permit-
president and CEO of Cleveland every staff member of the health system has a ted anywhere on the health systems campus.

PRACTICE MANAGEMENT
Clinic, was a high school junior, role on the care team. Everyone from the bus
He is equally committed to lowering the rates
his father took him to visit a family friend drivers and cafeteria workers to the chief of
of obesity, the effects of which cost the nation-
who was a college professor. staff and neurosurgeons are caregivers, he said.
al healthcare system billions of dollars per year.
Calling each individual a caregiver has had
Naturally, the conversation turned into, What We give a lot of lip service to population health
innumerable positive effects on the systems cul-
do we need to do to get Toby into college, Dr. and wellness, but its important to actually make
ture, morale and employee satisfaction.
Cosgrove told the audience during a keynote at it a part of the culture, said Dr. Cosgrove.
Beckers Hospital Reviews 8th Annual Meeting 2. Invest in IT.Health systems must invest in
4. Deliver care in the most cost-effec-
in Chicago. Rhoda Weiss, PhD, speaker, author, sophisticated IT systems if they want to keep
tive settings. There is little question were
consultant and co-chair of the meeting, moder- up with the explosion of knowledge going on
over-bedded in the U.S., said Dr. Cosgrove.
ated the conversation. The professor said he was in healthcare right now, said Dr. Cosgrove.
In the last 20 years, weve gone from 1 mil-
not interested in Dr. Cosgroves IQ, but rather
When the Cleveland Clinic was formed in lion beds to 800,000 beds across the country,
his GQ a term that neither Dr. Cosgrove nor
1921, the total amount of knowledge dou- and were still at an average of 65 percent oc-
his father had heard before.
bled every 150 years, he said. Now the total cupancy. The increasing rate of outpatient
Its guts quotient. In retrospect, that turned out amount of knowledge is doubling every 73 procedures combined with shorter lengths of
to be a really important thing for me, he added. days. There are 5,600 medical journals turn- stay is going to lead to even higher over-bed-
Guts refers to ones perseverance or grit in the ing out 900,000 articles every year. And one ding in the U.S., he added.
face of setbacks or in anticipation of challenges. human genome has 3 billion data points. So I
Consolidation enables hospitals to focus on their
think we are going to be very dependent on IT
Dr. Cosgrove went on after college and med- most successful service lines, pare down super-
going forward to help us manage this explo-
ical school to serve as chief of U.S. Air Force fluous or underutilized services and provide
sion of knowledge.
Casualty Staging Flight in Da Nang, Republic care in the most cost-effective settings, said Dr.
of Vietnam. He joined Cleveland Clinic in Cleveland Clinic has partnered with both IBM Cosgrove. Not every hospital has to do the most
1975 as a cardiac surgeon and has served as Watson and Microsoft to support staff and technical things, he said. Community hospitals
CEO of the system since January 2004. medical education. Both technology systems can do deliveries and handle emergencies, while
promise to revolutionize the way data is stored, academic medical centers, which have higher
Dr. Cosgrove, who today leads an $8 billion
processed and optimized to support education overhead costs and specialize in more complex
health system with facilities across the U.S.,
and clinical decision making. With Microsofts care, can take the more difficult cases.
Abu Dabi and soon in London, said it has
augmented reality technology, medical stu-
been his GQ that has driven his ability to pro- There are two aspects that are integral to the
dents can use holograms of human bodies and
pel his career and the Cleveland Clinic for- success of greater partnerships and consoli-
organs instead of cadavers, which, if anything,
ward. Despite the uncertain future of health dation between facilities, Dr. Cosgrove noted:
would benefit the social lives of first-year med-
reform, the rest of the industry must cultivate interoperability between disparate EMRs and
ical students so they dont have to constantly
higher GQ to not only survive, but to thrive efficient transportation.
smell like formaldehyde, Dr. Cosgrove said.
in a changing healthcare landscape.
5. Do not underestimate the devasta-
3. Make population health manage-
Here are five thoughts from Dr. Cosgrove on tion of the opioid epidemic.This is one
ment a strategic priority for pa-
how to succeed in the future of healthcare. of the great tragedies of our time and not many
tients and staff. The momentum behind
THOUGHT LEADERSHIP
people realize how bad it is, said Dr. Cosgrove.
1. Teach clinicians to be team play- population health management efforts to
I recently visited the Vietnam memorial in
ers. I realized some time ago that doctors mitigate the cost of chronic disease manage-
Washington. There are 53,000 names on that
are not trained to be team players, said Dr. ment under value-based care and lower re-
memorial. Last year there were 53,000 deaths
Cosgrove, yet none of us has the individual imbursements has surged in recent years. Dr.
caused by drug overdoses. We have a Vietnam
power of the doctors who used to go to pa- Cosgrove emphasized these efforts must be
War going on in our country every day.
tients houses with a black bag and deliver the targeted at staff in addition to patients.
cure alone. Healthcare today is dependent on Dr. Cosgrove said the Vietnam War ultimately
By the time Dr. Cosgrove became Cleveland
a huge number of players. ended due to highly negative public opinion.
Clinics CEO, he had a long time to observe
People saw the body bags every night on the
Team-based, highly coordinated care is a cen- the ravages of smoking, he explained. He saw
evening news. Everyone understood it. But not
tral component of Cleveland Clinics care deliv- the physical effects of smoking firsthand as a
everyone understands the magnitude of the is-
ery strategy. Physicians, nurses, dentists, physi- cardiac surgeon, and lost his father, a smoker,
sue right now and its getting worse. Increasing
cian assistants and other providers often come to emphysema. That, combined with the fact
public awareness of the problem, combined
together in one building for team training. The that smoking is the most preventable cause of
with improving the approach to combat it by
health systems leadership also evolved its phy- cancer, spurred Dr. Cosgrove to implement a
medical professionals and law enforcement,
sician-based departments into disease-based hiring ban on smokers in 2007. If a candidate
are the first steps the U.S. must take to control
institutes to facilitate greater collaboration be- tests positive for nicotine, he or she must com-
the epidemic of opioid abuse. n
tween formerly disparate groups of clinicians. plete smoking cessation treatment before be-
66

The Health System CEO's Affiliation Playbook: 5 Thoughts From a


CEO Who Has Executed 50+ Agreements
By Michael Dowling, President and CEO of Northwell Health

A
s hospitals and health sys- 2. Don't overemphasize the short-term benefits. Focus as
tems seek ways to fortify much on the short-term benefits of a partnership or affilia-
their organizational strat- tion as you do on your goals for five or 10 years down the
egies amid the transition to val- line. Most relationships hit a rough patch in the beginning,
ue-based care, the drive to forge but if you give up on the partnership because your troubles
new partnerships will continue. are making you doubt the viability of your short-term goals,
Although analysts forecast the you're being too impetuous. In other words, success takes
consolidation trend will carry on, time. Take steps to solve short-term complications, but hang
strategic organizations are increas- in there and try to make it work.
ingly realizing the value of estab-
lishing other relationships, such as 3. Be open to new partners. Keep an open mind when it
affiliations and joint ventures. comes to discussing new relationships with different part-
ners even those that don't seem to make much sense in
The local forces at play in a given region are a significant de- the beginning. The rapid pace of change in healthcare and
terminant of an organization's need to merge with, acquire or our collective pursuit of innovation oblige us to at least listen
be acquired by another hospital or health system. And while to others' ideas and consider new possibilities.
transactional deals will always be necessary, ongoing finan-
cial pressures stemming from the transition to value-based
reimbursement and the overall emphasis on population
health management have prompted healthcare leaders to
partner with their like-minded peers to deliver better, more
cost-effective care.
"If your organization is looking
The key is figuring out where your organization can do a bet- for a long-term partner not
ter job working with a partner than alone, and more impor-
tantly, who to collaborate with. just a fling the two entities
In some cases, this has led to the union of unlikely bedfellows
organizations that were formerly competitors are, in some must mesh culturally."
cases, coming together to pursue a joint goal. In other cases,
hospitals and health systems may benefit from establishing
partnerships with pharmaceutical companies, medical de- 4. Don't get stuck in an abusive relationship. New part-
vice makers, retail clinics or even nonhealthcare entities. For ners might hit a rough patch or need to adjust their com-
example, Northwell Health has worked with The Ritz-Carlton munication style to meet one another's needs, but it is also
and Tiffany & Co. as part of our efforts to improve the patient important to know when it's better to cut your losses and call
experience and our operational processes. it quits. If a relationship becomes abusive or dysfunctional,
As with all relationships, the most positive and high function- and there is no longer any benefit for being involved, then
ing are symbiotic; both partners must satisfy and comple- it's time to re-evaluate the situation.
ment the other. They must also at the most basic level get 5. Determine whether you're truly compatible with
along. Here are five more ideas on successful partnerships, a potential partner. If your organization is looking for a
affiliations and joint ventures.
THOUGHT LEADERSHIP

long-term partner not just a fling the two entities must


1. Know what you need and what you can offer. Partner- mesh culturally. When considering a potential partner, ask
ships create opportunities to expand into new markets and yourself if there is mutual respect on both sides. Do those
broaden your reach. But when it comes to selecting a part- who are in charge of communication and collaboration work
ner, it's important to clarify what it is they have that you want well together? Is the relationship riddled with conflicts or is
and visa versa. it smooth sailing? Keep in mind, however, that conflicts are
not necessarily a symptom of an impending breakup. Some-
For example, we have a strategic affiliation with Cold Spring times the issue can be resolved by changing the people or
Harbor (N.Y.) Laboratory, a premier cancer research facility on metrics at hand.
Long Island. They have an international reputation, with sev-
eral Nobel laureates in their ranks. We needed to strengthen Most importantly, there must be ongoing and open commu-
our cancer research, and they needed a clinical partner that nication. Two partners can disagree, but in most cases they
would allow them to connect with patients. We entered into a can work it out. n
long-term partnership in 2015. Even though we're very differ-
ent organizations, we both benefit from the relationship.
67

Corner Office: Temple University Hospital CEO Dr. Verdi


DiSesa on Fatherhood and Health System Leadership
By Tamara Rosin

D
espite years of higher education and York City and Washington, D.C., aren't far away. I like the climate and
clinical training, many of the most geography. It's pretty we have four real seasons. There's also a fair
important lessons Verdi DiSesa, MD, amount of diversity, both culturally and otherwise. I've raised four sons
has learned come from his family. in Philadelphia. There are great educational opportunities, both in pub-

PRACTICE MANAGEMENT
lic and private schools.
Dr. DiSesa has kept advice from his father
close to heart throughout his education and If you could eliminate one of the healthcare industry's
career. And as a father of four sons himself, he problems over night, which would it be?
has realized many of the lessons he's learned There are obviously a lot of problems. If I had to pick, I would say to
as a parent are applicable while leading others standardize credentialing for providers and standardize the metrics that
in his roles at Temple University. determine how we're paid, rather than every payer saying here's what
you have to do to be credentialed or here is the idiosyncratic way we
Dr. DiSesa serves as senior vice dean for clinical affairs at the Lewis Katz want to be billed or paid. If the requirements could be streamlined and
School of Medicine at Temple University, president and CEO of Temple standardized, it would be easier for everyone and save a lot of money
University Hospital and COO of Temple University Health System in because all of that work requires a lot of infrastructure.
Philadelphia. He is also a professor of surgery at the medical school. He
was named CEO of the hospital in January 2016 and has held his other What do you consider your greatest talent or skill outside
roles at the institution since April 2011. of the C-suite?
Fatherhood. Some of the skills I've learned as a parent are helpful in
After graduating from the University of Pennsylvania School of Medi- what I do now like how to help folks work together, grow and devel-
cine in Philadelphia, Dr. DiSesa trained in internal medicine at the Hos- op. How to give them enough rope so they can come up with their own
pital of the University of Pennsylvania in Philadelphia. He then went solutions but not so much as they hang themselves. This is how I ap-
on to complete his internship and residency in general surgery and a proached being a father to four sons. They're nice kids young adults
fellowship in cardiothoracic surgery at Brigham and Women's Hospital, now. I'm proud of the results so far.
Children's Hospital of Boston and Harvard Medical School in Boston.
A board-certified cardiothoracic surgeon, Dr. DiSesa also earned his How do you revitalize yourself?
MBA from the Wharton School of the University of Pennsylvania. I exercise pretty regularly. I also like to read, especially history and biogra-
phies. I've gotten into cycling in this phase of my life. I have a sore knee so
An established researcher and author, Dr. DiSesa's research and clinical I can't run on the road anymore, but I can cycle, which allows me to travel
interests include postoperative cardiac surgical management, including and to see the world at a human rate of speed. It's also very important to
the use of inotropic agents, and clinical and experimental heart trans- me to stay involved in our kids' lives. One is married now and another is
plantation. He has authored and co-authored multiple book chapters, getting married, and one is in law school and another in medical school.
as well as nearly 150 original papers. He is a current or past editorial
board member of the Annals of Thoracic Surgery, the Journal of Cardiac What's one piece of advice you remember most clearly?
Surgery and the European Journal of Cardiothoracic Surgery. I have two, and both came from my dad, who died a while ago when
he was too young. The first is the importance of giving an extra effort.
Here, Dr. DiSesa took the time to answer Becker's seven questions. Re- This is what separates the good from the outstanding. He taught me this
sponses have been lightly edited for length and clarity. when I was in school and I think that it still applies today.
What's one thing that really piqued your interest in health- The other is if you're doing something, don't think nobody ever saw.
care? Someone always sees. Not only does someone always see, but nowadays,
My uncle and great uncle were surgeons and my family heritage in- someone always records it.

THOUGHT LEADERSHIP
clined me toward medicine. Additionally, in college I helped a friend Another piece of advice I would offer others is don't write an email you're
who had a sprained ankle. I knew how to wrap ankles from playing not prepared to see on the front page of The New York Times tomorrow.
sports, but there was something about laying strong but gentle hands on
someone to help them heal that appealed to me. That small incident was What do you consider your greatest achievement at Tem-
a big contributor of my interest in medicine on top of my family in the ple University Hospital so far?
background telling me this is a worthwhile thing to do. I think we've done a good job in the past year of improving engagement
of our medical staff and employees. Since I'm a physician, I think we've
From taking care of one patient at a time to running systems, I've been for- been able to bridge the connection between the hospital administration
tunate to leverage my knowledge and have the chance to affect so many and medical staff. We've held focus groups as well as periodic town hall
people. I do miss treating patients. I stopped practicing about eight years types of meetings, and our employee engagement scores have improved
ago because cardiac surgical patients require a doctor who has the ability significantly they're up 10 percentage points from a couple of years ago.
to respond to them any time, day or night, and my administrative duties
wouldn't allow that. But by helping to run a health system, I have the op- We also implemented Epic last August and we're going to survive that,
portunity to make a positive contribution beyond a single patient at a time. I think. We haven't had any big catastrophes. The Epic team said it was
one of the better go-lives that they've done. Now with the EMR we are
What do you enjoy most about Philadelphia? starting to take advantage of new capabilities, such as data collection
There is a lot to like. I've lived in the Northeast most of my life. New and analysis and process improvement. n
68

Hospital and Health Systems Executive Moves


Fort Myers, Fla.-based Lee Health named Lar- Skabelund CEO of Sterling (Colo.) Regional interim CEO.
ry Antonucci, MD, president and CEO. MedCenter.
Lovelace Westside Hospital in Albuquerque,
Parker County Hospital District in Weatherford, Coliseum Medical Centers in Macon, Ga., N.M., named Amy Blasing CEO.
Texas, selected Randy Bacus to serve as CEO. named Stephen Daugherty its permanent CEO.
Charlotte, N.C.-based Carolinas HealthCare
Pasadena, Calif.-based Huntington Hospital Greensburg, Ind.-based Decatur County Me- System CFO Greg Gombar will retire at the
President and CEO Steve Ralph is retiring, end- morial Hospital appointed Rex McKinney end of 2017 after 32 years in his role.
ing a 22-year tenure as leader of the hospital. president and CEO, effective June 1.
Metairie, La.-based East Jefferson General
Doug DiVello, president of the University of Columbia-based University of Missouri Health Hospital tapped Gerald Parton to lead as its
Vermont Health Network-Alice Hyde Medical Care CFO Brian Steines is leaving for a new permanent president and CEO.
Center in Malone, N.Y., stepped down, effec- role, effective June 30.
tive May 3. Medical City McKinney (Texas), a 260-bed
Gastonia, N.C.-based CaroMont Health tapped hospital, appointed Brad Stein CFO.
Petersburg, Va.-based Southside Regional Chris Peek to serve as permanent president
Medical Center tapped Trent Erik Nobles to and CEO, effective May 15. Nashville, Tenn.-based Saint Thomas Medical
serve as its permanent CEO. Partners named Stacey D. Woodruff CFO.
Vivian Lee, MD, PhD, stepped down from her
Palm Beach Gardens (Fla.) Medical Center roles as senior vice president for health scienc- Richmond-based Hospital Corporation of
CEO Jeff Welch is leaving his post for a new es, medical school dean and CEO of University America Virginia selected Joe Mazzo, RN, to
position with Dallas-based Tenet Healthcare, of Utah Health Care in Salt Lake City. serve as CEO of John Randolph Medical Cen-
the medical centers parent. ter in Hopewell, Va.
Toby Cosgrove, MD, president and CEO of
TriStar Summit Medical Center in Hermitage, Cleveland Clinic, revealed plans to transition Honolulu, Hawaii-based The Queens Health
Tenn., hired Brian Marger to serve as CEO, ef- out of his executive roles later this year. Systems appointed Michel Riccioni CFO.
fective June 1. La Porte (Ind.) Hospital and Starke Hospital in
Lake Huron Medical Center in Port Huron,
Oswego (N.Y.) Health selected Michael Har- Mich., appointed Jay E. de los Reyes CEO, ef- Knox, Ind., named Drew Keesbury CFO.
lovic, BSN, MSN, RN, to serve as its new pres- fective in June. Joe Mitchell, RN, president of Trinity Hospital
ident and CEO. Twin City in Dennison, Ohio, is resigning, ef-
Chippewa County-Montevideo (Minn.) Hos-
West Des Moines, Iowa-based Mercy Health pital selected Chuck Bruhn as interim CEO. fective June 16.
Network named Bob Ritz CEO, effective July 1. Columbus-based Ohio State University Wex-
San Diego-based Sharp HealthCare appointed
Burbank, Calif.-based Providence Saint Joseph Staci Dickerson senior vice president and CFO. ner Medical Center CEO Sheldon Retchin,
Medical Center appointed Kelly Linden CEO. MD, resigned.
Western Plains Medical Complex in Dodge
Phoenix-based Banner Health named Hoyt City, Kan., selected Jerry Dooley to serve as Crozer-Chester Medical Center in Chester, Pa.,
tapped Michael Curran to serve as president. n

Hospital and Health System Transactions


Kansas City-based University of Kansas Health System and Oceanside, N.Y.-based South Nassau Communities Hospi-
Nashville, Tenn.-based Ardent Health Services plan to form a tal and New York City-based Mount Sinai Health System
joint venture company to acquire 378-bed St. Francis Health in signed a nonbinding letter of intent to affiliate.
Topeka, Kan.
San Antonio-based Methodist Healthcare System declared its
North Wilkesboro, N.C.-based Wilkes Regional Medical intent to acquire South Texas Regional Medical Center, a 67-
Center will rebrand once its lease agreement with Win- bed facility in Jourdanton, Texas.
ston-Salem, N.C.-based Wake Forest Baptist Medical Cen-
ter is finalized July 1. Nashville, Tenn.-based HCA Holdings is looking to grow by
acquiring more hospitals, officials said during a first quarter
Irving, Texas-based Christus Health revealed plans to ac- earnings call May 2.
quire Lake Area Medical Center, an 88-bed facility in Lake
Charles, La. St. Louis-based Ascension revealed plans to cease its corpo-
rate sponsorship of Buffalo, N.Y.-based Catholic Health.
Lewiston, Idaho-based St. Joseph Regional Medical Cen-
ter formed a partnership with Brentwood, Tenn.-based The boards of trustees of Edison, N.J.-based JFK Health and
RCCH HealthCare Partners, which took effect May 1. Hackensack Meridian Health, also in Edison, signed a de-
finitive agreement to merge the two health systems follow-
The board of directors for Syracuse, N.Y.-based Crouse Hos- ing five months of due diligence.
pital approved a proposal to enter into a clinical affiliation
with New Hyde Park, N.Y.-based Northwell Health. Franklin, Tenn.-based Community Health Systems complet-
ed its sale of eight hospitals to Boston-based Steward Health
69

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70

Care and divested two hospitals to Clinton, Tenn.-based Curae Center and Mount Airy, N.C.-based Northern Hospital of
Health May 1. Surry County are partnering to provide residents with better
access to cardiac rehabilitation services.
Brentwood, Tenn.-based Quorum Health Corp., and the
Walker County Hospital District in Texas mutually agreed After a four-year fight to gain federal regulatory approval for
to terminate a deal proposed last year for Quorum to acquire their proposed merger, Santa Barbara, Calif.-based Cottage
Huntsville (Texas) Memorial Hospital. Health and Sansum Clinic, also in Santa Barbara, called off
the deal.
Baptist Memorial Health Care, a 17-hospital system in
Memphis, Tenn., and Jackson-based Mississippi Baptist Cedars-Sinai Medical Center, an 886-bed academic medi-
Health Systems finalized their proposed merger agreement. cal center in Los Angeles, revealed plans to affiliate with 446-
bed Torrance (Calif.) Memorial Medical Center.
Mercyhealth in Rockford, Ill., revealed plans to form a com-
prehensive partnership with the Ann & Robert H. Lurie Chil- New Orleans-based Tulane Medical CenteracquiredCov-
drens Hospital of Chicago. ington, La.-based Lakeview Regional Medical Center, ef-
fective May 7.
Franklin, Tenn.-based Community Health Systems sold
125-bed Stringfellow Memorial Hospital in Anniston, Ala., to Columbus (Ga.) Regional Health and Piedmont Health-
The Health Care Authority of the City of Anniston. care, a seven-hospital system in Atlanta, signed a letter of
intent to enter into exclusive negotiations to form a potential
The respective boards of directors of HealthEast, a four-hos- partnership.
pital system in St. Paul, Minn., and Fairview Health Services,
a seven-hospital system in Minneapolis, approved the orga- Danville, Pa.-based Geisinger Health System and 25-bed
nizations plans to merge, effective June 1. Jersey Shore (Pa.) Hospital and Foundation signed an
agreement integrating Jersey Shores facilities into Geisinger.
Hackensack Meridian Health, a 13-hospital system in Edi-
son, N.J., and Paterson, N.J.-based St. Josephs Healthcare Buffalo, N.Y.-based Catholic Health System and BryLin Behav-
revealed plans to form a jointly owned home health services ioral Health System, also in Buffalo, are reportedly in discus-
agency and a hospice services agency. sions to form a potential affiliation.
Yale New Haven (Conn.) Health System and Putnam, Kenosha, Wis.-based United Hospital System revealed
Conn.-based Day Kimball Healthcare inked an agreement plans to affiliate with, and assume the brand name of,
to become community partners and enhance the breadth of Milwaukee-based Froedtert & the Medical College of
clinical care services available at Day Kimball. Wisconsin. n
Winston-Salem, N.C.-based Wake Forest Baptist Medical

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