Montefiore Health System CFO Colleen Blye on her daily mantra and facing today’s healthcare challenges

Colleen Blye serves as executive vice president and CFO of New York City-based Montefiore Health System.

Before joining the system in January 2016, she was executive vice president and CFO of Catholic Health Services of Long Island, an integrated healthcare delivery system based in Rockville Centre, N.Y.

She was also executive vice president for finance and integrated services at Englewood, Colo.-based Catholic Health Initiatives.

Here, Ms. Blye shares her proudest moment as Montefiore’s CFO, discusses her daily mantra and reveals the revenue cycle tools she’s most excited about.

Question: Since joining Montefiore, what has been one of your proudest moments as CFO?

Colleen Blye: When we restructured the balance sheet last year and [pursued] public financing. This was the first time in Montefiore’s history that we went for a public rating. As a result, this refinancing provided much needed liquidity for our system, and it allowed us to level debt service. We now have a solid baseline going forward which offers us access to additional financing, as needed. That was a big deal and positions our organization with a debt structure appropriate for a system of our size and scale.

Q: What is the greatest challenge you faced as CFO in 2018? Do you expect this to be your biggest challenge in 2019 as well?

CB: One [challenge] is shifting the finance culture overall from one of financial reporting to one of analytics, and being a business partner. In today’s healthcare world, I think this is imperative, and Montefiore has embraced this culture. I think businesses separate from the healthcare environment operate this way, and we need to be responding and shifting so that finance is a true business partner throughout the organization.

The other aspect that I think is increasingly challenging for all of us in financial healthcare is trying to understand how to diversify our shrinking revenue base. There’s been a lot of revenue compression by governmental payers and the market in general. Therefore, it is imperative that we continually think about how we’re going to diversify that revenue base and bring in new revenue streams to facilitate growth.

Q: What is a daily mantra that informs your leadership decisions?

CB: I always use the concept, “Leave an organization better than you received it.” That doesn’t always mean having absolute analytics or support. Seasoned CFOs understand [that] you must use your experience and other intellect, in addition to data and supporting analysis, to determine whether the risk of any given business decision is worthwhile going forward.

Q: Montefiore Health System has 11 hospitals and serves 3 million people in communities across the Bronx, Westchester and the Hudson Valley. How does the system’s financial strategy differ by location?  

CB: At the highest level, we are one system. However, every market has different opportunities, and it’s imperative that we find those opportunities and capitalize on them to benefit the patients, providers, communities, and therefore, the system overall.

Q: The system is bringing specialty care expertise in areas including cancer, advanced imaging, neuroscience, transplantation, musculoskeletal and heart and vascular care to new markets in its service region of four counties. How does this play a role in the system’s financial improvement plans?

CB: It’s certainly a big part. This goes back to diversifying the revenue stream and understanding where those opportunities are. Specialty care is a critical element of the future of healthcare. We’ve seen a significant shift from inpatient to outpatient care for the less complex services. But,it’s equally important to understand the more complex care as well, capturing that environment so we can take care of the whole person. From an economic point of view, it typically is that more complex care that produces some of the greater margins for our organization.

Q: What are your top cost containment strategies?

CB: We’re focused on all opportunities. One challenge many organizations have is to maintain a cost-focused culture while you’re trying to support growth to sustain the business. But we look at all aspects — how do we maintain our quality care yet utilize our size and scale to get efficiency? We’re constantly looking at that as it relates to our procurement strategy. We’re constantly looking at our employee and benefit cost structure. We [must] continually look at that resource consumption and make sure we’re spending wisely. As a system, our goal is to make sure that quality care is at the center of what we’re focused on but that we utilize who we are — scale and size — to maximize opportunities.

It’s [also] not just the cost side of the equation that we look at. To grow and sustain, we also have to grow our business. We have to be equally focused on where those growth opportunities lie for us as an organization, maintaining equal focused on our revenue efficiency to make certain we’re collecting every dollar we’re entitled to for the services we deliver.

Q: What new revenue cycle tool are you most excited about? 

CB: The tools we’re most excited about are those that are patient-focused. Consumers, particularly millennials, expect and look for that convenience. We are working with vendors that transition a complex billing and information cycle.  This enables us to communicate with our patients in a far more user-friendly way, We’re excited about these opportunities which are focused on patient-centered communications, allowing us to connect directly with patients, informing them at the earliest point about what their financial responsibilities are, how to interpret that information, and how to make payments on those responsibilities.

Q: If you could pass along one nugget of advice to another hospital CFO, what would it be?

CB: Always keep your eyes and ears open for opportunities and always think about how you can grow and expand your thinking and the perspective you bring to the work that you do.

I would also encourage thinking about how to become partners in the healthcare business. I think we have a calling now as CFOs to be far more involved in operations, rather than just financial reporting, providing data, trends and insight to our internal colleagues. I would really suggest moving from the traditional finance acumen to use those skills and techniques to be a strategic-thinking and better business partner.


Universal Health Services finance chief Steve Filton on cost containment and challenges hospital CFOs face

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As CFO of one of the nation’s largest hospital management companies, Steve Filton understands the challenges hospitals face.

Mr. Filton has served as executive vice president and CFO of King of Prussia, Pa.-based Universal Health Services since 2003.

He  joined the company in 1985 as director of corporate accounting and in 1991, he was promoted to vice president and controller.

Mr. Filton spoke with Becker’s about some of the challenges facing CFOs and his top cost-containment strategies.

Question: What is the greatest challenge hospital and health system CFOs faced in 2018? Do you expect this to be their biggest challenge in 2019 as well?

Steve Filton: I think effectively we’re in an environment where our payers have all concluded that costs and medical spending have to be reduced, and a lot of that burden ultimately falls on providers, like hospitals and doctors. As a [result], I think hospitals are tasked with the difficult goal of continuing to provide the highest quality care in more efficient ways. I think that was the biggest challenge last year and will be the biggest challenge this year. I think, frankly, for the foreseeable future, that’s the challenge of being a provider in today’s healthcare environment.

Q: How do you feel the CFO role has evolved in recent years?

SF: I think CFOs have a particularly challenging role in that our organizations explore the ways to deliver high quality care that’s best for our patients and try to create an environment that is satisfying for our employees. We as CFOs then say, ‘How do we accomplish these things and remain efficient and remain profitable?’ [That way organizations] can continue to do all the things we have to do as far as investing and reinvesting in the business and continuing to be competitive with our labor force and do all the things that allow us to continue to run high quality facilities, which in many cases involve significant expenditures.

Q: What are your top cost-containment strategies?

SF: I think a lot of our cost-containment strategies are focused on what I describe as driving the variability out of our business. I think so many other industries and businesses are accustomed to delivering their products and services in very standardized ways that are determined to be most efficient. I think healthcare has sort of long resisted that, and as a [result], we have lots of variability in the way that we deliver services in our various geographies. Various clinicians will deliver services differently. And I think we could benefit by following the lead of some of our peer industries and becoming much more focused on … delivering all our care and service in that standard way in accordance with best practice protocols. Driving out excess utilization and driving out rework and re-dos and errors — those things I think are a significant focus of getting the hospital industry to be more efficient and cost-efficient.

Question: During your tenure at UHS, what has been one of your proudest moments as CFO?

SF: What I take great pride in is the growth of the company. When I joined the company in the mid-1980s, it had maybe 35 [or] 40 hospitals around the country and maybe $500 million of consolidated revenues. This coming year we’ll have well over 300 domestic facilities and another 100 or so in the United Kingdom and over $11 billion of revenue.  And what I’m proud of is not just the growth of the company, but … the way the company has grown and yet really adhered to its core principles. When I joined the company 30 some odd years ago, it was very committed to high quality patient care and to the satisfaction to our employees. And honestly, if anything, I think the company has recommitted itself to those core principles over the years, and to be a much bigger company [and] not have abandoned our core principles, at least for me, is a source of great pride.

Q: If you could pass along one nugget of advice to another hospital CFO, what would it be?

SF: I tell the folks who work with me and for me all the time that it’s so important to behave every day with the highest level of integrity. I think at the end of the day you can’t replace that. People, I think, will give you a lot of leeway if they trust you, if they believe that you’re behaving transparently and with great honesty. And so I encourage everyone who works for me to do that, and I certainly endeavor to try to do that as best I can. And it’s tough. There are all kinds of pressures on folks in a financial role in this sort of environment. But I think if you behave with integrity, everything else will follow from that.