‘An opportunity to enhance our model’: Geisinger CEO Dr. Jaewon Ryu on Risant Health

As Danville, Pa.-based Geisinger Health awaits the closure of a deal that will make it the first health system to join Kaiser Permanente’s new nonprofit organization, Risant Health, President and CEO Jaewon Ryu, MD, said the system must remain focused on driving its strategy forward with “the same rigor to address the challenging headwinds our industry and our communities continue to face.”

Oakland-based Kaiser said in a May 15 financial report that it expects its deal to acquire Geisinger to close in 2024, pending regulatory approval. 

The newly created Risant Health, which will be headquartered in Washington, D.C., aims to “expand and accelerate the adoption of value-based care in “diverse, multipayer, multiprovider, community-based health system environments.” 

Dr. Ryu will transition to the role of Risant Health CEO as the deal approaches closure. He recently connected with Becker’s about why Geisinger joined Risant and how the new organization will measure success. 

Editor’s note: Responses have been lightly edited for brevity and clarity.

Q: Geisinger is the first health system to join Risant Health. How did Geisinger get involved and why did it decide to be the first to join? 

Dr. Jaewon Ryu: This came on the heels of strategic planning work that we had started over four years ago, when we were looking at ways that we might accelerate our goal — to make better health easier for the communities we serve. This path with Kaiser Permanente through Risant Health presented a great way to join with a fellow nonprofit, mission-aligned organization that is like minded and focused on improving health outcomes, affordability and access. Kaiser Permanente has been a best-in-class organization of this approach for quite some time, often viewed as the gold standard in value-based care, with operations across eight states and the District of Columbia, 39 hospitals, and top-notch physician groups. And Geisinger has been similarly committed to advancing innovation and value-based care models, partnering with other payers and other physician groups and health systems to do so.

Being part of Risant Health will allow Geisinger to access tools, capabilities and investments required to accelerate our charitable mission and strategy and continue to expand our impact to our communities.

Q: What is the most exciting aspect of joining Risant? 

JR: In addition to accelerating our ability to deliver on our mission and carrying forth the vision of our founder Abigail Geisinger, we’re excited to have a broader impact in healthcare. 

We’ve always believed Geisinger’s model in Pennsylvania — with a focus on value-based care leveraging multipayer and multiprovider capabilities — could be scaled to other places and benefit more people and communities. This “pluralistic” approach to value-based care, across communities less dense than more urban areas, is a capability that complements Kaiser Permanente’s other capabilities. Through Risant Health, we see an opportunity to further enhance our model and add to the suite of Risant Health capabilities so that more communities can benefit. As the first health system to become part of Risant Health, Geisinger will participate in building out the organization’s strategy and operational model. Working with Kaiser Permanente and connecting with like-minded health systems through Risant Health will allow us to be a part of the solution for the industry’s challenges in a rapidly changing healthcare environment.

Q: The deal is now awaiting regulatory approval. As that process unfolds, what is Geisinger doing to prepare for the transition? 

JR: Geisinger remains focused on delivering on our mission of making better health easier for the communities that we serve. In other words, our good work continues. Should the acquisition be approved, Risant Health’s model will be designed to support local ownership over operations and regional strategy while also preserving strong community engagement. This local ownership means that while we await a regulatory decision, but even beyond, we must remain focused on driving our strategy forward with the same rigor to address the challenging headwinds our industry and our communities continue to face. 

Q: You will be transitioning into the role of Risant CEO. Will that be in addition to your role at Geisinger, or will the system be getting a new CEO? If the latter, is there a succession plan in place? 

JR: I’m focused on my role as the president and CEO of Geisinger, ensuring our organization is delivering on our stated mission. Should we receive the necessary state and federal regulatory approvals, I will transition from my current role to serve as CEO of Risant Health as the transaction nears completion. While no definitive plans have been made, there will be a formal process to select a new CEO at the appropriate time, just as we have with prior leadership transitions.

Q: How will joining Risant benefit or enhance Geisinger’s health plan? 

JR: Geisinger will deliver the same quality care programs, benefits coverage and prevention support. We will enhance our capabilities over time in areas such as digital tools that make things easier for our members, or using augmented data and analytic tools that help target care programs at the right time so that we can address clinical needs before disease worsens. So while Geisinger’s approach to care will remain one anchored around outcomes and caring, how we go about this work will be bolstered with these and other capabilities.

Q: How will the success of Risant Health be measured?  

JR: Through Risant Health, Kaiser Permanente has shared its desire to seek out like-minded entities that are committed to quality care and improving access and affordability by promoting value-based care models through a “pluralistic” chassis, as mentioned earlier. In a very simple sense, success will be evaluated through better measures of health across more populations. For example, success could be lower blood sugars in diabetic patients, fewer ER or hospital visits for those with congestive heart failure or earlier detection of cancers through more effective preventive screening rates.

126 hospital and health system CFOs to know | 2023

The chief financial officers honored on this list are leading financial operations for health systems and hospitals throughout the nation. 

These leaders are key players in strategic financial planning, growth and partnerships for their organizations. These CFOs are responsible for the financial viability of their hospitals and health systems, and are crucial to the overall success of their respective organizations.

Chris Allen. Interim CFO at Keck Medicine of USC (Los Angeles). Mr. Allen was named interim CFO for Keck Medicine in early 2023. He is in charge of accounting and financial reporting, operating and capital budgeting, audits and internal controls and cash flow management and purchasing and strategic long-range planning. He has also conducted long-range financial planning for the university system. On a daily basis, he handles government regulations, the insurance industry, labor unions, banking and financing industry and medical device and pharmaceutical companies. 

Michael Allen. CFO at OSF HealthCare (Peoria, Ill.). Mr. Allen leads a team of 1,500 partners in the division of finance at OSF HealthCare. During his eight years in leadership at OSF, he has rebuilt its financial system and processes, rebuilt its capital management process, overseen significant asset increases, increased cash on hand by 36 percent, automated work processes, implemented self-service pricing for patients, partnered with the healthcare analytics team and automated document scanning. Previously, Mr. Allen served as CFO at Gundersen Health System, Winona Health and Quorum Health Resources/Gibson Area Hospital. 

Jennifer Alvey. Senior Vice President and CFO at Indiana University Health (Indianapolis). Ms. Alvey guided the Indiana University Health system through the COVID-19 pandemic, making investments to serve its patients in critical times. She spearheaded the system’s resource command center during the pandemic, redeploying employees, implementing free childcare, setting up dorms and cost-free housing options for employees and setting up payment grace periods for patients. Before being appointed CFO, Ms. Alvey worked as IU Health’s vice president of revenue cycle services and vice president and treasurer. 

Adam Anolik. Senior Vice President and CFO of University of Rochester (N.Y.) Medical Center. Mr. Anolik permanently assumed the role of CFO for the University of Rochester Medical Center in 2017, after having served in an interim capacity for several months. He manages the health system’s revenues and operating budget of more than $5 million annually. He brings a keen understanding of research funding, educational mission support, culture, diversity and strategic initiatives to the role. He first joined URMC in 1999 as director of financial operations and has taken on progressive responsibility as he was promoted to new roles. 

Thomas Arnold. CFO of Piedmont Healthcare (Atlanta). Mr. Arnold serves as CFO of Piedmont Healthcare, a 22-hospital system and the largest in the state of Georgia. He has managed the organization through a period of fantastic expansion, as the system grew from six hospitals to 22. Despite his executive position, he remains approachable and transparent, often taking the time to mentor young finance professionals.  

Jill Batty. CFO of Cambridge (Mass.) Health Alliance. Ms. Batty joined Cambridge Health Alliance as CFO in 2014 after spending time as senior vice president of finance and CFO of Cheshire Medical Center / Dartmouth-Hitchcock in Keene, N.H. Her 20-plus years of experience in leadership molded her background in transitioning organizations from fee-for-service to population health management and navigating reimbursement shifts while generating significant operating margin improvements. Ms. Batty is a fellow of the Healthcare Financial Management Association and has experience as a strategist, healthcare consultant and financial executive.

Chris Bergman. Vice President and CFO of Dayton (Ohio) Children’s Hospital. As the vice president and CFO of Dayton Children’s Hospital, Mr. Bergman oversees accounting, accounts payable, payroll and revenue cycle processes. He is also responsible for risk management, medical records, corporate compliance and supply chain. He has spent more than 35 years of his career in healthcare, previously serving as vice president and CFO of Cincinnati-based Christ Hospital and CFO of Sparrow Health System in Lansing, Mich.

Laurie Beyer. Executive Vice President and CFO of GBMC HealthCare (Towson, Md.). Ms. Beyer joined GBMC HealthCare in 2017 after spending 25 years in executive roles. She most recently spent 11 years as senior vice president and CFO of Union Hospital of Cecil County where she developed finance and revenue cycle teams as well as converted the organization’s patient revenue system. Ms. Beyer has experience leading an EHR implementation and spent time as corporate controller of St. Agnes Hospital in Baltimore.

Craig Bjerke. Executive Vice President and CFO of Methodist Health System (Dallas). Mr. Bjerke is responsible for Methodist Health System’s financial results and reporting. His overall goal as executive vice president and CFO is to ensure that reported financial results are healthy and sound. He has guided his team to successful year-over-year financial results, even during the challenges of the pandemic. Mr. Bjerke supports the system’s overall goals, helping Methodist Health expand its mission, embrace quality, maximize stewardship, drive growth and promote culture. 

Deborah Bloomfield, PhD. CFO of Bon Secours Mercy Health (Cincinnati). In charge of the health system’s treasury and investment, supply chain, managed care, and real estate and development, Dr. Bloomfield joined Bon Secours Mercy Health as CFO in 2013. Prior to working with BSMH, she had experience as CFO for Mercy Health, and as the system’s southern division CFO before that. In her career, Dr. Bloomfield has accrued over 30 years of experience in healthcare finance, and in 2013 was named CFO of the year by the Cincinnati Business Courier.

Colleen M. Blye. Executive Vice President and CFO of Montefiore Health System (Bronx, N.Y.). Ms. Blye oversees the financial strategy, reporting, investments and revenue cycle for Montefiore Health System and Albert Einstein College of Medicine as CFO. She has prior experience as executive vice president and CFO of Catholic Health Services of Long Island, a six-hospital health system, and executive vice president for finance and integrated services at Catholic Health Initiatives. Her career has afforded her a background in third party contracting, payroll and information technology in addition to financial planning and strategy.

Carlos Bohorquez. CFO of El Camino Health (Mountain View, Calif.). Mr. Bohorquez is charged with leading the finance division for El Camino Health, a fully integrated, multihospital health system. He serves as the executive sponsor for the finance and investment committees and oversees the departments of finance, accounting, decision support, supply chain, coding, payroll, revenue cycle, account payable and more. Under his leadership, the system’s financial results in 2022 were better than they have been in 20 years. 

Francine Botek. Senior Vice President of Finance of St. Luke’s University Health Network (Bethlehem, Pa.). Ms. Botek has spent over 20 years with St. Luke’s University Health Network. She joined the system as vice president of finance in August 2000 and became the senior vice president of finance, overseeing revenue management, policy and integration, reimbursement and payer contracting in 2018.

Cara Breidster. CFO of the Suburban Region of IU Health (Lafayette, Ind.). Ms. Breidster joined IU Health in 2005 and spent time as CFO for the West Central Region before becoming the Indianapolis Suburban Region CFO. She also has experience as vice president of finance and corporate controller for the health system. Prior to joining IU Health, Ms. Breidster spent 17 years specializing in healthcare and tax consulting with Ernst and Young.

Michael Breslin. Group Senior Vice President, Treasurer and CFO of NewYork-Presbyterian (New York City). Mr. Breslin is group senior vice president, CFO and treasurer for NewYork-Presbyterian, a 10-hospital health system. He is responsible for financial planning, reporting, budgeting and revenue cycle. He also oversees the health system’s reimbursement strategy, cost accounting, insurance, financing, managed care and supply chain. He joined NewYork-Presbyterian in 2015 after spending time as senior vice president of finance at New York Methodist Hospital and CFO of Lenox Hill Hospital and Richmond University Medical Center, both in New York City.

Robert Broermann. Executive Vice President and CFO of Sentara Healthcare (Norfolk, Va.). Mr. Broermann became executive vice president and CFO of Sentara Healthcare in 2001 after spending time as CFO of Tidewater Health Care, which merged with Sentara in 1998. He now oversees financial staff at 12 Sentara operating divisions in addition to the centralized finance teams. In addition to his responsibilities at Sentara, Mr. Broermann is chairman of the board for the United Way of South Hampton Roads and treasurer of Virginia Beach Education Foundation.

Michelle Bruhn. Executive Vice President, CFO and Treasurer of Sanford Health (Sioux Falls, S.D.). Ms. Bruhn has worked within the Sanford Health system for over 20 years. As executive vice president and CFO and treasurer, her responsibilities include overseeing Sanford Health’s financial strategy and operations, investments and asset management, and business development and innovation. These responsibilities span across the health system’s 47 medical centers and 2,800 employed physicians and practice providers.  

Laura Buczkowski. Executive Vice President and CFO at Wellspan Health (York, Pa.). Ms. Buczkowski joined WellSpan in 2020, leading its access and scheduling, facility management, financing, payer contracting, revenue cycle and supply chain. She has more than 30 years of healthcare experience, serving as chief financial officer for the Atlantic Group of Bon Secours Mercy Health. 

Dawn Bulgarella. President and Interim CEO UAB Health System and CFO of UAB/Ascension St. Vincent’s Alliance (Birmingham, Ala.). Ms. Bulgarella has more than 25 years of operations and finance experience. She oversees the health system’s $3 billion annual budgets and is instrumental in developing the strategic plan for optimized performance across UAB Medicine. She has previous experience with a “Big Four” international accounting and consulting firm and is now engaged as a member in multiple organizational boards and board-level committees. It was announced in June that, following the departure of UAB Health System’s former CEO, Ms. Bulgarella will also serve as interim CEO. 

Jacqueline Cabe. CFO of UW Medicine (Seattle) and Vice President for Medical Affairs of the University of Washington. Ms. Cabe has spent more than three years as CFO of UW Medicine and vice president for medical affairs at the University of Washington. In this role, she oversees the financial success of the health system, which includes 300 locations. Ms. Cabe has previous experience as a partner with KPMG.

Daniel Cancelmi. Executive Vice President and CFO of Tenet Healthcare (Dallas). Mr. Cancelmi is responsible for Tenet Healthcare’s finance, accounting and investor relations, as well as finance-related functions. He oversees the financial operations for the health system’s 65 hospitals, 23 surgical hospitals and 475 outpatient centers. The health system was responsible for 10 million patient encounters.

Michelle Cartwright. Group CFO of Palm Beach (Fla.) Market and Delray (Fla.) Medical Center. Ms. Cartwright is coming up on three years as Group CFO of Palm Beach Market and Delray Medical Center. A 536-bed community hospital and a level 1 trauma center, DMC houses 1,600 employees and 600 physicians. Prior to being appointed CFO in 2020, Ms. Cartwright had spent over a decade in financial leadership positions at St. Mary’s Medical Center and Palm Beach Children’s Hospital. 

Michael Coggin. Executive Vice President and CFO of LifePoint Health (Brentwood, Tenn.). Mr. Coggin is executive vice president and CFO for LifePoint Health, a role he took on after serving as senior vice president and chief accounting officer for the health system. In 2018, LifePoint merged with RCCH HealthCare Partners. He has overseen the health system’s external financial reporting, corporate accounting and consolidation functions as well as tax function and internal control compliance. During his career, Mr. Coggin has also spent time as CFO of Specialty Care Services Group and was in financial leadership of the Renal Care Group.

Matthew Cox. Senior Vice President and CFO of Spectrum Health (Grand Rapids, Mich.). Mr. Cox joined Spectrum Health in 2017 after serving as senior vice president of finance operations at Phoenix-based Banner Health. In his role as senior vice president and CFO of Spectrum Health, he leads the finance team for the $6.5 billion nonprofit health system. He has previous experience in leadership roles with two Catholic Health Initiatives markets and Central Maine Health Care in Lewiston.

Carol Crews. Executive Vice President and CFO of Tanner Health System (Carrollton, Ga.). Ms. Crews is the executive vice president and CFO of Tanner Health System, an organization she joined in 1991 as a staff accountant. Over the years, Ms. Crews has spent time as controller and vice president of finance before she became responsible for all business related activity for the system. Ms. Crews has experience in budgets, audits, accounting, payroll and patient financial services.

Michele Cusack. Executive Vice President and CFO at Northwell Health (New Hyde Park, N.Y.). Ms. Cusack joined the health system in 1996, progressively growing through the organization. She manages the day-to-day financial operations of the system’s 80,000 employees and $17 billion in revenue. She led the system through COVID-19, improving cash flows and managing a $1 billion capital budget. Prior to Northwell, she worked at Deloitte and Touche. 

Deborah Dage. CFO at Saint Francis Health System (Tulsa, Okla.). Ms. Dage is a certified public accountant and responsible for all financial activity for the Saint Francis system, which includes five hospitals and a physicians group. She is a mission-oriented leader, focused on what financial numbers mean for community care. She helped the system to launch a free clinic for undocumented and uninsured patients in the community. Ms. Dage joined the health system 25 years ago overseeing home health, hospice and durable medical equipment. She was eventually promoted to executive director of finance, and was named CFO in 2021. 

Dennis Dahlen. CFO of Mayo Clinic (Rochester, Minn.). Mr. Dahlen spent time as senior vice president and CFO of Phoenix-based Banner Health before becoming CFO of Mayo Clinic in 2017. In his role, Mr. Dahlen oversees financial operations for the health system, which includes 4,729 physicians and scientists as well as 58,405 administrative and allied health staff. He previously spent time as senior vice president of finance for a faith-based health system.

Robin Damschroder. Executive Vice President and Chief Financial and Business Development Officer of Henry Ford Health System (Detroit). Ms. Damschroder has more than 27 years of experience as a leader in healthcare. She became executive vice president and CFO of Henry Ford Health System after founding a healthcare consulting and advisory business firm. She also has experience as COO of the west market for Saint Joseph Mercy Health System.

Stephanie Daubert. CFO of Nebraska Medicine (Omaha). Ms. Daubert is the CFO for Nebraska Medicine, where she oversees the $1.2 billion academic health system’s financial operations. The system includes the 718-bed Nebraska Medical Center as well as nearly 70 specialty and primary care clinics. Ms. Daubert also serves on the board of directors for Nebraska Health Information Initiative, Building Healthy Futures, Nebraska Orthopaedic Hospital and the Nebraska Health Network. 

Adriana Day. Senior Vice President and CFO of Roper St. Francis Healthcare (Charleston, S.C.). Ms. Day oversees Roper St. Francis Healthcare’s financial strategy and performance, leading teams focused on finance, revenue cycle, managed care and data analytics. She has previously served in executive roles in both managed care organizations and hospital systems. She has directed growth, built tight knit teams and taken accountability for the system’s financial integrity. 

Andrew DeVoe. CFO of TriHealth (Cincinnati). Mr. DeVoe joined TriHealth in July 2016 after spending more than 25 years in finance leadership and executive management. In his role as CFO, Mr. DeVoe is responsible for planning, organizing and directing financial management for the health system. He has experience with financial planning, budgeting, accounting systems and patient financial services in addition to reimbursement and managed care contracting. He also holds responsibility for the system’s population health efforts.

Lori Donaldson. CFO of UC San Diego Health. Ms. Donaldson is the CFO of UC San Diego Health, overseeing the health system’s financial strategies, operating and capital budgets and financial reporting systems and controls – ultimately a budget of over $3 billion. Ms. Donaldson is also responsible for planning and executing strategic partnerships and financial planning for the system’s capital projects. In addition to this role, Ms. Donaldson serves as a board member for the Bannister Family House at UC San Diego.

Bridgett Feagin. Executive Vice President and CFO of Connecticut Children’s Medical Center (Hartford, Conn.). As executive vice president and CFO of Connecticut Children’s Medical Center, Ms. Feagin is responsible for leading the health system’s financial planning, analysis and operations, as well as directly overseeing the medical system information solutions and technology division. In addition to her role at Connecticut Children’s, Ms. Feagin also serves as Executive Lead for the Children’s Health Consortium. Ms. Feagin has over two decades of financial experience, having previously served as CFO for Detroit Medical Center’s seven hospitals and United Way for Southeastern Michigan. 

Steve Filton. Executive Vice President and CFO of Universal Health Services (King of Prussia, Pa.). Mr. Filton is responsible for the financial operations of Universal Health Services, an organization with acute care hospitals, ASCs and behavioral health centers. As executive vice president and CFO, Mr. Filton has been integral in ensuring the organization maintains a strong balance sheet and high ratings from Moody’s and Standard & Poor’s. In the first quarter of 2019, the health system reported a 4.3 percent increase in net revenue to $2.8 billion.

Jennifer Fitzgerald. CFO of Belmont Behavioral Health System (Philadelphia). Ms. Fitzgerald is CFO of Belmont Behavioral Health System, which is part of Nashville, Tenn.-based Acadia Healthcare. Her role entails overseeing financial operations for the 252-bed inpatient hospital, outpatient services, and specialty services such as New Oaks Academy and Children’s Crisis Response Center. She brings to the role a proven track record of leading operations, projects and staff at numerous healthcare organizations. 

Leslie Flake, BSN. CFO at Orlando Health. Ms. Flake serves as the most senior finance executive for Orlando Health, managing $8.1 billion in assets. One of her primary objectives is enhancing efficiencies through benchmarking and standardization. She also coordinates with hospital chief financial officers on performance. Ms. Flake has 20 years of healthcare finance experience, and helped Orlando Health to achieve a 14.4 percent operating cash flow margin in 2022. She is also supporting the system’s growth strategy, outlining a strategic growth plan through 2030. She has previously worked for big names including Spectrum Health, Banner Health and Piedmont Healthcare.

Liz Foshage. Executive Vice President and CFO at Ascension (St. Louis, Mo.). Ms. Foshage leads all financial planning for Ascension, including its tax and treasury functions. In addition to her professional responsibilities, Ms. Foshage is a member of the American Institute of Certified Public Accountants and the Health Care Financial Management Association. Ms. Foshage joined Ascension in 1992, holding positions including vice president of finance and senior vice president of finance. 

Carrie Fuller Spencer. CFO of University of Rochester (N.Y.) Strong Memorial Hospital. Ms. Fuller Spencer became interim CFO at Strong Memorial Hospital in October 2017 and, in 2018, was appointed CFO of Strong Hospital and Highland Hospital, both in the University of Rochester health system. She has a background in healthcare finances and experience developing and managing annual capital and operating budgets.

Lawrence Furnstahl. Executive Vice President and CFO of Oregon Health & Science University (Portland). Mr. Furnstahl is responsible for the financial and operational management of Oregon Health & Science University as executive vice president and CFO. The health system includes two hospitals and two partner hospitals as well as 16,478 employees. Mr. Furnstahl is integral in managing the system’s $3 billion operating budget. He has previous experience as chief financial and strategy officer for the University of Chicago Medical Center and biological sciences division.

Niyum Gandhi. Treasurer and CFO at Mass General Brigham (Somerville). Mr. Gandhi joined Mass General as the system was recovering from lasting effects of the COVID-19 pandemic. He helped the system rethink key things, including reporting structures, service lines, margin targets and more. He is focused on improving collaboration between health system departments to improve access and care, launching a value-based care and health equity initiative and increasing the system’s work on research and innovation. He joined Mass General from Mount Sinai, where he served as executive vice president and CFO. 

John Geppi. Executive Vice President and CFO of Covenant Health (Knoxville, Tenn.). Mr. Geppi is responsible for the financial operations of Covenant Health, which includes nine acute care hospitals and more than 1,500 affiliated physicians. In 2016, the health system reported $1.2 billion in operating revenue and as executive vice president and CFO, Mr. Geppi is an integral member of the system’s strategic leadership team.

Lisa Goodlett. CFO of Medical University of South Carolina Medical Center (Charleston, S.C.). Ms. Goodlett oversees the financial strategy and planning for MUSC Medical Center as CFO. She is responsible for the financial department that supports the 700-bed hospital, including a children’s hospital, and level 1 trauma center. MUSC and its affiliates have collective annual budgets of over $4.6 billion.

Joe Guarracino. Executive Vice President, Chief Administrative Officer and CFO of White Plains (N.Y.) Hospital. Mr. Guarracino joined White Plains Hospital in 2016 after spending more than 25 years overseeing financial operations for healthcare organizations. In his role as executive vice president, chief administrative officer and CFO, Mr. Guarracino takes responsibility for all financial operations, such as revenue, patient accounts and accounts payable. Prior to joining White Plains, Mr. Guarracino was senior vice president and CFO of Brooklyn Hospital Center and CFO of three Health Quest System hospitals.

Dana Haering. Executive Vice President and CFO of Lucile Packard Children’s Hospital Stanford (Palo Alto, Calif.). Ms. Haering was named interim CFO of Lucile Packard Children’s Hospital Stanford in 2013 and promoted to CFO in 2014. She spent more than 20 years in the accounting industry, serving healthcare organizations that include academic medical centers, community hospitals and health plans. She also spent time as a senior manager at KPMG in the healthcare practice.

Don Halliwill. Executive Vice President and CFO at Carilion Clinic (Roanoke, Va.). Mr. Halliwill oversees all financial activities of the health system, which has annual revenues of $2.2 billion. He joined Carilion in 2013, leading the system through the COVID-19 pandemic. He helped to establish a top-down reassessment of how healthcare systems provide care, creating new plans for efficiency. He has also piloted a $500 million expansion of Carilion Roanoke Memorial Hospital. He previously served as CFO of Carilion’s Hospital Division. 

Kristine Hanscom. Senior Vice President, CFO and Treasurer of South Shore Health System (South Weymouth, Mass.). Ms. Hanscom started in her current role in 2022 after a period as CFO of Tufts Medical Center in 2016 after spending time as interim CFO and vice president of finance. She has experience overseeing a team of more than 250 people and guiding strategic decisions on business investments. During her career, she was instrumental in preparing for the hospital’s first bond issue, which helped the hospital raise $210 million.

Fred Hargett. Executive Vice President and CFO of Novant Health (Winston-Salem, N.C.). Mr. Hargett is executive vice president and CFO of Novant Health, an organization he joined in 2003. He spent time as executive vice president of finance and senior vice president of financial planning before taking on his current role. Prior to joining Novant, Mr. Hargett was a manager of healthcare consulting at Ernst & Young.

Jeff Harrington. Senior Vice President and CFO at Children’s Hospital Colorado (Aurora). Mr. Harrington became CFO of the Children’s Hospital in 2013 after serving as its vice president of finance. He oversees the system’s accounting, financial planning, treasury, financial systems, decision support, payroll management, payer strategy and facility functions. He has overseen the system’s expansion and two hospital additions. He has also developed financial dashboards for real-time productivity and staffing analytics. He joined the hospital from the Atlantic Health System where he served as corporate director of finance. 

Dina Hermes. Corporate CFO of Critical Access Healthcare (Austin, Texas). Ms. Hermes is charged with providing financial oversight for Golden Plains Community Hospital in Borger, Texas, Rice Medical Center in Eagle Lake, Texas, Critical Access Lighthouse Management, Critical Access Billing and Critical Access Medical Group. Each of these entities are subsidiaries of Critical Access Healthcare. Since Critical Access Healthcare serves a rural population, acting as corporate CFO comes with many challenges, but Ms. Hermes strives to keep costs affordable in the midst of a rural economy based mainly on self-employment and small businesses. 

Rick Hinds. Executive Vice President and CFO of UC Health (Cincinnati). Mr. Hinds spent time as interim CEO for UC Health’s parent company, the Health Alliance of Greater Cincinnati, before stepping into his current role as executive vice president and CFO of UC Health, in 2010. He has previous experience as vice president of finance and operations from 1995 to 2005 he also served as CEO of Fort Hamilton (Ohio) Healthcare Corp.

Kim Hodgkinson. Senior Vice President and CFO at Hospital Sisters Health System (Springfield, Ill.). Ms. Hodgkinson leads all finance operations for Hospital Sisters’ physician clinics and 15 hospitals across Illinois and Wisconsin. She supports the system’s strategic operating and growth goals, managing debt, investments, supply chain, revenue cycle and more. She has 30 years of experience in healthcare finance, joining HHS in 2022 after serving at systems including Trinity Health, PeaceHealth and St. Vincent’s Healthcare. 

Linda Hoff. CFO of Stanford (Calif.) Health Care. Ms. Hoff is CFO of Stanford Health Care, which she joined in 2017 after spending time as senior vice president and CFO of Legacy Health, an Oregon-based health system. She brought with her more than 30 years of executive and finance experience. In her role, she oversees Stanford Health Care’s finance strategy, planning and reporting. 

Greg Hoffman. CFO at Providence (Renton, Wash.). Mr. Hoffman leads Providence’s financial operations, ensuring that performance is aligned with strategic objectives for a better world. He heads up annual operating revenue and capital budgets. He also communicates the system’s financial performance to stakeholders, ensuring that everything is conducted ethically. When COVID-19 hit, Mr. Hoffman helped the system to form a nimbler administrative structure and expand outpatient care. He also leads up the system’s donation efforts, contributing to the community and closing gaps in health access. 

Daniel Isacksen, Jr. Executive Vice President and CFO at Trinity Health (Livonia, Mich.). Mr. Isacksen leads all financial functions for Trinity Health, including financial reporting, enterprise development and payer strategy. He has spearheaded operational improvement and financial stabilization through the COVID-19 pandemic. Since joining the system in 2021, Mr. Isacksen has continued to grow its reach. As an executive sponsor of the electronic health record system Epic, he has guided its successful implementation. He has also launched a new strategic initiative and a population health analytics collection system. His leadership has led the system to an 11 percent growth in non-hospital annual revenue. 

Hannah Jacobs. Senior Vice President and CFO of Frederick (Md.) Health. Ms. Jacobs was promoted to senior vice president and CFO of Frederick Health in April 2022 after having served the organization as vice president of finance since 2009. The health system, which celebrated its 120th anniversary in May 2022, includes the 269-bed Frederick Health Hospital and employs over 3,300 individuals. In addition to her current role, Ms. Jacobs also serves as Finance Chair for the YMCA of Frederick County Board of Directors.

Daniel Jantzen. System CFO at Dartmouth Health (Lebanon, N.H.). Mr. Jantzen oversees all financial function for Dartmouth Health, working on strategic goals and long-term financial planning. He stepped into the role in 2016, eight days before a fiscal year end in which the organization incurred a large operating loss. Mr. Jantzen rose up from his role as chief operating officer after the departure of the prior CFO. Mr. Jantzen has overseen a development and execution performance plan that resulted in a $110 million operating margin improvement. He is currently in his 34th year with the organization. 

Dawn Javersack. Senior Vice President and CFO of Nicklaus Children’s Health System (Miami). Ms. Javersack serves as senior vice president and CFO of Nicklaus Children’s Health System, the only healthcare system in the region exclusively for children. In her role, she provides executive oversight of the financial planning, operations and performance of the system and its entities. In 2021 and 2022, she led the organization to some of the strongest financial years in its recent history. Under her leadership, the system improved its rating from Fitch Ratings and S&P Global. 

Paul Jenny. Senior Vice President of Finance and CFO at Cincinnati Children’s. Mr. Jenny oversees finances for the system’s $2.6 billion revenue. He successfully led the organization through the pandemic, putting focus on diversity, equity and inclusion. Previously, he served as chief business officer for the University of California San Francisco. 

Pat Keel. Executive Vice President, Chief Financial and Administrative Officer for St. Jude’s Children’s Research Hospital (Memphis, Tenn.). Ms. Keel has served as CFO for St. Jude since 2016, and was promoted to the expanded role of executive vice president and chief administrative and financial officer in 2020. Overseeing multiple departments, Ms. Keel’s responsibilities include managing finance, supply chain, reimbursements, revenue cycle, managed care contracting and grants. Prior to her time at St. Jude, she served as CFO and senior vice president for University Health in Shreveport and Monroe, La.

Adam Kempf. Senior Vice President and CFO of Norton Healthcare (Louisville, Ky.). Mr. Kempf spent six years in public accounting before joining Norton Healthcare in 2001 as a senior internal auditor. He is now senior vice president and CFO, responsible for the health system’s accounting systems, capital and operational budgets and long-term financial planning. He is active in the Kentucky chapter of the Healthcare Financial Management Association.

Hak Kim. Senior Vice President and CFO at AtlantiCare Health System (Egg Harbor, N.J.). Mr. Kim plans, directs and coordinates financial operations and long-term strategy for AtlantiCare and its 6,000 providers. He is responsible for business development initiatives, including expanding services and sustaining initiatives. He also serves on the system’s quality, finance, audit, compliance and risk committees. He plays a key role in securing regulatory approvals and state and federal funding, as well as implementing community programs. He leads the health system in enrolling community members in a program that increases health access for low-income and rural communities. 

Alec King. Executive Vice President and CFO of Memorial Hermann Health System (Houston). As executive vice president and CFO of Memorial Hermann Health System, one of the largest integrated healthcare delivery systems in southeast Texas, Mr. King is responsible for overseeing approximately $7 billion in total operating annual revenue. He is charged with maintaining the organization’s overall financial health. Mr. King is known for his transparency and prioritizes educating others on the nuances of healthcare finance. 

Lynn Krutak. Executive Vice President and CFO of Ballad Health (Johnson City, Tenn.). Ms. Krutak’s role as executive vice president and CFO of Ballad Health entails the oversight of the health system’s financial operations, processes and systems. She brings over 25 years of experience leading financial organizations to her position. With her deep industry experience, she is instrumental in leading long term financial sustainability efforts, including identifying growth opportunities, assessing healthcare trends and regulatory changes, and driving innovative business models.

JoAnn Kunkel. CFO of LCMC Health (New Orleans). Ms. Kunkel is the CFO for LCMC Health, a nine-hospital health system. She leads the finance and accounting departments, as well as serves the CEO and leadership team in an advisory capacity. She led efforts for the recent partnership between LCMC and New Orleans-based Tulane University, which will add Tulane Medical Center, Lakeview Regional Medical Center and Tulane Lakeside Hospital to the system. Ms. Kunkel brings years of experience to her current role, having previously served as corporate CFO of Sioux Falls, S.D.-based Sanford Health.

Kris Kurtz. COO and CFO at University of Michigan Health West (Wyoming). Mr. Kurtz is in charge of maintaining financial stability and operational efficiency for the university health system. Additionally, he oversees strategy, procurement, property, construction and support services as COO. As CFO, he has overseen university health system affiliations, created and implemented a new cardiovascular network and a new cancer network and developed direct to employer contracting. Mr. Kurtz has more than 25 years of experience in healthcare finance. 

Travis Lakey. CFO of Mayers Memorial Healthcare District (Fall River Mills, Calif.). Mr. Lakey has been credited with bringing Mayers Memorial Healthcare District from the brink of bankruptcy to financial stability. As a growing district with a frontier critical access hospital in rural California, Mayers Memorial Healthcare District and the surrounding community both directly benefit from Mr. Lakey’s fiscal responsibility and sound financial judgment. He has served as CFO since 2009.

Angela Lalas. Executive Vice President for Finance and CFO of Loma Linda (Calif.) University Health. Ms. Lalas spent time as Loma Linda University Health’s senior vice president for finance before being promoted executive vice president of finance and CFO in 2021. She has experience overseeing the six-hospital health system’s finances and directing the Loma Linda University Foundation. Prior to joining Loma Linda in 2006, Ms. Lalas was a senior tax consultant for Deloitte.

Kathy Lancaster. Executive Vice President and CFO of Kaiser Foundation Hospitals and Health Plan (Oakland, Calif.). After joining Kaiser Permanente in 1998, Ms. Lancaster was promoted to CFO in 2005. She is responsible for the health system’s corporate finance, financial planning, financial systems and revenue management. She also has oversight of supply chain, data analytics, actuarial services and the enterprise shared services. Before she joined Kaiser, Ms. Lancaster held senior leadership roles for Prudential Insurance Company’s Western region.

Dennis Laraway. CFO of Cleveland Clinic. Mr. Laraway was named Cleveland Clinic’s new CFO in March 2023. He joined Cleveland Clinic, a nonprofit academic medical center comprising 22 hospitals, after having served as executive vice president and CFO at Banner Health, a $12 billion Phoenix-based health system. He also has experience as CFO for Scott & White Health in Temple, Texas. 

Romaine Layne. CFO of Broward Health Ambulatory Services (Fort Lauderdale, Fla.). Ms. Layne was promoted to CFO for the ambulatory services division of Broward Health in 2020 after working as associate CFO for Broward Health Imperial Point since 2018. In her current role, she ensures funding for ambulatory care, identifies opportunities for contract negotiations and oversees 85 employees. In her time as CFO, one of Ms. Layne’s most notable achievements was increasing ambulatory services point-of-sale collections by over 30 percent. In the summertime, Ms. Layne serves as a mentor for Broward’s internship program.

Stacey Malakoff. Executive Vice President and Chief Financial and Administrative Officer of Hospital for Special Surgery (New York City). Ms. Malakoff oversees financial operations at Hospital for Special Surgery, a hospital focused on orthopedics and rheumatology. In 2021, alongside her in-house team and representatives from Avison Young, Ms. Malakoff represented HSS in lease negotiations that led to development plans for a new 30-story medical office tower in Manhattan’s Upper East side. The building will house HSS physician offices as well as other ancillary services. 

Divya Matai. Vice President and CFO of Emory Johns Creek Hospital and Emory Saint Joseph’s Hospital (Metro Atlanta). Ms. Matai joined Emory Healthcare in May 2022 as the new vice president and CFO of two of its hospitals, Emory Johns Creek Hospital and Emory Saint Joseph’s Hospital. The health system comprises 11 hospitals, the Emory Clinic and over 250 provider locations with more than 3,300 physicians. Prior to her new role at Emory, Ms. Matai spent about four years as the CFO of Northwest Texas Healthcare System.

David Mazurkiewicz. Executive Vice President and CFO at McLaren Healthcare Corp. (Grand Blanc, Mich). Mr. Mazurkiewicz has been with McLaren since 2009, overseeing the system’s financial integrity and ensuring its 14 hospitals can provide cost-effective care for patients. He also manages the system’s two health insurance plans. In Mr. Mazurkiewicz’s time with the health system, it has more than doubled, adding hospitals, ambulatory facilities and a cancer institute. 

Brenda McCormick. Senior Vice President and CFO of Children’s Minnesota (Minneapolis). Joining Children’s Minnesota as senior vice president and CFO in 2019, Ms. McCormick took on responsibilities including leadership among financial teams for planning and analysis, controllership, treasury, strategic payer contracting, revenue cycle operations and foundation finances. In addition to her financial duties with Children’s Minnesota, Ms. McCormick also serves on the board of regents with her alma mater, St. Olaf College in Northfield, Minn., as well as the Ridgeview Medical Board. 

Paul McDowell. Executive Vice President and CFO at The Queen’s Health System (Honolulu). Mr. McDowell joined the health system in 2020, controlling finances for Hawaii’s largest private employer. He oversees budgeting, financial planning and the adoption of sustainable financial policies. He also oversees information technology at the system, improving financial capacity and expanding pay performance contracts with payers. He also provides counsel to the system’s accountable care organization, leading to a realization of a $20 million cost reduction. He also led the health system to a $26 million financial improvement in fiscal year 2022. Mr. McDowell has 30 years of experience in health finance. 

Mike Meyer. CFO of UT Southwestern Medical Center (Dallas). Mr. Meyer oversees the financial solvency and direction of UT Southwestern Medical Center, which includes two hospitals, a medical school and more than 50 clinics. During his time at UT Southwestern, Mr. Meyer has improved the case mix index by 7 percent year over year and his approach to revenue cycle and cost management helped the hospital exceed its budget operating margin by nearly 200 percent. He is currently leading efforts to expand Clements University Hospital, a 30-month project to add a tower and 144 beds campuswide. He has previous experience as executive vice president and CFO of both Atlanta-based Grady Health System and Dallas-based Texas Health Resources.

Jennifer Mitzner. Executive Vice President and CFO of Baylor Scott & White Health (Dallas). In 2021, Ms. Mitzner was hired as executive vice president and CFO for Baylor Scott & White Health, the largest nonprofit health system in the state of Texas comprising 51 hospitals and over 1,100 access points. In this role, Ms. Mitzner oversees the health system’s finance, accounting and revenue cycle functions. Prior to working with Baylor Scott & White, Ms. Mitzner spent time as executive vice president of Hoag and CFO of St. Joseph Hoag Health.

Cecelia Moore. CFO of Vanderbilt University Medical Center (Nashville, Tenn.). Ms. Moore joined Vanderbilt University Medical Center in August 2013 after spending time as the vice president of finance and COO for the patient revenue management organization within Duke University Health System in Durham, N.C. She was later appointed CFO of the health system while it more than doubled its operating income. In 2016, the Nashville Business Journal awarded her CFO of the Year in the Not-for-Profit Sector. 

Dan Morrissette. CFO of CommonSpirit Health (Chicago). Mr. Morrissette ensures the viability of the organization from a financial standpoint. He works to optimize revenue through multiple avenues. He brings vast financial expertise to his role, having spent 25 years in health care, consulting and international business development. He most recently served as CFO of Stanford Health in Palo Alto, Calif. 

Bill Munson. Vice President and CFO of Boulder (Colo.) Community Health. Mr. Munson oversees the financial strategy, operations and sustainability for Boulder Community Health, a $450 million independent community health system. His sound strategic decisions and cultivation of various partnerships has enabled the system to thrive through adversity. He first joined the system in 2008 and brings a breadth of experience in hospital financial management to his current position. 

Dominic Nakis. Senior Vice President and CFO of Sutter Health (Sacramento). Mr. Nakis became CFO of Sutter Health in May 2023, where he will manage the entirety of the system’s financial operations, which includes financial planning, investments and treasury, financial accounting, health plan, supply chain and revenue cycle. He brings over 30 years of healthcare financial and leadership experience to the role. Prior to assuming the new role, he served as CFO of  Advocate Aurora Health in Milwaukee. 

Kaley Neal. CFO of Shenandoah (Iowa) Medical Center. Ms. Neal became financial controller of Shenandoah Medical Center in March 2016 and was promoted to CFO in July 2017. In her role, Ms. Neal oversees financial operations for the 25-bed critical access hospital with over 300 employees. The hospital’s main campus also includes a physician clinic, outpatient clinic, wellness center and home health and hospice.

Priscilla Needham. CFO of Tallahassee Memorial HealthCare. Ms. Needham became CFO of Tallahassee Memorial HealthCare earlier this year. She has previously served as CFO of Baylor St. Luke’s Medical Center in Houston and Billings Clinic. In her role, Ms. Needham oversees the financial operations for the 325-bed hospital with 4,700 employees.                                                                                            

Susan Nelson. Executive Vice President and CFO of MedStar Health (Columbia, Md.). Ms. Nelson is the executive vice president and CFO for MedStar Health. She is responsible for systemwide finances for the $6.5 billion nonprofit healthcare delivery system, including financial reporting, financial planning, revenue cycle, capital management, bond financing, investment activities, performance improvement, analytics and business development. She first joined the system in 2005 as the vice president of financial operations and has taken on increasing responsibility, most recently serving as senior vice president of finance before assuming her current role. 

Terri Newsom. Senior Vice President and CFO of Boston Medical Center Health System. Ms. Newsom serves as the senior vice president and CFO of Boston Medical Center Health System. She oversees all financial planning and operations for the system, which consists of a 514-bed academic medical center and five other major entities and has an annual operating budget of $6 billion. Since joining the health system in 2020, she has driven the system’s efforts in health equity, community outreach and financial stability. 

Joyce Nwatuobi. CFO of Indiana University Health Methodist and University Hospitals (Michigan City, Ind.). In 2021, Ms. Nwatuobi joined IU Health as CFO for Methodist and University Hospitals after serving as CEO and co-founder of ThriveHealth in Milwaukee the year prior. Her role as CFO entails administration, direction, and monitoring of all hospital finances. In addition to sustaining financial security for the $2 billion health system, Ms. Nwatuobi is currently providing oversight to a new IU Health downtown hospital project.

John Orsini. Senior Vice President and CFO of Northwestern Memorial HealthCare (Chicago). Mr. Orsini has more than 30 years of experience in healthcare finance, including time as executive vice president and CFO of Cadence Health, which merged with Northwestern Memorial HealthCare. After the merger, Mr. Orsini became senior vice president and CMO of NMHC. He oversees strategic financial management for the seven-hospital health system.

Bill Pack. CFO of Conway (Ark.) Regional Health System. Mr. Pack is responsible for Conway Regional Health System’s financial operations, which includes leading the system’s accounting, business office and admissions, and medical information teams. He brings over 30 years of healthcare experience to his role and has built a reputation as a results-driven leader. He is adept in crafting innovative action plans to optimize processes, workflow productivity and profitability. 

Eric Peburn. Executive Vice President and CFO of Halifax Health (Daytona Beach, Fla.). In 1996, Mr. Peburn joined Halifax as corporate controller and was promoted to director of finance in September 2003. He also spent time as assistant administrator before he became executive vice president and CFO in November 2007. In addition to his role at Halifax Health, Mr. Peburn serves on the executive committee and board of directors for the Daytona Regional Chamber of Commerce and is a board member of Volusia Health Network, Halifax Insurance Plan and Healthcare Purchasing Alliance.

Robert Pekofske. Vice President of Finance and CFO at Advocate Health (Downers Grove, Ill.). Mr. Pekofske manages Advocate’s systemwide financial policies and implements operating unit procedures to ensure system policies are followed. He also manages the system’s assets, revenues, expenditures and financial activities. He oversees a total of $2.1 billion in operating revenue. Mr. Pekofske started his career in finance at Evangelical Hospital Association in 1978. In 2023, he celebrated 25 years with Advocate Health. 

Frank Pipas. Executive Vice President and CFO at RWJBarnabas Health (West Orange, N.J.). Mr. Pipas controls finances for the health system and its medical healthcare system, providing healthcare to the communities it serves. He joined the organization in 2022 after serving at another major healthcare organization. Mr. Pipas is focused on stabilizing the health system’s finances and driving growth and profitability in the wake of COVID-19. 

Alice Pope. CFO of Inova Health System (Falls Church, Va.). As CFO of Inova, Ms. Pope handles financial operations including financial reporting, revenue cycle operations, managed care contracting, treasury and investment management. She works to guarantee the financial stability of the organization. Prior, she served as senior vice president and CFO of Scottsdale, Ariz.-based HonorHealth. She has more than 30 years of experience in finance and 20 of those years were in healthcare.

Scott Posecai. Executive Vice President, CFO and Treasurer of Ochsner Health System (New Orleans). Mr. Posecai joined Ochsner Clinic in 1987 and was promoted to CFO in 1995. He became CFO of Ochsner Clinic Foundation in 2001 after it merged with Ochsner Clinic and then CFO of the Ochsner Health System in 2006. He oversees financial planning, reimbursement, managed care contracting and health information management in his current role. Mr. Posecai also oversees accounting and revenue cycle functions.

Julia Puchtler. CFO of the Hospital of the University of Pennsylvania (Philadelphia). Ms. Puchtler joined Penn Medicine in 2015 and was vice president of finance operations and budget before being promoted to CFO in 2019. She also has experience as vice president of strategic financial planning and decision support at Trinity Health in Livonia, Mich. In addition to being promoted to CFO in 2019, Ms. Puchtler was named to the 2020 class of the Carol Emmott Fellowship, which was established to uplift and increase visibility for women in health leadership.

Michael Reney. Executive Vice President and Chief Finance and Business Officer at Dana-Farber Cancer Institute (Boston). Mr. Reney was CFO of Boston-based Brigham and Women’s Hospital before joining Dana-Farber in 2015. He also has experience as assistant controller of Massachusetts General Hospital and has held several positions with Partners Healthcare, both in Boston. In addition to his role at Dana-Farber, Mr. Reney is on the board of the Fenway Community Health Center and Medical Academic and Scientific Community Organization.

Josh Repac. CFO of Meritus Health (Hagerstown, Md.). Mr. Repac serves as CFO for Meritus Health, a role that entails overseeing all financial actions of the health system. His responsibilities include managing finances, revenue cycle, supply chain and more. He was promoted to the role in 2022, after serving as vice president of revenue cycle and clinical support services. He played an integral role in an innovative partnership between Meritus and Goodwill, a partnership that created a pathway to employment for underserved community members and established a necessary medical care site. 

Lisa M. Replogle. Senior Vice President and CFO of HonorHealth (Scottsdale, Ariz.). Ms. Replogle has more than 20 years of healthcare finance experience under her belt, and has been an integral part of HonorHealth since she joined the health system in 2015. Her current role involves overseeing financial and accounting functions, as well as patient financial services, supply chain, real estate, insurance contracting and construction management. Prior to working with HonorHealth, Ms. Replogle was the CFO for the Center for Orthopedic and Research Excellence in Phoenix. 

LuCinda Rider. CFO of UHS Delaware Valley Hospital (Walton, N.Y.). Ms. Rider is responsible for overseeing all financial operations for the progressive critical access hospital. Some of her notable accomplishments include consistently leading the hospital to a positive bottom line 10 years in a row as well as implementing a successful strategic investment and cost containment plan. In addition to her role as CFO, Ms. Rider also serves as the UHS Delaware Valley Hospital compliance officer and as a board chair for UHS Employee Federal Credit Union. 

Dan Rieber. CFO at University of Colorado Health (Aurora). Mr. Rieber was appointed CFO at the university system in 2018, overseeing 12 hospitals and 150 clinic locations. He joined the system in 2007 as a director of finance and controller. He has been in healthcare finance for two decades, previously working at Centura Health and the University of Iowa Hospitals and Clinics. 

Kevin Roberts. Executive Vice President and CFO of Geisinger (Danville, Pa.). Mr. Roberts joined Geisinger in April 2018 as executive vice president and CFO, responsible for all financial activities in the health system. He most recently served as senior vice president and CFO of St. Louis-based BJC HealthCare. His background is in business development, corporate finance, health plans, mergers and acquisitions and financial operations.

Brigette Rose. CFO of LSU Health Sciences Center-Shreveport (La.). Ms. Rose joined LSU Health Sciences Foundation in 2018 and now oversees the health system’s finances. She has previous experience as the hospital’s department of neurosurgery business director. The health system is currently funding a $60 million expansion project on a center for medical education and wellness to address the healthcare workforce charges. 

Mark Runyon. Executive Vice President and CFO at Tampa General Hospital (Fla.). Mr. Runyon joined Tampa General in 2020, spending more than 30 years in healthcare finance. He works with the system’s CEO to enhance operational efficiency and financial performance. He delivers timely and responsive patient billing support, supplies needed to deliver patient care, responsive patient friendly scheduling and timely access for patients. Prior to joining Tampa General, Mr. Runyon served as acting vice president of operational finance at Intermountain Health and senior vice president of operations finance at Inova Health System.

William Rutherford. Executive Vice President and CFO of HCA Healthcare (Nashville, Tenn.). Mr. Rutherford is Executive Vice President and CFO of HCA Healthcare, a role he took on in 2011. He now manages the health system’s treasury department, government programs and investor relations. During his 30-year career, he spent nine years as CFO of the health system’s Eastern Group, where he was responsible for 90 hospitals and $12 billion of net revenue.

Cheryl Sadro. CFO of UC Davis Health (Sacramento, Calif.). As CFO of UC Davis Health, Ms. Sadro provides executive oversight for financial functions, operations and planning for the $4 billion health system, which includes two hospitals, a large outpatient care network and two schools of health. Since assuming the role in 2022, she has assisted in the establishment of a new internal funds flow system, rewarding productivity and fairly allocating resources. She oversees a 13-story tower addition to the UC Davis Medical Center, a $6.5 billion construction project. In addition, she helps maintain one of the nation’s best cash-on-hand positions to maintain confidence in bond markets and financial liquidity. 

Anthony Saul. Executive Vice President and CFO of Grady Health System (Atlanta). As executive vice president and CFO of Grady Health System, Mr. Saul is responsible for the fiscal health of the system, one of the academic safety net health systems in the nation. He focuses on long term financial sustainability and leadership accountability, which ensures that the system invests in people, planning and physical resources that improve the health of the overall community. He advises and supports the CEO and board of directors, and is responsible for the strategic direction of the organization. 

Shelly Schorer. Interim President and CFO of CommonSpirit Health, Northern California Division (Chicago). Ms. Schorer serves as interim president and CFO of CommonSpirit’s Northern California division, which comprises 13 hospitals under the Dignity Health umbrella. She presents consolidated financial reporting, projections and other financial presentations for the division. Before joining Dignity Health in 2017, she served as a regional CFO for St. Louis-based Mercy Health. 

Sidney Sczygelski. Senior Vice President and CFO of Aspirus Health (Wausau, Wis.). As CFO, Mr. Sczygelski is accountable for traditional accounting, financial and treasury operations within Aspirus Health. Additionally, he takes ownership of the supply chain, revenue cycle, system health plan, and mergers and acquisitions. He has spent over 31 years as the system’s CFO. He has been instrumental in driving growth from approximately $50 million to about $2 billion in net revenue from 1992 to 2023. During his tenure, he led the acquisition of various hospitals, clinics and other entities, leading the system to its current composition of 17 hospitals and 70 clinics. 

Bob Segin. Executive Vice President and CFO of Virtua Health (Marlton, N.J.). Mr. Segin takes ownership of Virtua’s strategic financial planning and treasury management. He oversees mergers and acquisitions, physician joint ventures and business partnerships, planning and development, managed care, support services, construction management, supply chain, internal audit and corporate compliance. Under his guidance, Virtua became New Jersey’s first health system to receive an AA- credit rating from S&P Global and Fitch Ratings. 

Richard Silveria. Senior Vice President and CFO of Cape Cod Healthcare (Hyannis, Mass.). Mr. Silveria is senior vice president and CFO of Cape Cod Healthcare. From 2017-21, he served as executive vice president and CFO of the University of Chicago Medical Center, overseeing finances for the health system’s community health and hospitals division. He previously spent time as senior vice president and CFO of Boston Medical Center. His background also includes 12 years as corporate director of revenue finance at Partners HealthCare in Boston.

J. Dean Swindle. President of Enterprise Business Lines and CFO of Catholic Health Initiatives (Englewood, Colo.). Since joining Catholic Health Initiatives in 2010, Mr. Swindle has overseen financial strategy, revenue cycle, payer strategy, treasury services and clinical engineering. He previously served as dean of Novant Health System in Winston-Salem, S.C., where he spent 11 years growing the system’s annual revenue from $800 million to $3.5 billion.

Michael Szubski. CFO at University Hospitals Cleveland. Mr. Szubski became the hospital’s CFO in 2008, controlling the system’s insurance, revenue cycle, financial operations, supply chain and more. He also leads the venturing division of the health system. In 2022, the hospital was faced with tough economic issues and Mr. Szubski spearheaded initiatives that led to its financial recovery, including reducing costs for the system, obtaining rebates through a value improvement program, enhancing revenue cycle performance and adding new ACA marketplace agreements. In 2021, he led the hospital through an EHR transition, joining Epic. Prior to joining the University Hospitals, Mr. Szubski worked at EMH Regional Healthcare System as its executive vice president and CFO. 

Karen Testman, RN. CFO of MemorialCare (Fountain Valley, Calif.). Ms. Testman joined MemorialCare in 1998 and then became senior vice president of financial operations before her promotion to CFO in 2013. Ms. Testman was integral to the health system’s ambulatory growth and joint venture strategy. The health system also received positive ratings under her leadership. Ms. Testman has more than 20 years of leadership experience and worked with the system to invest in strategic physician acquisition, an EHR build and adding to its ambulatory network.

Paula Tinch. Executive Vice President and CFO of Penn State Health (Hershey, Pa.). Ms. Tinch joined Penn State Health in 2019 as executive vice president and CFO. She is responsible for the health system’s financial planning, financial risk management and revenue cycle. Prior to joining Penn State Health, Ms. Tinch was senior vice president of finance for Rochester Regional Health in N.Y., where she was responsible for core functions and aspects of the $2.2 billion health system.

Patt Vilt. Senior Vice President and CFO at Riverside Health (Kankakee, Ill.). Ms. Vilt is in charge of Riverside’s financial operations and key strategic responsibilities for the organization. She also leads the system’s pharmacy program and serves as its chief compliance officer. She has more than 25 years of experience in healthcare finance, and navigated Riverside through the challenges of COVID-19. She joined the organization in 1995 as a reimbursement analyst and was promoted to CFO in 2021 after moving her way up in the system. 

Jennifer Wakem. CFO of University Medical Center of Southern Nevada (Las Vegas). Ms. Wakem now has five years of experience as CFO of University Medical Center of Southern Nevada. She oversees the financial health of the hospital, which includes Nevada’s only level 1 trauma center, pediatric trauma center, burn care center and transplant center. She has previous experience as associate CFO of Tenet Healthcare.

Cheryl Wathen. Senior Vice President and CFO at Deaconess Health System (Evansville, Ind.). Ms. Wathen has been with Deaconess for 30 years, growing the system from a single hospital to a 13 hospital operation across three states. She has helped to build strategy and ensure that the system has capital to expand. She has set up a patient payment program that allows patients to pay their bills and build credit without occurring interest expenses. 

Sean Whilden. Vice President and CFO of Houston Healthcare. Mr. Whilden joined Houston Healthcare in 2012 after serving as system controller of DeKalb Regional Health System in Decatur, Ga. As CFO of Houston Healthcare, he oversees financial aspects of the 282-bed health system that provides inpatient and outpatient services. The health system has seven separate locations and serves around 300,000 people annually.

Bonnie White. CFO of UNM Hospital (Albuquerque). Ms. White oversees the finance department at UNM Hospital, part of the UNM Health System, which includes the only academic medical center in New Mexico. With providers specializing in over 150 areas of medicine, the system cares for over a million patients per year and handles about 22,000 surgical cases annually.

Christine Williams Bond. CFO of University Medical Center New Orleans. As CFO of University Medical Center New Orleans, Ms. Williams Bond oversees the financial department for the 446-bed hospital. She has previous experience as assistant CFO of Atlanta Medical Center and controller at Emory Johns Creek (Ga.) Hospital.

Gena Wingfield. Executive Vice President and CFO of Arkansas Children’s (Little Rock, Ark.). Ms. Wingfield is the executive vice president and CFO for Arkansas Children’s, where she is responsible for all financial matters and functions of the health system. She actively participates in ideating and executing the system’s overall strategic plan and determines the financial impact of external factors on the organization, such as changes in Medicaid funding. She brings over 35 years of experience at the health system to her role, and has played a large part in Arkansas Children’s becoming financially healthy. 

Jeanette Wojtalewicz. Senior Vice President and CFO of CHI Health (Omaha). Ms. Wojtalewicz has more than 30 years of experience in healthcare finance and is a past president of the Healthcare Financial Management Association in Nebraska. In her role as CFO of CHI Health, Ms. Wojtalewicz oversees the financial operations of a 28-hospital, 800-employed physician health system. She also serves on the CyncHealth, Midlands Choice, and Nebraska Total Care boards. Ms. Wojtalewicz has been recognized by a number of organizations for her work, including by the Healthcare Financial Management Association with the Gold Merit Award, and the Lincoln Family Medicine Program with the John C. Finegan Award.

Stacey Woodroof. CFO of Orlando (Fla.) Health Medical Group. In her role as CFO for Orlando Health Medical Group, Ms. Woodroof is accountable for business growth and revenue, financial operations, real estate project management, strategy and acquisition support, and physician compensation contracting. In 2020, she created HealthCare Pink, a project aiming to support working mothers in a COVID-19 world; the project is currently in the final stages of a U.S. trademark status and pending a launch date. In 2019, Ms. Woodroof was recognized with the Nashville Business Journal CFO award for non-profit/institution for her work as a financial steward and leader.

David Wrigley. Executive Vice President and CFO of Cedars-Sinai Health System (Los Angeles). Mr. Wrigley is executive vice president and CFO of Cedars-Sinai Health System. He is responsible for financial planning and reporting, revenue cycle, treasury, financial operations, capital structure and planning, risk management, corporate compliance, ventures and technology transfer. He is devoted to Cedar-Sinai’s mission and supports its unique role in patient care, research, education and community benefit.   

John L. Zabrowski, III. Senior Vice President, CFO and Chief Strategy Officer of VHC Health (Arlington, Va.). A seasoned healthcare executive with over a decade of healthcare industry experience, Mr. Zabrowski focuses on strategic planning and financial stewardship at VHC Health. He works to ensure the health system can serve the region’s healthcare needs by providing access to high quality, affordable services. He owns systemwide strategy and planning, strategic financial planning and analysis, financial reporting, accounting and disbursements, decision support, investment management, revenue cycle, capital funding and more. He has been a key player in aggressively positioning VHC Health for continued high acuity growth through expansions of its specialty programs. 

Stacey Zimmer. CFO at AVALA (Covington, La.). Ms Zimmer focuses on the health system’s financial strategy, financial operations, risk management and compliance. She has overseen the expansion of the physician network satellite locations. She works closely with AVALA’s physician owners, executive leadership, board of directors and stakeholders to help guide expansion. She is also building a foundation for the hospital’s revenue cycle management process.

UPMC operating profit doubles to $100M in Q1

Pittsburgh-based UPMC’s operating income hit $100.4 million in the first quarter — up from $50.4 million in the prior year period — due to increased patient volumes, the growth of its insurance division and equity earnings in its investment in CarepathRx.

UPMC said quarterly results were partially offset by reduced pandemic-related funding and increased labor costs. First-quarter revenue increased 12 percent year over year to $6.9 billion and expenses rose 11 percent to $6.8 billion.

Year over year, UPMC’s admissions and observations increased 6 percent, while its health plan grew by almost 500,000 members to 4.5 million. UPMC attributed the 12 percent jump to the expansion of its behavioral health and Medicaid programs in eastern Pennsylvania. 

“While meeting strong patient preference for care to be provided more conveniently in ambulatory settings closer to home, UPMC’s outpatient revenue increased 9 percent compared to a year ago,” CFO Edward Karlovich said in a May 25 news release. “Our patient volumes continue to shift from inpatient to outpatient settings.”

After including the performance of its investment portfolio and other nonoperating items, the 40-hospital system reported an overall gain of $187.3 million, compared with a loss of $226.2 million in the first quarter of 2022.

Health system finances looking up

Fitch Ratings Senior Director Kevin Holloran dubbed 2022 the worst operating year ever and most nonprofit health systems reported large losses. However, the losses are shrinking and some systems have even reported gains during 2023 so far.

Cleveland Clinic reported $335.5 million net income for the first quarter of the year, compared with a $282.5 million loss over the same period in 2022. The health system reported revenue of $3.5 billion for the quarter. Cleveland Clinic has 321 days cash on hand, which puts it in a strong position for the future.

Boston-based Mass General Brigham reported $361 million gain for the second quarter ending March 31, which is up from a $867 million loss in the same period last year. The health system reported quarterly revenue jumped 11 percent year over year to $4.5 billion. The system’s quarterly loss on operations was down significantly this year, hitting $8 million, compared to $183 million last year.

Renton, Wash.-based Providence reported first quarter revenues were up 5.1 percent in 2023 to $7.1 billion, and operating loss is also moving in the right direction. The system reported $345 million operating loss in the first quarter of 2023, down from $510 million last year.

All three systems cited ongoing labor shortages and labor costs as a challenge, but are working on initiatives to reduce expenses. Cleveland Clinic and Mass General Brigham reported operating margin improvement to nearly positive numbers.

Kaiser Permanente, based in Oakland, Calif., also reported operating income at $233 million for the first quarter of the year, an increase from $72 million operating loss over the same period last year. The system is focused on advancing value-based care for the remainder of the year and its health plan grew more than 120,000 members year over year.

Even more regional systems are stemming their losses. SSM Health, based in St. Louis, went from a $57.4 million loss for the first quarter of 2022 to $16.5 million quarterly loss this year. Revenue increased 13.3 percent to $2.5 billion for the quarter, with increased labor expenses and inflation on supply costs continuing to weigh on the system.

UCHealth in Aurora, Colo., also reported a first quarter income of $61.8 million and revenue of more than $5 billion.

Not every system is seeing losses decline. Chicago-based CommonSpirit Health, which reported larger operating losses in the first quarter year over year, hitting $658 million and $1.1 billion for the nine-month’s end March 31. The system was able to reduce contract labor costs, but still finds hiring a challenge and spent time last year recovering from a cybersecurity incident.

Hospitals face a long road to financial recovery from the pandemic as inflation persists and labor shortages become the norm, but movement in the right direction is welcome.

Why ‘boomerang’ nurses are ditching contract work for hospital staff positions

During the pandemic, many nurses left hospital staff jobs for more lucrative travel jobs. However, many of these nurses are returning to hospitals for full-time positions, especially as travel pay falls and organizations offer new staff benefits, Melanie Evans writes for the Wall Street Journal.

How Allegheny Health Network re-recruits experienced RNs

Hospitals see more nurses return to their positions

During the pandemic, many hospitals struggled with staffing shortages as many nurses left their positions as a result of burnout or for more high-paying travel opportunities. However, many nurses are now returning to staff positions, especially as travel pay declines.

According to  Aya Healthcare CEO Alan Braynin, travel nurse pay is now down 28% compared to a year ago. Hospital openings for travel nurses were also down by 51% at the end of April compared to the same time last year.

At HCA Healthcare, the country’s largest publicly traded hospital chain, nurse hiring increased by 19% in the first three months of the year compared to the average across the last four quarters. In addition, turnover levels have almost declined to pre-pandemic levels, and HCA’s travel nurse costs have dropped by 21% in the first quarter of this year compared to 2022.

According to the organization, many nurses who initially left their hospitals during the pandemic are now coming back. Since 2022, around 20% of the 37,000 nurses hired at HCA hospitals previously worked for the company at some point between 2016 and 2022.

Similarly, Houston Methodist has rehired around 60 nurses who initially left during the pandemic. Roberta Schwartz, the chief innovation officer at the health system’s flagship hospital, said these returning nurses have helped the hospital make more beds available and keep up with an 8% increase in demand.

“The boomerang nurses have returned,” said Gail Vozzella, Houston Methodist’s chief nurse.

How hospitals are attracting boomerang nurses

To attract more nurses to staff positions, hospital officials said they are offering higher pay, as well as several new benefits, such as childcare, less demanding work positions, and more flexible schedules.

For example, Suzane Nguyen, who took a teaching job during the pandemic, rejoined Houston Methodist in June 2022 after she was offered a virtual job. In her new position, she collects patient information by video. “The stress doesn’t compare,” she said.

Similarly, Linda Allen, an ED nurse who left to work for a temporary agency during the pandemic, returned to Sentara Healthcare in 2022 after the hospital system increased its wages and offered new, more flexible schedules.

According to Terrie Edwards, Sentara’s regional VP, the organization has increased its nurse wages by around 21% in the last two years and now offers student debt relief up to $10,000, as well as adoption and infertility benefits.

Overall, these changes have helped Sentara hire around 400 boomerang nurses, which has reduced staff overtime and cut its travel nurse expenses in half.

“They really did step up,” said Allen, who became a full-time employee in September 2022 after initially working temporary 13-week contracts.

Outside of these benefits, some nurses are also just ready for more permanent positions after spending the pandemic working in several different hospitals. “There is something to be said for working in the same place every day, consistently,” said Alexis Brockting, an advanced practice nurse at Mercy Hospital South.

53 hospitals, health systems cutting jobs

A number of hospitals and health systems are trimming their workforces or jobs due to financial and operational challenges. 

Below are workforce reduction efforts or job eliminations that were announced within the past nine months and/or take effect later this year. 

1. Wenatchee, Wash.-based Confluence Health has eliminated its chief operating officer amid restructuring efforts and financial pressures, the health system confirmed to Becker’s May 16.

2. Conemaugh Memorial Medical Center, a Duke LifePoint hospital in Johnstown, Pa., has laid off less than 1 percent of its workforce, the hospital confirmed to Becker’s May 15.  

3. Community Health Network, a nonprofit health system based in Indianapolis, plans to cut an unspecified number of jobs as it restructures its workforce and makes organizational changes. The health system confirmed the job cuts in a statement shared with Becker’s on May 11. It did not say how many jobs would be cut or which positions would be affected. 

4. New Orleans-based Ochsner Health eliminated 770 positions, or about 2 percent of its workforce, on May 11. This is the largest layoff to date for the health system. 

5. Cedars-Sinai Medical Center eliminated the positions of 131 employees and cut about two dozen other jobs at related Cedars-Sinai facilities, a spokesperson confirmed via a statement shared with Becker’s May 7. The Los Angeles-based organization said reductions represent less than 1 percent of the workforce and apply to management and non-management roles primarily in non-patient care jobs.

6. Rochester (N.Y.) Regional Health is eliminating about 60 positions. A statement from RRH said the changes affect less than one-half percent of the system population, mostly in nonclinical and management positions.

7. Memorial Health System laid off fewer than 90 people, or less than 2 percent of its workforce.The Gulfport, Miss.-based health system said May 2 that most of the affected positions are nonclinical or management roles, and the majority do not involve direct patient care. 

8. Monument Health laid off at least 80 employees, or about 2 percent of its workforce. The Rapid City, S.D.-based system said positions are primarily corporate service roles and will not affect patient services. Unfilled corporate service positions were also eliminated. 

9. Habersham Medical Center in Demorest, Ga., laid off four executives. The layoffs are part of cost-cutting measures before the hospital joins Gainesville-based Northeast Georgia Health System in July, nowhaberbasham.com reported April 27. 

10. Scripps Health is eliminating 70 administrative roles, according to WARN documents filed by the San Diego-based health system in March. The layoffs take effect May 8 and affect corporate positions in San Diego and La Jolla, Calif.

11. Trinity Health Mid-Atlantic, part of Livonia, Mich.-based Trinity Health, eliminated fewer than 40 positions, a spokesperson confirmed to Becker’s April 24. The layoffs represent 0.5 percent of the health system’s approximately 7,000-person workforce.

12. PeaceHealth eliminated 251 caregiver roles across multiple locations. The Vancouver, Wash.-based health system said affected roles include 121 from Shared Services, which supports its 16,000 caregivers in Washington, Oregon and Alaska.

13. Toledo, Ohio-based ProMedica plans to lay off 26 skilled nursing support staff. The layoffs, effective in June, affect 20 employees who work remotely across the U.S, and six who work at the ProMedica Summit Center in Toledo, according to a Worker Adjustment and Retraining Notification filed April 18. Most affected positions support sales, marketing and administrative functions for the skilled nursing facilities, Promecia told Becker’s.

14. Northern Inyo Healthcare District, which operates a 25-bed critical access hospital in Bishop, Calif., anticipates eliminating about 15 positions, or less than 4 percent of its 460-member workforce, by April 21, a spokesperson confirmed to Becker’s. The layoffs include nonclinical roles within support and administration, according to a news release. No further details were provided about specific positions affected. 

15. West Reading, Pa.-based Tower Health is eliminating 100 full-time equivalent positions. The move will affect 45 individuals, according to an April 13 news release the health system shared with Becker’s. The other 55 positions are either recently vacated or involve individuals who plan to retire in the coming weeks and months.

16. Grand Forks, N.D.-based Altru Health is trimming its executive team as its new hospital project moves forward. The health system is trimming its executive team from nine to six and incentivizing 34 other employees to take early retirement.

17. Tacoma, Wash.-based Virginia Mason Franciscan Health laid off nearly 400 employees, most of whom are in non-patient-facing roles. The job cuts affected less than 2 percent of the health system’s 19,000-plus workforce.

18. Katherine Shaw Bethea Hospital in Dixon, Ill., will lay off 20 employees, citing financial headwinds affecting health organizations across the U.S. It will also leave other positions unfilled to reduce expenses amid rising labor and supply costs and reductions in payments by insurance plans. Affected employees largely work in administrative support areas and not direct patient care.

19. Danbury, Conn.-based Nuvance Health will close a 100-bed rehabilitation facility in Rhinebeck, N.Y., resulting in 102 layoffs. The layoffs are effective April 12, according to the Daily Freeman.

20. Charleston, S.C.-based MUSC Health University Medical Center laid off an unspecified number of employees from its Midlands hospitals in the Columbia, S.C. area. Division President Terry Gunn also resigned after the facilities missed budget expectations by $40 million in the first six months of the fiscal year, The Post and Courier reported March 30. 

21. Winston-Salem, N.C.-based Novant Health laid off about 50 workers, including C-level executives, the health system confirmed to Becker’s March 29. The layoffs affected Jesse Cureton, the health system’s executive vice president and chief consumer officer since 2013; Angela Yochem, its executive vice president and chief transformation and digital officer since 2020; and Paula Dean Kranz, vice president of innovation enablement and executive director of the Novant Health Innovation Labs. 

22. Penn Medicine Lancaster (Pa.) General Health eliminated fewer than 65 jobs, or less than 1 percent of its workforce of about 9,700, the health system confirmed to Becker’s March 30. The layoffs include support, administrative and executive roles, and COVID-19-related support staff, spokesperson John Lines said, according to lancasteronline.com. Mr. Lines did not provide a specific number of affected workers.

23. McLaren St. Luke’s Hospital in Maumee, Ohio, will lay off 743 workers, including 239 registered nurses, when it permanently closes this spring. Other affected roles include physical therapists, radiology technicians, respiratory therapists, pharmacists and pharmacy support staff, and nursing assistants. The hospital’s COO is also affected, and a spokesperson for McLaren Health Care told Becker’s other senior leadership roles are also affected.

24. Bellevue, Wash.-based Overlake Medical Center and Clinics laid off administrative staff, the health system confirmed to the Puget Sound Business Journal. The layoffs, which occurred earlier this year, included 30 workers across Overlake’s human resources, information technology and finance departments, a spokesperson said, according to the publication. This represents about 6 percent of the organization’s administrative workforce. Overlake’s website says it employs more than 3,000 people total.

25. Columbia-based University of Missouri Health Care is eliminating five hospital leadership positions across the organization, spokesperson Eric Maze confirmed to Becker’s March 20. Mr. Maze did not specify which roles are being eliminated saying that the organization won’t address individual personnel actions. According to MU Health Care, the move is a result of restructuring “to better support patients and the future healthcare needs of Missourians.”

26. Greensboro, N.C.-based Cone Health eliminated 68 senior-level jobs. The job eliminations occurred Feb. 21, Cone Health COO Mandy Eaton told The Alamance NewsOf the 68 positions eliminated, 21 were filled. Affected employees were offered severance packages. 

27. The newly merged Greensburg, Pa.-based organization made up of Excela Health and Butler Health System eliminated 13 filled managerial jobs. The affected employees and positions are from across both sides of the new organization, Tom Chakurda, spokesperson for the Excela-Butler enterprise, confirmed to Becker’s. The positions were in various support functions unrelated to direct patient care.

28. Crozer Health, a four-hospital system based in Upland, Pa., is laying off roughly 215 employees amid financial challenges. The system announced the layoffs March 15 as part of its “operational restructuring plan” that “focuses on removing duplication in administrative oversight and discontinuing underutilized services.” Affected employees represent about 4 percent of the organization’s workforce.

29. Philadelphia-based Penn Medicine is eliminating administrative positions. The change is part of a reorganization plan to save the health system $40 million annually, the Philadelphia Business Journal reported March 13. Kevin Mahoney, CEO of the University of Pennsylvania Health System, told Penn Medicine’s 49,000 employees last week that changes include the elimination of a “small number of administrative positions which no longer align with our key objectives,” according to the publication. The memo did not indicate the exact number of positions that were eliminated.

30. Sovah Health, part of Brentwood, Tenn.-based Lifepoint Health, eliminated the COO positions at its Danville and Martinsville, Va., campuses. The responsibilities of both COO roles will now be spread across members of the existing administrative team. 

31. Valley Health, a six-hospital health system based in Winchester, Va., eliminated 31 administrative positions. The job cuts are part of the consolidation of the organization’s leadership team and administrative roles. 

32. Marshfield (Wis.) Clinic Health System said it would lay off 346 employees, representing less than 3 percent of its employee base.

33. St. Mark’s Medical Center in La Grange, Texas, is cutting nearly 50 percent of its staff and various services amid financial challenges. 

34. Roseville, Calif.-based Adventist Health plans to go from seven networks of care to five systemwide to reduce costs and strengthen operations. The reorganization will result in job cuts, including reducing administration by more than $100 million.

35. Arcata, Calif.-based Mad River Community Hospital is cutting 27 jobs as it suspends home health services.

36. Hutchinson (Kan.) Regional Medical Center laid off 85 employees, a move tied to challenges in today’s healthcare environment. 

37. Oklahoma City-based OU Health eliminated about 100 positions as part of an organizational redesign to complete the integration from its 2021 merger.

38. Memorial Sloan Kettering Cancer Center announced it would lay off to reduce costs amid widespread hospital financial challenges. The layoffs are spread across 14 sites in New York City, and equate to about 1.8 percent of Memorial Sloan’s 22,500 workforce.

39. St. Louis-based Ascension completed layoffs in Texas, the health system confirmed in January. A statement shared with Becker’s says the layoffs primarily affected nonclinical support roles. The health system declined to specify to Becker’s the number of employees or positions affected.

40. Lebanon, N.H.-based Dartmouth Health is freezing hiring and reviewing all vacant jobs at its flagship hospital and clinics in an effort to close a $120 million budget gap. 

41. Chillicothe, Ohio-based Adena Health System announced it would eliminate 69 positions — 1.6 percent of its workforce — and send 340 revenue cycle department employees to Ensemble Health Partners’ payroll in a move aimed to help the health system’s financial stability.

42. Ascension St. Vincent’s Riverside in Jacksonville, Fla., will end maternity care at the hospital, affecting 68 jobs, according to a Workforce Adjustment and Retraining Notification filed with the state Jan. 17. The move will affect 62 registered nurses as well as six other positions.

43. Visalia, Calif.-based Kaweah Health said it aimed to eliminate 94 positions as part of a new strategy to reduce labor costs. The job cuts come in addition to previously announced workforce reductions; the health system already eliminated 90 unfilled positions and lowered its workforce by 106 employees. 

44. Oklahoma City-based Integris Health said it would eliminate 200 jobs to curb expenses. The eliminations include 140 caregiver roles and 60 vacant jobs.

45. Toledo, Ohio-based ProMedica announced plans to lay off 262 employees, a move tied to its exit from a skilled-nursing facility joint venture late last year. The layoffs will take effect between March 10 and April 1. 

46. Employees at Las Vegas-based Desert Springs Hospital Medical Center were notified of layoffs coming to the facility, which will transition to a freestanding emergency department. There are 970 employees affected. Desert Springs is part of the Valley Health System, a system owned and operated by King of Prussia, Pa.-based Universal Health Services.

47. Philadelphia-based Jefferson Health plans to go from five divisions to three in an effort to flatten management and become more efficient. The reorganization will result in an unspecified number of job cuts, primarily among executives.

48. Pikeville (Ky.) Medical Center said it would lay off 112 employees as it outsources its environmental services department. The 112 layoffs were effective Jan. 1, 2023.

49. Southern Illinois Healthcare, a four-hospital system based in Carbondale, announced it would eliminate or restructure 76 jobs in management and leadership. The 76 positions fall under senior leadership, management and corporate services. Included in that figure are 33 vacant positions, which will not be filled. No positions in patient care are affected. 

50. Citing a need to further reduce overhead expenses and support additional investments in patient care and wages, Traverse City, Mich.-based Munson Health said it would eliminate 31 positions and leave another 20 jobs unfilled. All affected positions are in corporate services or management. The layoffs represent less than 1 percent of the health system’s workforce of nearly 8,000. 

51. West Reading, Pa.-based Tower Health on Nov. 16 laid off 52 corporate employees as the health system shrinks from six hospitals to four. The layoffs, which are expected to save $15 million a year, account for 13 percent of Tower Health’s corporate management staff.

52. Sioux Falls, S.D.-based Sanford Health announced layoffs affecting an undisclosed number of staff in October, a decision its CEO said was made “to streamline leadership structure and simplify operations” in certain areas. The layoffs primarily affect nonclinical areas.

53. St. Vincent Charity Medical Center in Cleveland closed its inpatient and emergency room care Nov. 11, four days before originally planned — and laid off 978 workers in doing so. After the transition, the Sisters of Charity Health System will offer outpatient behavioral health, urgent care and primary care.

7 systems with recently affirmed credit ratings

Below is a summary of hospitals and health systems that have recently received affirmations of existing credit ratings. Some of these have not been reported on previously.

  1. New York City-based cancer specialist Memorial Sloan Kettering Cancer Center was affirmed by Fitch Ratings May 22 at “AA” with a stable outlook both for its default rating and on a series of bonds totaling approximately $2.6 billion.
  2. Baltimore-based University of Maryland Medical System had an “A” rating affirmed on a series of bonds May 19 amid its robust operating profile and status as a premier healthcare provider in Maryland, S&P Global said. The 12-hospital system reported an operating loss of $8.9 million for the nine months ending March 31.
  3. Oakland, Calif.-based Kaiser Permanente had its “AA” default rating and that on a series of bonds affirmed May 15 by Fitch as the system was able to maintain a strong financial profile even in the face of a challenging operating environment.
  4. Providence, R.I.-based Care New England has had its default rating and that on $135.8 million of bonds affirmed at “BB-,” Fitch Ratings said May 12. The system’s outlook remains negative.The ratings reflect Care New England’s “ongoing operational challenges and thin liquidity,” Fitch said. While operating performance is expected to improve, there remains a low cash position of concern, the note said.
  5. New Hyde Park, N.Y.-based Northwell Health had an “A-” rating affirmed on a series of bonds amid strong market share and robust financial performance, Fitch said April 28. The 21-hospital system had $15.6 billion revenues in 2022.
  6. While its relatively weaker operating performance may continue in the shorter term, Rochester, Minn.-based Mayo Clinic has had its long-term ratings affirmed because of its excellent reputation in overall health services, both S&P Global and Moody’s said.Mayo Clinic’s revenue bonds remain at “AA” with a stable outlook, S&P said. Mayo Clinic’s “Aa2” stable credit profile is characterized by its excellent reputations for clinical services, research and education, Moody’s said.
  7. Moody’s affirmed New York City-based Montefiore Health System‘s “Baa3” rating because of the 10-hospital system’s leading market share in the Bronx, its clinical expertise, and its flagship status as the primary teaching hospital for Albert Einstein College of Medicine.

Providence reports Q1 operating loss of $345M

Renton, Wash.-based Providence has reported a $345 million operating loss in the first quarter on revenue of $6.8 billion.

While revenues were up on the same period in 2022, expenses also rose 5.1 percent to total $7.1 billion. The operating loss compares with a $510 million loss in the first quarter of 2022.

Improving non-operating income, mainly from investment returns, helped mitigate the net loss to $117 million compared with an $840 million net loss in the same period last year, excluding the disaffiliation of Newport Beach, Calif.-based Hoag.

The 51-hospital system reiterated it is taking a number of initiatives to reduce some of its costs under its Destination Health 2025 Recover and Renew plan. One of those prime areas of focus is reducing staffing costs, particularly in regard to contract labor, which continues to be a challenge for Providence.

“With current labor shortages, the use of premium labor, including the number and wage rate of agency nurses, continues to be significantly higher than in previous years,” management said in its filing. “Several initiatives are underway to reduce those expenses in combination with increasing core productivity.”

Providence is also undergoing portfolio management reassessment to try and improve efficiencies and save costs, according to the filing.

The system, which had $7.8 billion long-term debt as of March 31, provided $563 million in community benefit in the first quarter, up from $412 million in the same period of 2022.

“Together, we will continue meeting the health care needs of our communities, no matter how challenging the environment gets, and will ensure the mission of Providence thrives for years to come,” Rod Hochman, MD, Providence president and CEO said in the filing.

United Healthcare: Anatomy of a Behemoth


In the mid-1980’s, managed care advocate Dr. Paul Ellwood predicted that eventually, US healthcare would be dominated by perhaps a dozen vast national firms he called SuperMeds that would combine managed care based health insurance with care delivery systems. Ellwood was a leader of the “managed competition” movement which advocated for a private sector alternative to a federal government-run National Health Insurance system. Ellwood and colleagues believed that Kaiser Foundation Health Plans and other HMOs would be able to stabilize health costs and thus affordably extend care to the uninsured.

The US political system and market dynamics would not co-operate with Ellwood and his Jackson Hole Group’s vision. In the ensuing thirty-five years, healthcare has remained both highly fragmented and regional in focus. However, unbeknownst to most, during the past decade, as a result of a major merger and relentless smaller acquisitions, two SuperMeds were born- CVS/Aetna and UnitedHealth Group, that whose combined revenues comprise 14% of total US health spending.

CVS/Aetna is slightly larger than United, by dint of grocery sales in its drugstores and its vast Caremark pharmacy benefits management business. However, CVS’s Aetna health insurance arm is one third the size of United’s, and though CVS is rapidly scaling up its care delivery apparatus through its in-store Health Hubs, it remains is a tiny fraction of United’s care footprint. Despite being slightly smaller at the top line, United’s market capitalization is more than 3.5 times that of CVS.

United’s vast scope is difficult to comprehend because much of it is not visible to the naked eye, and the most rapidly growing businesses are partly nested inside United’s health insurance business.

United employs over 300 thousand people. At $287.6 billion total revenues in 2021, United exceeded 7% of total US health spending (though $8.3 billion are from overseas operations).

In 2021, United was $100 billion larger than the British National Health Service. It is more than three times the size of Kaiser Permanente, and five times the size of HCA, the nation’s largest hospital chain. United is both larger and richer than energy giant Exxon Mobil. United has over $70 billion in cash and investments, and is generating about $2 billion a month in operating cash flow.

Its highly regulated health insurance business is the visible tip of a rapidly growing iceberg. Revenue from United’s core health insurance business grew at 11% in 2021, compared to 14% growth in United’s diversified Optum subsidiary. Optum generated $155.6 billion in 2021 (of which 60% were from INSIDE United’s health insurance business). You can see the relationship of Optum’s three major businesses to United’s health insurance operations in Exhibit I.

Optum is the Key to United’s Growth

Understanding the role of Optum is key to understanding United’s business. It is remarkable how few of my veteran health care colleagues have any idea what Optum is or what it does. Optum was once a sort of dumping ground for assorted United acquisitions without a seeming core purpose. A private equity colleague once derided Optum as “The Island of Lost Toys”. Now, however, Optum is driving United’s growth, and generates billions of dollars in unregulated profits both from inside the highly regulated core health insurance business and from external customers.

Optum consists of three parts: Optum Health, its care delivery enterprise ($54 billion revenues in 2021), Optum Rx, its pharmacy benefits management enterprise ($91 billion revenues in 2021) and Optum Insight, a diversified business services enterprise ($12.2 billion in 2021). Virtually all of United’s acquisitions join one of these three businesses.

Optum Health: The Third Largest Care Delivery Enterprise in the US

By itself, Optum Health is almost the size of HCA ($54 billion in 2021 vs HCA’s $58.7 billion) and consists of a vast national portfolio of care delivery entities: large physician groups, urgent care centers, surgicenters, imaging centers, and now by dint of the recently announced $5.7 billion acquisition of LHC, home health agencies. Optum Health has studiously avoided acquiring beds of any kind: hospitals, nursing homes, etc. and likely will continue to do so. Optum Health’s physician groups not only generate profits on their own, but also provide powerful leverage for United to control health costs for its own subscribers, pushing down United’s highly visible and regulated Medical Loss Ratio (MLR), and increasing health plan profits.

Optum Health began in 2007 when United acquired Nevada-based Sierra Health, and thus became the new owner of a small multispecialty physician group which Sierra owned. The group did not belong in United’s health insurance business and came to rest over in Optum. Over the past twelve years, Optum Health has acquired an impressive percentage of the major capitated medical groups in the US- Texas’ WellMed, California’s HealthCare Partners (from DaVita), as well as Monarch, AppleCare and North American Medical Management, Massachusetts’ Reliant (formerly Fallon Clinic) and Atrius in Massachusetts (pending) , Kelsey Seybold Clinic (also pending) in Houston, TX and Everett Clinic and PolyClinic in Seattle.

Optum Health claims over 60 thousand physicians, though many of these are actually independent physicians participating in “wrap around” risk contracting networks. By comparison, Kaiser Permanente’s Medical Groups employ about 23 thousand physicians. United’s management claims that Optum Health provides continuing care to about 20 million patients, of whom 3 million are covered by some form of so-called “value based” contracts. Perhaps half of this smaller number are covered by capitated (percentage of premium-PMPM) contracts.

Optum Health straddles fierce competitive relationships between United’s health insurance business and competing health plans in well more than a dozen metropolitan areas. Almost half (44%) of Optum Health’s revenues come from providing care for health plans other than United.

When Optum acquires a large physician group, it acquires those groups’ contracts with United’s health insurance competitors, some of which contracts have been in place for decades. Premium revenues from other health plans, presumably capitation or per member per month (PMPM) revenues, are one-quarter of Optum Health’s $54 billion total revenues. These “external” premium revenues have quadrupled since 2018, largely for Medicare Advantage subscribers. Optum Health contributes about $4.5 billion in operating profit to United. It is impossible to determine from United’s disclosures how much of this profit comes from Optum Health’s services provided to United’s insured lives and how much from its medical groups’ extensive contracts with competing health plans.

Optum Health’s surgicenters and urgent care centers provide affordable alternatives to using expensive hospital outpatient services and emergency departments, potentially further reducing United medical expense. This creates obvious tensions with United’s hospital networks, since Optum Health can use its large medical practices and virtual care offerings to divert patients from hospitals to its own services, or else render those services unnecessary.

Though some observers have termed Optum/United’s business model “vertical integration”-ownership of the suppliers to and distributors of a firm’s product– Optum Health has actually grown less vertical since 2018, with revenues from competing health plans growing from 36% of total revenues in 2018 to 44% in 2021. A 2018 analysis by ReCon Strategy found at best a sketchy matchup between United’s health plan enrollment by market and its Optum Health assets (https://reconstrategy.com/2018/04/uniteds-medicare-advantage-footprint-and-optumcare-network-do-not-overlap-much-so-far/.

Optum Rx: The Nation’s Third Largest Pharmacy Benefits Management Business

Optum’s largest business in revenues is its Optum Rx pharmaceutical benefits management (PBM) business, which generates $91 billion in revenues, and processes over a billion pharmacy claims not only for United but also many competing insurers and employer groups. Pharmaceutical costs are a rapidly growing piece of total medical expenses, and controlling them is yet another source of largely unregulated profits for United; Optum Rx generated over $4.1 billion of operating profit in 2021.

Optum Rx is the nation’s third largest PBM business after Caremark, owned by CVS/Aetna and Express Scripts, owned by CIGNA, and processes about 21% of all scripts written in the US. Pharmacy benefits management firms developed more than two decades ago to speed the conversion of patients from expensive branded drugs to generics on behalf of insurers and self-funded employers. They were given a big boost by George Bush’s 2004 Medicare Part D Prescription Drug benefit, as a “pro-competitive” private sector alternative to Medicare directly negotiating prices with pharmaceutical firms.

Reducing drug spending is one key to United’s profitability. Since generics represent almost 90% of all prescriptions written, Optum Rx now relies on fees generated by processing prescriptions and on rebates from pharmaceutical firms to promote their costly branded drugs as preferred drugs on Optum Rx’s formularies. These rebates are determined based on “list” prices for those drugs vs. the contracted price for the PBMs, and are actual cash payments from manufacturers to PBMs.

Drug rebates represent a significant fraction of operating profits for health insurers that own PBMs, particularly for their older Medicare Advantage patients that use a lot of expensive drugs. Unfortunately, PBMs have incentives to inflate the list price, because rebates are caculated based on the spread between list prices and the contract pricel Unfortunately, this increases subscribers’ cash outlays, because patient cost shares are based on list prices.

Optum Rx generates about 39% of its revenues (and an undeterminable percentage of its profits) serving other health insurers and self-funded employers. Many of those self-funded employers demand that Optum pass through the rebates directly to them (even if it means being charged higher administrative fees!).

Unlike the situation with Optum Health, the “verticality” of Optum’s PBM business-the percentage of Optum revenues derived from serving United subscribers- has increased in the last seven years, to more than 60% of Optum Rx’s total business. What happens to the billions of dollars in rebates generated by Optum Rx is impossible to determine from United’s disclosures. However, our best guess is that pharmaceutical rebates represent as much as a quarter of United’s total corporate profits.

Optum Insight: “Intelligent” Business Solutions

The fastest growing and by far the most profitable Optum business is its business intelligence/business services/consulting subsidiary. Optum Insight was generated $12.2 billion in revenues in 2021, but a 27.9% operating margin, five times that of United’s health insurance business. Optum Insight is strategically vital to enhancing the profitability of United’s health insurance activities, but also generates outside revenues selling services to United’s health insurance competitors and hospital networks.

The core of Optum Insight is a business intelligence enterprise formerly known as Ingenix, which provided “big data” to United and other insurers about hospital and pricing behavior and utilization-crucial both for benefits design and administration. In 2009, Ingenix was accused by New York State of under reporting prices for out of network health services for itself and its clients, which had the effect of reducing its own medical reimbursements, and increasing patient cost shares. United signed a consent decree to alter Ingenix business practices and settled a raft of lawsuits filed on behalf of patients, physicians and employers. Its name was subsequently changed to Optum Insight.

By dint of aggressive acquisitions, Optum Insight has dramatically increased its medical claims management business, consulting services and business process outsourcing activities. . Most of United’s investment in artificial intelligence can be found inside Optum Insight. Big data plays a crucial role in United’s overall strategy. Optum Insight’s claims management software uses vast medical claims data bases and artificial intelligence/machine learning software to spot and deny medical claims for which documentation is inadequate or where services are either “inappropriate” or else not covered by an individual’s health plan. Providers also claim that the same software rejects as many as 20% of their claims, often for problems as tiny as a mis-spelled word or a missing data field.

Optum Insight software plays a crucial role in helping United’s health insurance plans manage their medical expense. Traditional health plan profitability is generated by reducing medical expense relative to collected premiums to increase underwriting profit. These profits are regulated, with highly variable degrees of rigor by state health insurance commissioners, and also by provisions of ObamaCare enacted in 2010.

Though its acquisition of Equian in 2019 and the proposed $13 billion acquisition of health information technology conglomerate Change Healthcare in 2021, United came within an eyelash of a near monopoly on “intelligent” medical claims processing software. The Justice Department challenged this latter acquisition and United may agree to divest Change’s claims processing software business as a condition of closing the deal. Even without the Change acquisition, Optum Insight processes hundreds of millions of medical claims annually not only for United’s health insurance business but for many of United’s competitors.

However, Optum Insight’s claims management system can also be used to increase MLR if medical expense unexpectedly declines, exposing the firm to federal requirement that it rebate excessive ‘savings’ to subscribers. This happened in 2020, when the COVID pandemic dramatically and unexpectedly added billions to United’s earnings due to hospitals suspending elective care. The chart below shows United’s 2Q2020 earnings per share almost doubling due to the precipitous drop in its medical claims expenses!

Hospital finance colleagues reported an immediate and substantial drop in medical claims denials from United and other carriers in the summer and fall of 2020. United’s quarterly profits dutifully and steeply declined in the subsequent two quarters, because its medical expenses sharply rebounded. The rise in

United’s medical expenses helped the firm avoid premium rebates to patients required by provisions of the ObamaCare legislation passed in 2010. The firm did voluntarily rebate about $1.5 billion to many of its customers in June, 2020.

However the most rapidly growing part of Optum Insight is its Optum 360 business process outsourcing business, which helps hospitals manage their billing and collections revenue cycle, as well as information technology operations, supply chain (purchasing and materials management) and other services. Through Optum 360, Optum Insight has signed five long term master contracts in the past two years’ worth many billions of dollars with care providers in California, Missouri and other states to provide a broad range of business services.

With all these different businesses, it is theoretically possible for one piece of Optum to be reducing a hospital’s cash flow by denying medical claims for United subscribers, while United’s health insurance network managers bargain aggressively to reduce the hospital’s reimbursement rates while yet another piece of Optum runs the billing and collection services for the same hospital and its employed physicians, while yet another piece of Optum competes with the hospital’s physicians and ambulatory services, diverting patients from its ERs and clinics, reducing the hospital’s revenues.

It is not difficult to imagine a future in which Optum/United offers hospital systems an Optum 360 outsourcing contract that run most of the business operations of a hospital system in exchange for preferred United health plan rates, an AI-enabled EZ pass on its medical claims denials and inpatient referrals from Optum physician groups and urgent care centers, at the expense of competing hospitals.

Managing these potential conflicts will be an increasing challenge as these various businesses grow, placing intense pressure on United’s leadership to get the various pieces of United to work together. To many anxious hospital executives, United resembles nothing so much as the Kraken, rising up out of the sea, surrounding and engulfing them- a powerful friend perhaps or a fearsome foe. As you might expect, United’s growing market power and growth has generated a fierce backlash in the hospital management community.

What Business is United Healthcare In?

United Healthcare is the most successful business in the history of American healthcare. The rapid growth of Optum and continued health insurance enrollment growth from government programs like Medicaid and Medicare has created a cash engine which generates nearly $2 billion a month in free cash flow. Optum’s portfolio has given United an impressive array of tools, unequalled in the industry, to improve its profitability and to reach into every corner of the US health system. United Healthcare is managed care on steroids.

United’s diversified portfolio of businesses gives the firm what a finance-savvy colleague termed “optionality”- the ability to redirect capital and management attention to areas of growth and away from areas that have ceased to grow, in the US or overseas. With its substantial investable capital, it will have the pick of the litter of the 11 thousand digital health companies as the overextended digital health market consolidates. United will be able to use its vast resources to build state-of-the-art digital infrastructure to reach and retain patients and manage their care.

United’s main short term business risks seem to be running out of accretive transactions effectively to deploy its growing horde of capital and managing the firm’s rising political exposure. United has had tremendous business discipline and has shied away from speculative acquisitions that are not immediately accretive to earnings. If its earnings growth falters, however, it will also encounter pressure from the investment community to increase dividends (presently about 1.2%) or share buybacks to bolster its share price, or else divest some or all of Optum in order to “maximize shareholder value”.

Answering the question, “What Business is United In” is simple: just about everything in health but hospitals and nursing homes.

Answering the questions- who are its customers and what do they want? — is a great deal harder. The customers United serves are in a sort of cold war with one another. United’s original business was protecting employers from health cost growth , and tempering the influence of hospitals and doctors by reducing their rates and utilization. By fostering so-called Consumer Directed Health Plans that expose many of their subscribers to very high front-end copayments, United and its health insurance brethren, have also increased their out-of-pocket costs, whether they have the savings to pay them or not.

There are also some ironies in United’s development. Optum Insight’s suite of hospital business services are designed to reduce administrative costs created in major part by United and other insurers’ medical claims data requirements. Its PBM business, originally intended to reduce drug spending by bargaining aggressively with pharmaceutical manufacturers has ended up pushing up drug list prices and consumer cost shares.

While presumably everybody benefits if United can somehow help patients become and remain healthy, it is still far from obvious how to do this. Managing all these markedly divergent customer needs will be a tremendous management challenge for whoever succeeds United’s reclusive (and very effective) 70 year old Chairman Stephen Hemsley.

What Does Society Get from this Vast Enterprise?

However, as Peter Drucker told a different generation of business giants, businesses are not entities unto themselves, accountable only to shareholders and customers. They are organs of society, and are expected to create social value. Americans are suspicious of vast enterprises, as businesses from Standard Oil, US Steel and ATT to Microsoft and Facebook have learned. As businesses grow and become more successful, public suspicion grows.

Private health insurers already face strident opposition from progressive Democrats, who believe that health coverage ought to be a public good, a right of citizenship provided publicly; in other words, that private health insurers have no business being in business. And large insurers like United also face intense opposition from hospitals and many physicians because they reduce their incomes and impose major administrative burdens upon them.

In the age of Twitter and TikTok, United is highly vulnerable to “event risks” that confirm the hostile narratives of the firm’s detractors that United is mainly about maximizing its own profits, not about improving the health of its subscribers or the communities it serves. It is not clear how many the tens of millions of United subscribers have warm and fuzzy feelings about their giant health insurer. Memories of the HMO backlash of the 1990’s reside in the firm’s corporate memory.

United has grown to its present immense scale largely without public knowledge. United has within its reach the capability of constraining overall health cost growth across dozens of metropolitan areas and regions, not merely cost growth for its own beneficiaries (roughly one in seven US citizens already get their health insurance through United). With its expanding digital health operations, it can deploy state of the art tools for helping United’s 50 million subscribers avoid illness and live healthier lives.

United also has the ability to damage the financial operations of beloved local hospitals and deny coverage to families, raising their out of pocket expenses. How United frames and defends its social mission and how it manages all the delicate and increasingly fraught customer relationships will determine its future, and in important ways, ours as well.