Inflation, labor pressures, and general economic uncertainty have created significant financial strain for hospitals in the wake of the COVID pandemic. Compressed operating margins and weakened liquidity have left many hospitals in a precarious economic situation, with some entities deciding to delay or even cancel planned capital expenditures or capital raising. Given these tumultuous times, hospital entities could look to the realm of the higher education sector for a playbook on how to leverage non-core assets to unlock significant unrealized value and strengthen financial positions, in the form of public-private partnerships.
These structures, also known as P3s, involve collaborative agreements between public entities, like hospitals, and private sector partners who possess the expertise to unlock the value of non-core assets. A special purpose vehicle (SPV) is created, with the sole purpose of delivering the responsibilities outlined under the project agreement. The SPV is typically owned by equity members. The private sector would be responsible for raising debt to finance the project, which is secured by the obligations of the project agreement (and would be non-recourse to the hospital). Of note, the SPV undergoes the rating process, not the hospital entity. Even more importantly, the hospital retains ownership of the asset while benefiting from the expertise and resources of the private sector.
Hospitals can utilize P3s to capitalize on already-built assets, in what is known as a “brownfield” structure. A brownfield structure would typically result in an upfront payment to the hospital in exchange for the right of a private entity to operate the asset for an agreed-upon term. These upfront payments can range from tens of millions to hundreds of millions of dollars.
Alternatively, hospitals can engage in “greenfield” structures where the underlying asset is either not yet built or needs significant capital investment. Greenfield structures typically do not result in an upfront payment to the hospital entity. Instead, (in the example of a new build) private partners would typically design, build, finance, operate and maintain the asset. The hospital still retains ownership of the underlying asset at the completion of the agreed upon term.
P3 structures can be individually tailored to suit the unique needs of the hospital entity, and the resulting benefits are multifaceted. Financially, hospitals can increase liquidity, lower operating expenses, increase debt capacity, and create headroom for financial covenants. These partnerships provide a means to raise funds without directly accessing the capital markets or undergoing the rating process. Upfront payments represent unrestricted funds and can be used as the hospital entity sees fit to further its core mission. Operationally, infrastructure P3s offer hospitals the opportunity to address deferred maintenance needs, which may have accumulated over time. Immediate capital expenditure on infrastructure facilities can enhance reliability and efficiency and contribute to meeting carbon reduction or sustainability goals. Furthermore, these structures provide a means for the hospital to transfer a meaningful amount of risk to private partners via operation and maintenance agreements.
For years, various colleges and universities have adopted the P3 model, which is emerging as a viable solution for hospitals as well. Examples of recent structures in the higher education sector include:
Fresno State University, which partnered with Meridiam (an infrastructure private equity fund) and Noresco (a design builder) to deliver a new central utility plant. The 30-year agreement involved long-term routine and major maintenance obligations from the operator, with provisions for key performance indicators and performance deductions inserted to protect the university. Fresno State is not required to begin making availability payments until construction is completed.
The Ohio State University, which secured a $483 million upfront payment in exchange for the right of a private party to operate and maintain its parking infrastructure. The university used the influx of capital to hire key faculty members and to invest in their endowment.
The University of Toledo, which received an approximately $60 million upfront payment in exchange for a 35-year lease and concession agreement to a private operator. The private team will be responsible for operating and maintaining the university’s parking facilities throughout the term of the agreement.
Ultimately, healthcare entities can learn from the successful implementation of infrastructure P3 structures in the higher education sector. The experiences of Fresno State, The Ohio State University, and the University of Toledo (among others) serve as compelling examples of the transformative potential of P3s in the healthcare sector. By unlocking the true value of non-core assets through partnerships with the private sector, hospitals can reinforce their financial stability, meet sustainability goals, reduce risk, and shift valuable focus back to the core mission of providing high-quality healthcare services.
Author’s note: Implementing P3 structures requires careful consideration and expert guidance. Given the complex nature of these partnerships, hospitals can greatly benefit from the support of experienced advisors to navigate the intricacies of the process. KeyBank and Cain Brothers specialize in guiding entities through P3 initiatives, providing valuable expertise and insight. For additional information, please refer to a recording of our recent webinar and associated summary, which can be accessed here: https://www.key.com/businesses-institutions/business-expertise/articles/public-private-partnerships-can-unlock-hospitals-hiddenvalue.html
Despite a reasonably solid third quarter, Trinity Health is still operating at a loss in its 2023 fiscal year, according to a new filing.
The health system’s fiscal year began July 1, 2022, with the latest figures covering the first nine months. Its latest operating loss shrank to $263.1 million from the prior six months’ $298 million loss. Fiscal year 2023 operating revenue currently stands at $15.9 billion, up from the same period last year.
The nonprofit health system attributed its operating revenue growth to several acquisitions (MercyOne, North Ottawa Community Health System, Genesis Health System), which collectively added $1 billion of operating revenue. Net income for the last nine months was $856.3 million, compared to $43 million in the same period the prior year.
Though inpatient volumes are stabilizing to “a new normal,” management wrote in the latest filing, most of Trinity’s revenue comes from outpatient and other non-patient revenue. Operating expenses rose $1.1 billion compared to the same period in fiscal year 2022, mostly driven by the acquisitions.
Nonoperating income was $1.2 billion during the first nine months of fiscal year 2023, up from $264.6 million in the first six months. This hike was driven partly by a $629.3 million increase in investment returns.
The health system’s operating margin was 1.6%, per the latest filing, compared to 0.1% during the same period a year ago. Margins were affected by expenses outpacing revenue, primarily driven by premium labor rates and inflation impacting supplies as well as a $137 million reduction in CARES Act grant funding.
Trinity reports $10.2 billion in unrestricted cash and investments, including 180 days cash on hand compared to 211 days in fiscal year 2022, in its latest filing.
Trinity is focused on diversifying its business by shifting to ambulatory, home health, PACE, urgent care, specialty pharmacy and telehealth. The filing also noted the recent launch of a new care delivery model dubbed TogetherTeam, involving on-site and virtual nurses, that is expected to be implemented systemwide by the end of its 2024 fiscal year.
Salaries, wages and employee benefit costs rose 2.2%, offset by a reduction of $54.6 million in executive compensation and $39.7 million more pharmacy rebates than in the same period in fiscal year 2022. Same-facility contract labor costs decreased more than 40% to $193.9 million, reflecting “unprecedented” pandemic-related costs during the third quarter in 2022.
Trinity “continues to use strong cost controls over contract labor and other operational spending as colleague investment and utilization of its FirstChoice internal staffing agency promotes labor stabilization,” management wrote.
Trinity Health spans 88 acute care hospitals and hundreds of other care locations in 26 states and purports to have the second-largest Medicare PACE (Program of All-inclusive Care for the Elderly) program in the country. It provided services to 1.3 million people and reported a community benefit and charity of $1.4 billion in fiscal year 2022.
BJC HealthCare of St. Louis and Saint Luke’s Health System of Kansas City are exploring a merger that would yield a 28-hospital, $10 billion, integrated, academic health system, the nonprofits announced Wednesday.
The two have signed a nonbinding letter of intent and “are working toward reaching a definitive agreement in the coming months” with a targeted close before the end of the year, they said. The cross-market deal would be subject to regulatory review and other customary closing conditions.
“Together with Saint Luke’s, we have an exciting opportunity to reinforce our commitment to providing extraordinary care to Missourians and our neighboring communities,” BJC HealthCare President and CEO Richard Liekweg said in the announcement. “Amid the rapidly changing health care landscape, this is the right time to build on our established relationship with Saint Luke’s. With an even stronger financial foundation, we will further invest in our teams, advance the use of technologies and data to support our providers and caregivers and improve the health of our communities.”
Both systems are based in Missouri but “serve distinct geographic markets,” they said.
St. Louis-based BJC Healthcare’s footprint is spread across the greater St. Louis, southern Illinois and southeast Missouri regions. It comprises 14 hospitals including two (Barnes-Jewish and St. Louis Children’s) affiliated with Washington University School of Medicine. It also operates multiple health service organizations providing home health, long-term care, workplace health and other offerings.
Kansas City, Missouri-based Saint Luke’s is a faith-based system with 14 hospitals and more than 100 offices throughout western Missouri and parts of Kansas. It also provides home care and hospice, adult and children’s behavioral care and a senior living community.
Should the deal close, both systems would continue to serve their existing markets and maintain their branding. The joined organization would be run from dual headquarters with BJC’s Liekweg as CEO but an initial board chair hailing from Saint Luke’s.
The organizations said their combination will expand the services available to patients and provide an estimated $1 billion in annual community benefits. The arrangement would also fuel clinical and academic research while supporting greater workforce investment.
“Our integrated health system, with complementary expertise and team of world-class physicians and caregivers, will set a new national standard for medical education and research,” Saint Luke’s President and CEO Melinda Estes, M.D., said in the announcement. “Through our decade-long relationship as a member of the BJC Collaborative, we’ve established mutual trust and respect, so the opportunity to come together as a single integrated system that can accelerate innovation to better serve patients is a logical next step.”
Years of health system consolidation have led to increased scrutiny from regulators and lawmakers, who have worried that mergers can harm competition. To date, however, efforts to block announced deals have been limited to situations where the parties are operating in the same geographic markets.
Larger, cross-market deals like BJC and Saint Luke’s have become more common in the past year, potentially due to the opportunity to distribute operational risks with limited regulatory scrutiny, analysts have noted.
Multiple health policy researchers have warned that these deals are relatively understudied and, according to some prior analyses, very rarely translate to the quality and consumer cost savings often touted by health systems.
Pennsylvania unions have filed a complaint with the Department of Justice alleging integrated hospital giant UPMC is abusing its dominant market position to suppress wages and retain workers.
On Thursday, SEIU Healthcare Pennsylvania and a coalition of labor unions filed a 55-page complaint against UPMC, the largest private employer in the state, saying the hospital system’s size has allowed it to stamp out wage growth, “drastically increase” workload and keep workers from departing to other jobs.
The unions are asking federal regulators to investigate UPMC for antitrust violations, citing its dominance of the healthcare market in select regions of Pennsylvania. UPMC denied allegations of wage suppression.
Dive Insight:
The Pittsburgh-based system has seen a rise in labor complaints, according to the unions, as the system has grown into its 41-hospital footprint through a series of mergers and acquisitions. UPMC, which also operates 800 doctors offices and clinics and a handful of health insurance offerings, reported $26 billion in operating revenue last year.
Attempts in the last decade to organize UPMC’s hourly workers have been unsuccessful, according to SEIU.
Matt Yarnell, president of SEIU Healthcare Pennsylvania, called the complaints groundbreaking on a Thursday call with reporters, saying that no entity has ever filed a complaint arguing that mobility restrictions and labor violations are anticompetitive, and in violation of antitrust law.
The complaint alleges that, for every 10% increase in market share, the wages of UPMC workers falls 30 to 57 cents an hour on average. UPMC hospital workers face an average 2% wage gap compared to non-UPMC facilities, according to a study cited in the complaint.
In addition, the labor groups allege that UPMC’s staffing ratios have fallen over the past decade, resulting in its staffing ratios being 19% lower on average compared with non-UPMC care sites as of 2020.
The unions are going after UPMC for being a “monopsony,” or a company that controls buying in a given marketplace, including controlling a large number of jobs. UPMC has some 92,000 workers, according to the complaint, and has cut off avenues of competition through non-compete agreements, in addition to preventing employees from unionizing.
“If, as we believe, UPMC is insulated from competitive market pressures, it will be able to keep workers’ wages and benefits — and patient quality — below competitive levels, while at the same time continually imposing further restraints and abuses on workers to maintain its market dominance,” the complaint states. “Because we believe this conduct is contrary to Section 2 of the Sherman Act, we respectfully urge the Department of Justice to investigate UPMC and take action to halt this conduct.”
In response to the allegations, UPMC said it has the highest entry-level pay of any provider in the state, and offers “above-industry” employee benefits. UPMC’s average wage is more than $78,000, Paul Wood, UPMC’s chief communications officer, told Healthcare Dive in a statement.
“There are no other employers of size and scope in the regions UPMC serves that provide good paying jobs at every level and an average wage of this magnitude,” Wood said.
Healthcare workers are increasingly pushing for better working conditions and pay amid the COVID-19 pandemic, as hospitals grapple with recruitment and retention issues driven by burnout and heightened labor costs.
Congressional Republicans and the White House reached a deal over the weekend to raise the debt ceiling that includes healthcare wins for both sides of the aisle, creating a path forward to prevent economic upheaval roughly a week before a potential federal default.
The 99-page agreement released Sunday to suspend the debt ceiling until January 2025 doesn’t include Medicaid work requirements, a key priority for the White House, but it does claw back billions of unspent COVID-19 relief funds.
The bill, which already faces opposition from some hard-right Republicans, could still be halted in Congress. The government could run out of money to meet its payment obligations as early as Monday without a debt ceiling increase, according to the Treasury Department, with a default threatening Medicare and Medicaid reimbursements to states and providers.
What’s in the agreement
The deal claws back roughly $30 billion in unspent pandemic relief fundsfrom dozens of programs under the CMS, National Institutes of Health and Centers for Disease Control and Prevention, among other agencies.
However, the White House did retain money for some COVID priorities. The Biden administration will retain about $5 billion to develop coronavirus vaccines and treatments in Project NextGen, and to cover the cost of those therapies for uninsured people, according to The New York Times.
The deal leaves healthcare-related federal entitlement programs mostly untouched, a key win touted by the White House in its messaging to Democrats. Despite being targeted by Republicans during negotiations, Medicare, Medicaid and the Inflation Reduction Act emerged unscathed.
Medicaid was particularly at risk. Though the final agreement excludes Medicaid work requirements, last month Republicans in the House passed a debt ceiling bill that would have included the controversial policy. Those requirements would have resulted in an estimated 600,000 people being booted from the safety-net insurance coverage, according to the Congressional Budget Office.
“One thing this budget deal suggests: Democrats won’t go along with Republican proposals to cut or impose restrictions on Medicaid,” tweeted Larry Levitt, executive vice president of health policy at the Kaiser Family Foundation.
If passed, however, the deal would enact work rules for people receiving federal food stamps and those on the family welfare benefits program. Veterans and homeless people would be exempt from food stamp work requirements.
Those provisions put food assistance at risk for very low-income older adults, and “will increase hunger and poverty among that group,” nonpartisan think tank the Center on Budget and Policy Priorities said in a statement on the bill.
The agreement also increases funding for the Cost of War Toxic Exposures Fund, created by bipartisan legislation last summer that expanded healthcare and disability benefits for veterans exposed to toxic burn pits.
The House Rules Committee, which includes a number of critics of House Speaker Kevin McCarthy, R-Calif., who spearhead the negotiations for Republicans, will discuss the legislation Tuesday afternoon.
A full House vote on the bill could come as soon as Wednesday. Senate Majority Leader Chuck Schumer, D-N.Y., has said the Senate will immediately move to consider the bill once it leaves the House.
Healthcare’s most recent billion-dollar deal took the industry by surprise, leaving medical experts and hospital leaders grappling to comprehend its implications.
In case you missed it, California-based Kaiser Foundation Health Plan and Hospitals, which make up the insurance and facilities half of Kaiser Permanente, announced the acquisition of Geisinger, a Pennsylvania-based health system once acknowledged by President Obama for delivering “high-quality care.”
Upon regulatory approval, Geisinger will become the first organization to join Risant Health, Kaiser Foundation’s newly created $5 billion subsidiary. According to Kaiser, the aim is to build “a portfolio of likeminded, nonprofit, value-oriented, community-based health systems anchored in their respective communities.”
Having spent 18 years as CEO of The Permanente Medical Group, the half of Kaiser Permanente responsible for the delivery of medical care, I took great interest in the announcement. And I wasn’t alone. My phone rang off the hook for weeks with calls from reporters, policy experts and healthcare executives.
After hundreds of conversations, here are the three most common questions I received about the acquisition—and the implications for doctors, insurers, health-system competitors and patients all over the country.
Question 1: Why did Kaiser acquire Geisinger?
Most callers wanted to know about Kaiser’s motivation, figuring there must’ve been more to the acquisition than the press release indicated. Although I don’t have inside information, I believe they were right. Here’s why:
Kaiser Permanente has a long and ongoing reputation for delivering nation-leading care. The organization has consistently earned the highest quality and patient-satisfaction rankings from the National Committee for Quality Assurance (NCQA), Leapfrog Group, JD Power and Medicare.
And yet, despite a 78-year history, dozens of hospitals and 13 million members across eight states, Kaiser Permanente is still considered a coastal—not national—health system. It maintains a huge market share in California and a strong presence in the Mid-Atlantic states, yet the organization has failed repeatedly to replicate that success in other geographies.
With that context, I see two compelling reasons why the Kaiser Foundation Health Plan and Hospitals wish to become a national brand:
Influence. Elected officials and regulatory bodies often turn to healthcare’s biggest players to set legislative agendas and carve out national policy. At that table, there are a limited number of seats. By shedding its reputation as a “local” health system, Kaiser could earn one.
Survival. In recent years, companies like Amazon, CVS and Walmart have been scooping up organizations that provide primary care, telehealth, home health and specialty care services. These “retail giants” are spending up to $13 billion per acquisition. And they’re consuming already-successful healthcare companies like One Medical, Oak Street Health, Signify, Pill Pack and many others. Like an army preparing for war, these corporate behemoths are amassing the components needed to battle the traditional healthcare incumbents and ultimately oust them entirely.
The Geisinger deal expands Kaiser’s footprint, adding 600,000 patients, 10 hospitals and 100 specialty and primary care clinics. These assets lend gravitas, even though Geisinger also comes with a 2022 operating loss of $239 million.
The lesson to draw from this first question is clear: size matters. The days of solo physicians and stand-alone hospitals are over. Nostalgia for medicine’s folksy, home-spun past is understandable but futile. To survive, healthcare players must get bigger quickly or team up with someone who can. That insight leads to the next question and lesson.
Question 2: How much value will Kaiser give Geisinger?
Almost everyone I’ve spoken with understands Kaiser’s desire for greater national influence, but they’re less sure how this deal will affect Geisinger Health.
Geisinger’s Pennsylvania-based hospitals and clinics have been locked in territorial battles for years with surrounding health systems. More recently, the pandemic, combined with staffing shortages and national inflation, have challenged Geisinger’s clinical performance and eroded its bottom line.
Assuming Kaiser plans to invest roughly $1 billion in each of the four to five health systems it’s planning to acquire, that surge in cash inflow will provide Geisinger with temporary financial safety. But the bigger question is how will Kaiser improve Geisinger’s value-proposition enough to grow its market share?
In public comments, Kaiser leaders spoke of the acquisition as an opportunity for Risant to “improve the health of millions of people by increasing access to value-based care and coverage, and raising the bar for value-based approaches that prioritize patient quality outcomes.”
Many of the experts I spoke with understand Kaiser’s value intent. But they question how Kaiser can could deliver on that promise since The Permanente Medical Group (TPMG) wasn’t involved in the deal.
If, hypothetically, Kaiser and Permanente leaders were to strike a deal to collaborate in the future, TPMG’s physician leaders could bring tremendous knowledge, experience and expertise to the table. Otherwise, I agree with those who’ve expressed doubt that Kaiser, alone, will be able to significantly improve Geisinger’s clinical performance.
Health plans and insurance companies play an important role in financing medical care. They possess rich data on performance and can offer incentives that boost access to higher-quality care. But insurers don’t work directly with individual doctors to coordinate medical care or advance clinical solutions on behalf of patients. And without strong physician leadership, the pace of positive change slows to a crawl. As a example, research conducted within The Permanente Medical Group found that it takes only three years to turn a proven clinical advance into standard practice—that’s nearly six times faster than the national average.
For decades, the secret sauce for Kaiser Permanente has been the cohesive success of its three parts: Kaiser Health Plan, Kaiser Foundation Hospitals and The Permanente Medical Group.
And KP’s results speak for themselves:
90% control of hypertension for members (compared to 60% for the rest of the country)
30% fewer deaths from heart attack and stroke (compared to the rest of the country)
20% fewer deaths from colon cancer
The big lesson: insurance, by itself, doesn’t drive major improvements in medicine. It must be a combined effort between forward-looking insurers and innovative, high-performing clinicians.
But there’s another takeaway here for doctors everywhere: now is the time to join forces with other clinicians in your community. Together, you can collaborate to improve clinical quality. You can augment access and make care more affordable for patients. Simultaneously, this is the time for the insurers and the retail giants to figure out which medical groups can deliver the best care and make the best partners. Neither side will flourish alone. And this leads to a third question and lesson.
Question 3: Will the deal work?
Almost all of my conversations ended with this query. I say it’s too early to tell. But as I look years down the road, one part of the deal, in particular, gives me doubt.
Today, Geisinger uses a hybrid reimbursement model—blending both “value-based” care payments with traditional “fee-for-service” insurance plans. In addition to offering its own coverage, it contracts with a variety of other insurance companies. Rarely have I seen this scattered approach succeed.
Most healthcare observers understand the inherent flaw in the “fee for service” (FFS) model is also its greatest appeal to providers: the more you do the more you earn. FFS is how nearly all financial transactions take place in America (i.e., provide a service, earn a fee). In medicine, however, this financial model results in frequent over-testing and over-treatment with minimal if any improvement in clinical outcomes, according to researchers.
The “value-based” alternative to FFS involves prepaying for care—a model often referred to as “capitation.” In short, capitation involves a single fee, paid upfront for all the medical care provided to a defined population of patients for one year based on their age and health status. The better an organization at preventing disease and avoiding complications from chronic illness, the greater its success in both clinical quality and affordability.
Within the small world of capitated healthcare payments, there’s an important element that often gets overlooked. It makes a big difference who receives that lump-sum payment.
In the case of Kaiser Permanente, capitated payments are made directly to the medical group and the physicians who are responsible for providing care. In almost every other health system, an insurance company collects capitated payments but then pays the medical providers on a fee-for-service basis. Even though the arrangement is referred to as capitated, the incentives are overwhelmingly tied to the volume of care (not the value of that care).
In a mixed-payment model, doctors and hospitals invariably prioritize the higher paying FFS patients over the capitated ones. When I think about these conflicting incentives, I’m reminded of a prominent medical group in California. It had a main entrance for its fee-for-service patients and a second, smaller one off to the side for capitated patients.
I doubt the time spent with the patient—or the overall care provided—was equal for both groups. When income is based on quantity of care, not quality, clinicians focus more on treating the complications of chronic disease and medical errors rather than preventing them in the first place. Geisinger has walked this tightrope in the past, but as economic pressures mount, I fear doctors will find the two sets of incentives conflicting and difficult to navigate.
The big lesson: as financial pressures mount, the most effective approaches of the past will likely fail in the future. All healthcare organizations will need to make a decision: keep trying to drive volume and prices up through FFS or shift to capitation. Getting caught in the middle is a prescription for failure.
Examining the healthcare acquisitions made by Amazon and CVS, it’s clear these giants have decided to move aggressively toward a model more like Kaiser Permanente’s—one that brings insurance, pharmacy, physicians and sophisticated IT systems under one roof. These companies, along with Walmart, are aggressively marching down a path toward capitation, focusing on Medicare Advantage (the value-based option for Americans 65+) as an entry point.
So far, Geisinger has hedged its bets by maintaining a hybrid revenue stream. I doubt they can do so successfully in the future. That brings us to a final question.
The biggest question remaining
Over the next decade, hospital systems, insurers and retailers will battle for healthcare supremacy. The most recent Kaiser-Geisinger deal reflects an industry that’s undergoing massive change as health systems face intensifying pressure to remain relevant.
The most important issue to resolve is whether these shifts will ultimately help or harm patients. I’m optimistic for a positive outcome.
Whether or not the retail giants displace the incumbents, they will redefine what it takes to win. For all their faults, companies like Amazon and Walmart care a lot about meeting the needs of customers—a mindset rarely found in today’s healthcare world. As these companies grow ever larger, they’ll place consumer-oriented demands on doctors and hospitals. This will require care providers to deliver higher quality care at more affordable prices.
The retailers will only do deals with the best of the best. And they’ll kick the underachievers to the curb. They’ll use their sophisticated IT systems to better coordinate and innovate medical care. Insurers, hospitals and doctors who fail to keep up will be left behind.
Over time, patients will find themselves with far more choices and control than they have today. And I’m optimistic that will be good for the health of our nation.
A decline in COVID-19 funding and sustained expenses issues helped lead St. Louis-based Ascension to a $1.8 billion operating loss in the nine months ending March 31.
The nine-month loss was on revenue of $21.3 billion. In the quarter ending March 31, the 140-hospital system reported an operating loss of $1.4 billion on $6.9 billion in revenue.
Such losses compared with $640 million and $671 million deficits in the nine-month and three-month periods, respectively, ending March 31, 2022.
Expenses for the nine-month period increased 3.7 percent on the previous year to total $22.3 billion.
“The reduction in COVID-19 funding negatively impacted revenue in the current year,” Ascension management said in the filing. “Additionally, challenges to expenses continue to persist resulting from the inflationary environment.”
The operating losses were offset by improved non-operating income in the first three months of 2023 but not over the nine-month period, which saw a net deficit of $1.9 billion.
Ascension, which operates 2,600 sites of care across 19 states and Washington, D.C., had 219 days of cash on hand as of March 31 compared with 259 at the same time last year.
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.
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 Brighamreported $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.
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.
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.
HENRY KOTULA 