Executive

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

Dr. Toby Cosgrove

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

Other Feature Stories:

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

FEATURED 4 Tips for Developing a Great Leadership Team

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

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

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

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

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

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

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

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

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

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

The 16 Tech Companies Paying Interns Most

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

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

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

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JD, Chairperson, Co-Chief Information Officer,
McGuireWoods LLP Hackensack University
Medical Center
REGISTER HERE
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AMN Healthcare Services
com or jcole@beckershealthcare.com
 6

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

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

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

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

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

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

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

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

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

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 8

2017 CEO Advisory Board

Beckers Hospital Review

Nancy Howell Agee Steven I. Goldstein

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

Barry Arbuckle, phd

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

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

Verdi DiSea, MD, MBA

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

Rhoda Weiss, phd

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

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

Pat Fry
Former President and CEO
Sutter Health
 9

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

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

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

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

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To learn more and register, please visit:
http://www.beckershospitalreview.com/conferences-and-events.
html.
Should you have any questions or if I can be of help in any manner,
please do not hesitate to contact me at sbecker@beckershealthcare.
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CHS Records $199M Net Loss, Says Divestiture

CFO / FINANCE

Spree is Over
By Ayla Ellison

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

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

Profit Rises Hospital Bill by Selling
By Ayla Ellison Jewelry Collection

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

buying a new facility, said LifePoint Chairman and CEO Bill
Carpenter on a first quarter earnings call with investors April 28.
LifePoint saw its financial picture improve in the first quarter of this
year. The for-profit hospital operator recorded net income of $64
million on revenues of $1.63 billion in the first quarter of 2017, up
from a net income of $23.9 million on revenues of $1.58 billion in
the same period of the year prior.
The financial boost was attributable to several factors, including an
increase in equivalent admission volumes and higher reimburse-
ment rates from commercial payers, said LifePoint Executive Vice
President and CFO Mike Coggin during the call with investors.
With its strong financial results in the first quarter, LifePoint is con-
sidering taking over additional hospitals.
We believe we have opportunities for growth in each of our exist-
ing markets by adding profitable service lines and recruiting phy-
sicians, said Mr. Carpenter during the earnings call. Additionally,
if we identify an acquisition that makes compelling, strategic and
financial sense, we have the financial flexibility to take advantage of
it and maintain a strong balance sheet.
Mr. Carpenter said there is a pipeline of hospitals LifePoint is an-
alyzing as potential acquisition targets. The companys strategy is
to bring any acquired hospitals from single-digit to double-digit
margins within the first three years. n
C
hildrens Hospital of Orange (Calif.) County re-
ceived reimbursement for a bill from nearly four
decades ago after a family sold their jewelry
collection to pay the $10,000 tab, The Orange County
Register reports.
The jewelry collection belonged to Josefina Sal-
daa-Gaffoglio, who unexpectedly passed away from
a stroke in January. Ms. Saldaa-Gaffoglio had a long-
time wish to use her jewelry to pay a waived hospital bill
for treatment her son, Eric Gaffoglio, received in 1982.
Mr. Gaffoglio suffered a collapsed lung after his birth at
Newport Beach, Calif.-based Hoag Hospital, and was
transferred to CHOC. He spent three days at CHOC
and racked up a $10,000 bill, according to the report.
At the time, Ms. Gaffoglio and her husband could not
afford the bill, and CHOC waived it.
Following her death, Ms. Saldaa-Gaffoglios son and
daughter-in-law acted on her wishes and gathered about
50 pieces of her jewelry to sell and give to CHOC. They
presented a check to the hospital on April 12.
Its what she wanted, Mr. Gaffoglio told two nurses,
who were both in the neonatal intensive care unit when
he was an infant. That was her wish. When she died it
was our responsibility to take care of [the bill]. n
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 12
DOJ Sues UnitedHealth Over $1B+ in Medicare
CFO / FINANCE
Claims
By Morgan Haefner
T
he Justice Department sued Minnetonka, Minn.-based United-
Health Group May 16, alleging the payer defrauded Medicare
at least $1 billion in false claims.
In the 79-page lawsuit filed in a Los Angeles federal court, the Justice
Department alleged the payer knowingly inflated risk adjustment
payments by providing the government inaccurate data about the
health status of its beneficiaries. Department officials cited United-
Health's "one-sided" chart review process that reportedly didn't ad-
dress errors elevating its revenues.
The department also alleges the payer ignored "invalid diagno-
ses from healthcare providers with financial incentives to furnish
such diagnoses."
OIG Tags Arkansas Hospital for
Incorrect Billing
By Ayla Ellison
T
he University of Arkansas Medical Sciences Medical Center
in Little Rock failed to comply with Medicare billing require-
ments for 16 of 130 inpatient claims reviewed by HHS Office
of Inspector General for the audit period of Jan. 1, 2013, through
Dec. 31, 2104, according to an OIG report.
The 16 claims that did not comply with Medicare billing require-
ments resulted in the hospital receiving $197,172 in overpayments,
according to the OIG.
Extrapolating from the sample results, the OIG estimated University
of Arkansas Sciences Medical Center received at least $278,000 in
overpayments from Medicare during the audit period.
Based on its findings, the OIG recommended the hospital refund
$278,000 to the Medicare contractor, to which CMS outsources the
processing and payment of claims submitted by hospitals. The OIG
also recommended the hospital exercise reasonable diligence to
identify and return any additional overpayments outside of the au-
dit period and strengthen controls to ensure full compliance with
Medicare requirements.
In written comments, University of Arkansas Sciences Medical Center
agreed nine of the 16 claims identified by the OIG contained billing
errors. The hospital reserved the right to appeal the OIGs determina-
tions and the overpayment estimates for the remaining seven claims.
After reviewing the hospitals comments, the OIG maintained its
findings and recommendations. n
The DOJ filing is an intervention in a lawsuit filed under seal in
2011 by Benjamin Poehling, former finance director of United-
Healthcare Medicare and Retirement. That suit alleges United-
Health billed Medicare higher payments for patients by making
patients appear sicker than they were. In an earlier statement to
StarTribune, UnitedHealth spokesperson Matt Burns said the pay-
er denied the claims and has "been transparent with [CMS] about
our approach under its unclear policies. We reject these claims
and will contest them vigorously."
This is the second lawsuit the department has filed against the in-
surer this month. The move follows the department's decision to
intervene in a whistle-blower suit filed by James Swoben in 2009. It
concerns separate but similar allegations. n
Georgia Hospital to Close
After Years of Financial
Troubles
By Ayla Ellison
S
avannah, Ga.-based Optim Healthcare an-
nounced April 25 that it will close Optim
Medical Center-Jenkins in Millen, Ga., on
June 24.
Optim said the hospital has faced financial chal-
lenges for several years caused by dwindling pa-
tient volumes and declining reimbursement from
government payers. Optim said the hospital also
has major infrastructure challenges, which would
require significant investments to address.
To help stem future losses, the system will con-
solidate the services of Optim Medical Cen-
ter-Jenkins with its facility about 20 minutes away
in Sylvania, Ga.
We made this difficult decision to close our Jen-
kins facility following a lengthy analysis during
which we looked for ways to keep Jenkins open,
said Optim.
When the hospital closes, 55 full- and part-time
jobs will be eliminated, according to WBJF. n
 69 % OF HOSPITAL EXECUTIVES
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 14
Brigham and
CFO / FINANCE
Womens Offers
Voluntary
Buyouts to
1,600 Workers
By Tamara Rosin
B
oston-based Brigham and Womens
Hospital said April 27 it is offering
voluntary buyouts to 1,600 em-
ployees as a means to cut costs, The Bos-
ton Globe reported.
Officials said the hospital, which is one of
the citys largest employers, is profitable.
However, its facing pressure amid shrink-
ing payments from government and com-
mercial insurers and growing labor costs.
Labor represents about 66 percent of the
hospitals costs, according to the report.
Brigham is also dealing with debt from two
major infrastructure projects, including a
$510 million building that opened in 2016
and a $335 million software system that
rolled out in 2015, according to the report.
You cant just keep spending more and
more and more and not making any more,
Brigham spokeswoman Erin McDonough
told The Boston Globe. We know we need
to work differently to sustain our mission
for the future. Were really looking at how
you reduce costs.
Although the buyouts are voluntary, hospital
officials said layoffs could come later this year
depending on how many employees accept
the buyout offer, reports The Boston Globe.
Brigham and Womens, which is owned
by Boston-based Partners HealthCare, has
about 18,000 employees, according to the
report. To be eligible for the buyout offer,
employees must be 60 or older. The deal in-
cludes one year of base pay.
About 5,300 employees including phy-
sicians, faculty and research staff will
be excluded from the offer, according to
the report. Approximately 475 unionized
workers are eligible for the buyout, but
Brigham officials said it must get approval
from the unions before offering members
the deal. n
The $12M Patient Who Drove Insurance
Rates Higher in Iowa
By Ayla Ellison
Iowas health insurance exchange faces a unique challenge an individual who
has $1 million per month in medical claims.
David Anderson, a research associate at Duke University Margolis Center and
former health insurance official, discusses Iowas exchange market in a post on
his healthcare blog called Balloon Juice. He notes that Iowas exchange market
is facing many of the same challenges as those in other states, such as tran-
sitional, underwritten health plans covering most of the profitable individual
market, but it is also experiencing the unique problem of providing insurance
to an individual with $12 million in annual medical claims.
Des Moines, Iowa-based Wellmark Blue Cross and Blue Shield sent letters to
its 30,000 customers last spring, telling them it was raising their premiums by
about 38 to 43 percent for 2017. According to Mr. Anderson, about 10 percent-
age points of that increase stemmed from one patient with a severe genetic
disorder who receives $1 million worth of care per month.
This extreme outlier creates a difficult situation for insurers offering plans on the
exchange in Iowa, according to Mr. Anderson. In a competitive market where
the subsidies are tied to the second least expensive Silver [plan] and there is
one super-outlier who cannot be reinsured against, every carrier lives in fear of
being chosen by the one outlier, he wrote. If they set their rates low enough to
be attractive to healthy people, they lose money on the catastrophic expected
claims. If they set the rates high enough to cover a $12 million claim, no one
buys their product.
Mr. Anderson says a solution to this issue is to remove the super-outlier from the
risk pool and use general taxes to pay for the individuals healthcare, which would
lower premiums in the individual market in Iowa by $10 per member per month.
Wellmark Blue Cross and Blue Shield announced this month it is exiting Iowas
ACA health insurance exchange for next year. Over the past three years, the
payer has implemented double-digit premium hikes and still sustained $90
million in losses on its exchange plans in Iowa. n
US Drug Spending to Hit $610B by 2021
By Mackenzie Bean
U.S. prescription drug spending could peak at $610 billion by 2021, according
to a new report from QuintilesIMS Holding.
Here are four things to know.
1. QuintilesIMS analysts expect U.S. drug spending to jump 4 percent to 7 per-
cent through 2021, hitting $580 billion to $610 billion.
2. While analysts originally predicted an average spending growth of 6 percent
to 9 percent, the company lowered its forecast due to fewer new drug approv-
als, increasing market competition and heightened scrutiny over prices.
3. When manufacturer discounts and rebates are considered, analysts expect
spending to jump 2 percent to 5 percent through 2021, reaching $375 billion
to $405 billion.
4. In 2016, prescription drug spending increased 5.8 percent from the year
prior to $450 billion based on list prices. When adjusted for discounts and re-
bates, spending jumped 4.8 percent to $323 billion. n

9 Healthcare Bankruptcies So Far in 2017
By Ayla Ellison
F
rom reimbursement landscape challenges to dwindling patient
volumes, many factors lead hospitals and other healthcare orga-
nizations to file for bankruptcy.
Here are nine healthcare organizations that have filed for bankruptcy
since Jan. 1, beginning with the most recent.
1. York, Pa.-based medical device company Unilife Corp., which
develops and markets injectable drug delivery systems, filed for
Chapter 11 bankruptcy in early April. We have conducted an
extensive review of alternatives to address Unilifes capital struc-
ture, and we believe pursuing a balance sheet restructuring or sale
through Chapter 11 is the best path forward at this time, said John
Ryan, CEO of Unilife.
2. Green Valley (Ariz.) Hospital filed for Chapter 11 bankrupt-
cy April 3. In its bankruptcy documents the hospital says it was
poorly managed and undercapitalized since it opened about
two years ago.
3. Naperville, Ill.-based Vital Wellness Home Health, which provides
home health and private duty services in the Chicago, Phoenix and
Denver areas, filed for Chapter 11 bankruptcy March 2. In its bank-
ruptcy petition the company listed its liabilities as $2.3 million, and
the total value of its assets as about $1 million.
4. California Proton Treatment Center, the San Diego-based invest-
ment group that owns Scripps Proton Therapy Center, filed for Chap-
Tenet Sees Net Loss Narrow to $53M, Inks Deal to Sell 3 Hospitals
to HCA
By Ayla Ellison
D
allas-based Tenet Healthcare said May 1 it ended
the first quarter with a net loss. However, the com-
pany said it has entered into several agreements to
improve its financial picture in the long term.
Tenet recorded revenues of $4.8 billion in the first quarter
of 2017, a 4.6 percent year-over-year decrease. The compa-
nys ambulatory care segment and revenue cycle manage-
ment subsidiary had strong performance in the first quarter,
but revenue from its hospital operations was down. Tenet
said the decrease in revenue was attributable, in part, to the
sale of its hospitals in Atlanta in April 2016 and not being
able to record revenue under the California Provider Fee
Program, since extension of the program hasnt been ap-
proved by CMS.
Tenet ended the first quarter with a net loss of $53 million,
which was an improvement from the $59 million net loss it
recorded in the same period of the year prior. The company
expects its financial performance to improve further due to
several strategic agreements it recently entered.
On May 1, Tenet announced it signed a definitive agree-
ment to sell its three hospitals in Houston to Nashville,
15
CFO / FINANCE
ter 11 bankruptcy March 1. According to documents filed with the
court, the proton therapy center has not operated on a profitable or
even a break-even basis since it opened in February 2014.
5. Humble (Texas) Surgical Hospital filed for Chapter 11 bankruptcy
Feb. 24. The hospital filed its bankruptcy petition after a judge ordered
it to pay Hartford, Conn.-based Aetna $51.4 million in a seven-year-
old court battle over the hospitals out-of-network charges.
6. Louisiana Heart Hospital in Lacombe filed for Chapter 11 bank-
ruptcy Jan. 30. The hospital shut down Feb. 10 and closed its 16 med-
ical clinics Feb. 28.
7. Aventura, Fla.-based Advanced Neuro Spine Institute, a medical
group specializing in neurology, neurosurgery and pain management,
filed for Chapter 11 bankruptcy Jan. 25.
8. North Texas Medical Center in Gainesville, which is owned by the
Gainesville Hospital District, filed for Chapter 9 bankruptcy Jan. 17.
With the hope of regaining its financial footing, the hospitals board
approved a partnership with King of Prussia, Pa.-based Universal
Health Services in December.
9. The public trust that operates Atoka (Okla.) County Medical Center
filed for Chapter 9 bankruptcy Jan. 10. At that time, the critical access
hospital was about $16 million in debt. n
Tenn.-based HCA Holdings for about $725 million. The
transaction, which is subject to regulatory approval, is ex-
pected to close in the third quarter of this year.
Tenet is also accelerating the purchase of ambulatory sur-
gery center chain United Surgical Partners International.
Tenet said its ownership interest in USPI would increase to
80 percent by July 3.
In addition to the hospital and ASC transactions, Tenet also
announced it reached a new, multiyear agreement with
Louisville, Ky.-based insurer Humana that calls for all of
Tenets hospitals, hospital-affiliated outpatient centers and
employed physicians to be phased back into the insurers
network between June 1, 2017, and Oct. 1, 2017.
Tenet Chairman and CEO Trevor Fetter said the transac-
tions and the new agreement with Humana are part of a
strategic effort to reduce complexity across the enterprise
and enhance returns for our shareholders. In January, Mr.
Fetter said Tenets long-term strategy is to increase the per-
centage of markets where the company has the leading or
second-place market share. n
 16
RAND Study: MACRA Could Cause $250B Drop in
CFO / FINANCE
Hospital Medicare Revenue by 2030
By Emily Rappleye
D
epending on the amount of risk physicians choose to take on
under the Medicare Access and CHIP Reauthorization Act,
hospitals Medicare revenue could drop by $250 billion by
2030 or it could increase by $32 billion, according to a study published
in Health Affairs.
The study estimates the effect of MACRA on physician and hospital
Medicare revenue under various scenarios using the RAND Corpo-
rations Health Care Payment and Delivery Simulation Model. Unfor-
tunately for physicians the outlook is less favorable their Medicare
revenue is expected to drop by billions of dollars in all scenarios.Phy-
sicians Medicare revenue will decline between $35 billion and $106
billion from 2015 to 2030, according to the study.
The researchers examined three MACRA scenarios based on how
much risk providers choose to take on under the laws alternative
payment model track. These three scenarios were compared against
a counterfactual pre-MACRA baseline, which was the control group
of sorts; it projected spending as if MACRA did not exist and sustain-
able growth rate fixes continued. Each of the three MACRA scenarios
assumed APM participation rates over the projection period (2015 to
2030) by extrapolating current ACO participation rates. Using this
method, by 2030, 40 percent of physicians would be participating in
some type of APM, while the remaining 60 percent would be in the
other track, the merit-based incentive payment system.
Here is how Medicare spending would change under each of the sce-
narios presented by the study.
Scenario 1: Pre-MACRA baseline. Under this scenario, the
study authors project that physician Medicare revenue would increase
from $81 billion in 2014 to $109 billion in 2030. Hospital Medicare
revenue would grow from $223 billion to $413 billion in 2030.
Scenario 2: Low-strength incentives. This scenario assumes
the bulk of physicians participating in APMs are participating in pa-
tient-centered medical homes, such as the Comprehensive Primary
Care Plus model. These models are considered low-strength because
they do not require providers to take on downside financial risk. Un-
der this scenario, physician Medicare revenue would decline by $35
billion from 2015-2030 compared to the baseline. However, hospital
revenue is projected to increase by $32 billion.
Scenario 3: Medium-strength incentives. This scenario as-
sumes physicians participate in a mix of APMs, the majority in PCM-
Hs, some in models similar to the Medicare Shared Savings Program
Track 2 ACO model, and a minority in high-risk models like the Next
Generation ACO. For example, by 2030, the medium-strength scenar-
io assumes 4 percent of physicians are in Next Generation ACO-like
models, 12 percent are in models similar to MSSP Track 2 ACOs and
24 percent are in PCMHs. The remaining physicians are in the MIPS
track. Compared to the baseline, this scenario would mean physician
Medicare revenue would decline by $47 billion from 2015-2030. Most
of the decline would happen in the second half of the study period
because of the way payment rates are structured under the law. From
2015 to 2019, the law prescribes a 0.5 percent nominal payment rate
increase. Then from 2020 to 2025, there is no nominal payment rate
increase. However, APMs have the opportunity to earn lump sum bo-
nuses that could increase Medicare payments by up to 5 percent from
2019 to 2024. Beginning in 2026, there is a 0.25 percent annual update
to payment rates for MIPS physicians and a 0.75 percent update for
those in APMs. This scenario would produce a projected $22 billion
decline in hospital Medicare revenues.
Scenario 4: High-strength incentives. This scenario assumes the
majority of physicians in APMs are in high-financial risk models like the
Next Generation ACO. Compared to the baseline, physician revenue from
Medicare would decline $106 billion from 2015-2030. Hospital Medicare
revenue is projected to decline by $250 billion under this scenario because
physicians would be more likely to respond to the strong incentives and
try to reduce the use of hospital services, according to the report. n
Study: High Prices Not
Necessarily Indicative of Better
Quality for Outpatient Services
By Kelly Gooch
H
igh prices for outpatient services at physician
practices do not necessarily guarantee better
care quality and efficiency, suggests a new study
published in Health Affairs.
For the study, researchers identified high- or low-price
physician practices using commercial claims data. They
said they also examined 2013 fee-for-service Medicare
CAHPS survey data and linked 20112012 Medicare
claims to compare high- and low-price physician prac-
tices in the same geographic area based on care quality,
utilization and spending.
The study, which included a sample of roughly 31,200
survey respondents, found high-price physician practic-
es received an average of $84.45 for an outpatient visit,
up 36 percent compared with the average of $62.06 for
low-price physician practices.
As far as care quality, patients who visited high-price phy-
sician practices reported significantly higher scores on
some measures of care coordination and management,
according to the study. However, patients who visited
high-price physician practices and patients who visited
low-price physician practices did not differ meaningful-
ly with their overall care ratings, physician ratings and
access to care, receipt of preventive services, acute care
use or total Medicare spending, the study notes.
This suggests an overall weak relationship between
practice prices and the quality and efficiency of care
and calls into question claims that high-price provid-
ers deliver substantially higher-value care, the studys
authors concluded. n
Executive Briefing 17
 18 Executive Briefing
Sponsored by:
Avoiding Friction in the Age of High-Deductible Health Plans: How
Innovative Solutions Can Help Providers Succeed
T
he consumer-driven healthcare era has transformed the
role of the patient. Today, patients are more informed
about their treatment options and what they will have
to pay out-of-pocket. Driven by a desire to obtain affordable
healthcare, patients seek providers that align with their overall
needs without compromising care.
As higher premiums and deductibles propel healthcare orga-
nizations into more consumer-facing interactions, hospitals and
health systems today understand they can no longer solely fo-
cus on the clinical side of care. They must also be upstanding
in the revenue cycle management process and ensure patients
have the information they need to follow through on payments.
Healthcare's transformative business model
The evolution of the healthcare business model corresponds
to the development of the payment process. What once was a
business-to-business transaction has been replaced by some-
thing more complex and difficult to navigate a business-to-busi-
ness-to-consumer model. In a business-to-business model, a prac-
tice would file a claim to the insurance company who would then
adjudicate the claim and pay the provider for services rendered.
"That was the easy money," says T. Scott Law, founder and CEO
of Zotec Partners, a leading provider of revenue cycle manage-
ment services to multi-specialty practices and health systems.
"The transaction was electronic; you were dealing with a busi-
ness. You had rules to comply with but it was pretty straight-
forward with reasonable technology."
In the business-to-business-to-consumer payment model, pro-
viders have to send the insurance company a bill and get it ad-
judicated. The insurance company may well come back to the
provider saying a patient owes the deductible, so the provider
then bills the patient for that deductible. After billing the patient
for the deductible, a provider has to get that money adjudicat-
ed by the insurance company and only then can the provider
bill the patient and collect for the services rendered.
This model has taken shape due to rising deductibles and copay-
ments. In 2016, covered employees had an average deductible of
$1,478 for single coverage, up from $1,318 in 2015, according to
data from the Kaiser Family Foundation. Additionally, many covered
workers have copayments. Sixty-seven percent of covered workers
have a copayment for a primary care visit. For primary care, the
average in-network copayment totaled $24 in 2016. An InstaMed
study found the number of consumer payments to healthcare pro-
viders increased 193 percent between 2011 and 2014.
All facets of the healthcare industry are waiting to see if Re-
publicans' healthcare bill, the American Health Care Act, will
pass, as reform legislation may increase premiums for some
and lower rates for others depending on their age and health.
Recent Congressional Budget Office data found the average
premium for a 21-year-old will total $5,100 under the ACA and
$3,900 under the AHCA in 2026. A 64-year-old will pay an av-
erage premium of $15,300 under the ACA and $19,500 under
the AHCA in 2026. Any escalated premiums will likely create
more price-sensitive consumers who seek a relatively seamless
process in all aspect of care, including the payment process.
Therefore, hospitals and providers will need to employ the right
tools to make this process as painless as possible.
Limiting friction in the payment process
When providers fail to effectively manage claims and obtain
the necessary information from patients to avoid payer denials,
they risk creating diversions in the payment process that can
harm the patient-provider relationship and create friction. Mr.
Law defines friction as any irregularity to an otherwise smooth
payment process.
For instance, a provider could obtain an inappropriate denial
from an insurance company, which raises a slew of questions
including whether the administrative team received all the cor-
rect information from the patient. This could be a product of a
staff member failing to verify a patient's information or a patient
hastily writing down their information and making an error in
the process. Nonetheless, friction occurs and this is a phenom-
enon providers want to avoid in their RCM process.
Mr. Law cites data that found almost 30 percent of all claims are
either inappropriately denied or inappropriately paid. Of that
30 percent, half of claims are not followed up on. In those cases,
a provider is essentially walking away with nothing.
"If a patient calls and complains, that's friction in the process,"
Mr. Law explains. "We measure the amount of friction, which
depends on how clean the data is, how the carrier processes
the claims, the ability of a patient to pay... Friction is any excep-
tion to the payment process."
Zotec's technology has the ability to predict the likelihood of
friction on a per-patient basis. Technology can assess several
factors to determine this value, including a patient's propensity
to pay, as well as the insurance company's likelihood of deny-
ing or filing inappropriate denials and the provider's consisten-
cy in relaying accurate insurance or payment information to the
patient. However, all of this information must be 100 percent
correct because inaccurate information can completely alter a
specific patient's estimated friction.
"We have statistic modeling tools we use under the umbrella
of big data. The most important thing we've found is you have
to be able to track these events with a great deal of certainty so
you come up with the proper conclusion," Mr. Law says.
Executive Briefing
How technology can reduce friction
If providers successfully employ technology to determine an
estimated amount of friction, they can then fine-tune the best
next steps to boost a patient's likelihood of paying. Zotec caters
its technological solutions to each patient to ensure they use
the platform that best suits their needs and preferences.
"We personalize patients profiles based on what they are most
likely to appreciate in terms of collection methods," Mr. Law
says. "If a patient is a millennial, they may want a text telling
them to pay online. If a patient is 70, they may want to receive a
text because their grandkids are texting, but they may still want
to hand-write a check and mail that in."
Through its individualized platforms, the payment process is eas-
ier for patients and will likely translate to a higher propensity for
patients to follow through on bills. As the industry continues to
trend toward the consumer, providers cannot forgo the impor-
tance of minimizing friction, particularly because value-based
outcomes and patient satisfaction scores dictate payments.
Employing a third-party revenue cycle management partner
can empower healthcare organizations to reduce the friction
with patients and help providers bolster their bottom line by
increasing collections.
A 2017 Navicure survey found 51 percent of providers say it
takes an average patient more than three months to pay their
full balance. However, only 18 percent of patients claim it took
them longer than three months to pay their last balance, indi-
cating a lack of consensus between the two parties on this topic.
Whether a lapse in communication or varying perspectives on
payment dates, many providers and patients are not on the
same page regarding payments and their timeliness. Using
a third party vendor is becoming more commonplace in the
industry, especially as healthcare executives are increasingly
adopting more responsibilities, such as improving infection
control protocols or meeting CMS' reporting requirements.
Letting the patient billing experience fall to the wayside may
cost a provider significant amounts of money, which is where a
revenue cycle management partner comes into play.
Black Book projected the market for outsourced revenue cycle
management services is likely to increase at a compound an-
nual growth rate of 26.5 percent in the next two years, reach-
ing $9.7 billion by 2018. On a micro-level, hospital executives
understand the benefits a revenue cycle management partner
can offer. The survey found almost 50 percent of hospital CFOs
acknowledged outsourcing has become a more viable alterna-
tive to in-house management in 2017.
Zotec works with providers around the United States to improve
the payment process so practices and hospitals can focus on other
areas, such as clinical delivery. Mr. Law says Zotec brings patients
into the mix much earlier in the process, which helps eliminate
some of the missteps that can occur along the way with payments.
The company will file a claim to the insurance company on be-
half of a practice. Once completed, Zotec will send the patient a
Zotec Partners is an industry leader in revenue cycle and practice management services for physicians and health systems, managing in
excess of 70 million medical encounters annually. The company is committed to the continual pursuit of excellence, delivering effective
solutions through its proprietary technology, personalized service and measurable client results. Currently, Zotec Partners serves more
than 8,000 physicians in all 50 states.
19
text message informing them that Zotec filed the claim and the
patient should be aware they will likely owe a certain amount of
money. In the text, Zotec tells patients they will be notified once
the insurance company adjudicates that claim.
"The big problem with consumers is the surprise," Mr. Law says.
"They get a bill for $5,000 and they didn't even know. They are
getting billed for an entire deductible maybe in the first en-
counter they have [with a provider]. That's a big surprise for
$5,000 that they don't have and for [care] they don't think they
need. Who is going to make that choice?"
Being transparent with consumers is increasingly important, and
having an open dialogue about the estimated cost of care will
often translate to reduced friction. Healthcare payments do not
work the same way as other industries. If an individual fails to
make a credit card payment repeatedly, this will affect their Fed-
eral Insurance Contributions Act (FICA) score. If a patient does
not make a payment for a healthcare service they received, this
will not impact their FICA score, making it exceedingly difficult
for providers to exercise disincentives when collecting payments.
"I don't have a hammer to affect people's credit ratings," Mr. Law
says. "[Instead], we introduce things earlier in the process by edu-
cating patients on their deductible and why they owe this money.
We do it through technology, versus the old days, where you'd
send two or three payments and hope patients paid them."
Zotec offers a portal that allows patients to stay updated on
their insurance information and set up payment plans through a
text or integrated voice response system. Texting is a preferred
method of communication for a large portion of patients, and
using a platform that bodes well with patients will fare well for
providers in receiving payments.
"Text messaging is by far the [most popular] thing when you
get into the consumer space," Mr. Law says. "We have to meet
consumers in spaces they understand in order for them to ap-
preciate the exchange."
Technology can also minimize the likelihood of a denial due
to inaccurate or incomplete information. Equipped with editing
engines, Zotec has solutions that compare a claim to a patient's
policy information to ensure there aren't any discrepancies that
would prohibit a provider from receiving payment in full. Ad-
ditionally, Zotec does eligibility checks and verifies statements
prior to sending those to patients. "We wouldn't send a bill for a
high-dollar amount without that [the verification]. Those are the
ones that cause the most friction," Mr. Law notes.
With technology, providers can avoid friction that impedes a
successful payment process. Zotec was aware of the consumer-
ism shift within healthcare nearly five to seven years ago and has
been creating solutions to address this trend. Providers that fail
to prioritize the consumer will fall behind their competitors, both
in terms of reputation and finances, as patient satisfaction is a
core component of the value-based healthcare era. With the rise
of high-deductible health plans, patient-focused care is here to
stay and providers should prepare to thrive in this landscape. n
 20
230 Hospital Benchmarks | 2017
By Ayla Ellison and Jessica Kim Cohen
H
ospitals across the nation compete in a
number of ways, including on quality
of care and price, and many use bench-
marking to determine the top priorities for
improvement. The continuous benchmarking
process allows hospital executives to see how
their organizations stack up against regional
competitors as well as national leaders.
For the sixth year,Beckers Hospital Reviewhas
collected benchmarks related to some of the
most important day-to-day areas hospital ex-
ecutives oversee: quality, patient satisfaction,
staffing, utilization, finance, affiliations, com-
pensation and health IT.
Quality and process of care
Source: Hospital Compare, HHS, Complica-
tions-National Averages December 2016 and
Timely and Effective Care Measures-National
Averages December 2016, the latest available
data for these measures.
Hospital-acquired conditions
The following represent the average percentage of
patients in the U.S. who experienced the conditions.
1. Collapsed lung due to medical treatment:
0.41 percent
2. A wound that splits open on the abdomen or
pelvis after surgery: 2.32 percent
3. Accidental cuts and tears from medical treat-
ment: 1.43 percent
4. Serious blood clots after surgery: 5.31 per-
cent
5. Serious complications: 0.9 percent
6. Bloodstream infection after surgery: 10.21
percent
7. Infections from a large venous catheter: 0.17
percent
8. Developed a blood clot while in the hospital
and did not get treatment that could have pre-
vented it: 2 percent
Heart attack patients
9. Median time to fibrinolysis: 28 minutes
10. Median time to transfer to another facility
for acute coronary intervention: 58 minutes
Outpatients with chest pain or possible heart
attack
11. Who received aspirin within 24 hours of
arrival or before transferring from the emer-
gency department: 96 percent
12. Who received drugs to break up blood clots
within 30 minutes of arrival: 59 percent
13. Median time before patient received an
electrocardiogram: 7 minutes
Lower extremity joint replacement patients
14. Rate of complications for hip/knee replace-
ment patients: 3 percent
Stroke patients
15. Who received fibrinolysis within three
hours after symptoms started: 87 percent
Blood clot patients
16. Who were discharged on a blood thinner
medicine and received written instructions
about that medicine: 93 percent
Colonoscopy patients
17. Who received appropriate recommenda-
tion for follow-up colonoscopy: 80 percent
18. Percentage of patients with history of pol-
yps who received follow-up colonoscopy in the
appropriate timeframe: 87 percent
Flu vaccination
19. Preventive care patients assessed and given
flu vaccination: 94 percent
20. Healthcare workers who received flu vacci-
nation: 86 percent
Pregnancy and delivery care
21. Mothers whose deliveries were scheduled
one to two weeks early, when a scheduled de-
livery was not medically necessary: 2 percent
Emergency department care
22. Average time spent in the ED before patient
is admitted to the hospital as an inpatient: 279
minutes
23. Average time patient spent in ED after the
physician decided to admit as an inpatient but
before leaving the ED for the inpatient room:
99 minutes
24. Average time patient spent in the ED before
sent home: 140 minutes
25. Average time patient spent in the ED before
seen by a healthcare professional: 22 minutes
26. Average time patient who came to the ED
with broken bones had to wait before receiving
pain medication: 52 minutes
27. Percentage of patients who came to the ED
with stroke symptoms who received brain scan
results within 45 minutes of arrival: 69 percent
28. Percentage of patients who left the ED be-
fore being seen: 2 percent
Patient satisfaction
Source: Hospital Compare, HHS, HCAHPS Na-
tional Survey Results December 2016, the latest
available data for these measures.
Overall hospital rating
29. Patients who gave the hospital a rating of
nine or 10: 72 percent
30. Patients who gave the hospital a rating of
seven or eight: 21 percent
31. Patients who gave the hospital a rating of
six or lower: 7 percent
Patient recommendation
32. Patients who said, yes, they would definitely
recommend the hospital to friends and family:
72 percent
33. Patients who said, yes, they would probably
recommend the hospital to friends and family:
23 percent
34. Patients who said, no, they probably or
definitely would not recommend the hospital
to friends and family: 5 percent
Cleanliness
35. Patients who said their room and bathroom
was always clean: 74 percent
36. Patients who said their room and bathroom
was usually clean: 18 percent
37. Patients who said their room and bathroom
was sometimes or never clean: 8 percent
Noise
38. Patients who said the area around their
room was always quiet at night: 62 percent
39. Patients who said the area around their
room was usually quiet at night: 29 percent
40. Patients who said the area around their
room was sometimes or never quiet at
night: 9 percent
Physician communication
41. Patients who said their physicians always
communicated well: 82 percent
42. Patients who said their physicians usually
communicated well: 14 percent
43. Patients who said their physicians some-
times or never communicated well: 4 per-
cent
Nurse communication
44. Patients who said their nurses always
communicated well: 80 percent
45. Patients who said their nurses usually
communicated well: 16 percent

46. Patients who said their nurses sometimes
or never communicated well: 4 percent
Pain control
47. Patients who said their pain was always
well controlled: 71 percent
48. Patients who said their pain was usually
well controlled: 22 percent
49. Patients who said their pain was some-
times or never well controlled: 7 percent
Explanation of medicines
50. Patients who said staff always explained
medicines before administering: 65 percent
51. Patients who said staff usually explained
medicines before administering: 18 percent
52. Patients who said staff sometimes or
never explained medicines before adminis-
tering: 17 percent
Assistance from hospital staff
53. Patients who said they always received
help as soon as they wanted: 69 percent
54. Patients who said they usually received
help as soon as they wanted: 23 percent
55. Patients who said they sometimes or
never received help as soon as they wanted:
8 percent
Recovery plan
56. Patients who said staff provided informa-
tion about what to do during their recovery at
home: 87 percent
57. Patients who said staff did not provide in-
formation about what to do during their recov-
ery at home: 13 percent
Care plan at discharge
58. Patients who strongly agreed they under-
stood their care when they left the hospital: 52
percent
59. Patients who agreed they understood their
care when they left the hospital: 43 percent
60. Patients who disagreed or strongly dis-
agreed they understood their care when they
left the hospital: 5 percent
Staffing
Source: American Hospital Association Hospi-
tal Statistics report, 2017 Edition.
Full- and part-time staff averages are for the
hospital unit only and do not include separate
nursing home units.
Average full-time staff
61. Hospitals with six to 24 beds: 99
62. Hospitals with 25 to 49 beds: 176
63. Hospitals with 50 to 99 beds: 286
64. Hospitals with 100 to 199 beds: 646
65. Hospitals with 200 to 299 beds: 1,192
66. Hospitals with 300 to 399 beds: 1,727
67. Hospitals with 400 to 499 beds: 2,562
68. Hospitals with 500 or more beds: 5,005
Average part-time staff
69. Hospitals with six to 24 beds: 50
70. Hospitals with 25 to 49 beds: 81
71. Hospitals with 50 to 99 beds: 132
72. Hospitals with 100 to 199 beds: 263
73. Hospitals with 200 to 299 beds: 453
74. Hospitals with 300 to 399 beds: 567
75. Hospitals with 400 to 499 beds: 835
76. Hospitals with 500 or more beds: 1,341
Utilization
Source: American Hospital Association Hospi-
tal Statistics report, 2017 Edition.
Average admissions per year
77. Hospitals with six to 24 beds: 394
78. Hospitals with 25 to 49 beds: 922
79. Hospitals with 50 to 99 beds: 2,098
80. Hospitals with 100 to 199 beds: 5,779
81. Hospitals with 200 to 299 beds: 11,011
82. Hospitals with 300 to 399 beds: 16,133
83. Hospitals with 400 to 499 beds: 20,410
84. Hospitals with 500 or more beds: 33,623
Average length of stay
85. Hospitals with six to 24 beds: 4.5 days
86. Hospitals with 25 to 49 beds: 5.1 days
87. Hospitals with 50 to 99 beds: 5.5 days
88. Hospitals with 100 to 199 beds: 4.6 days
89. Hospitals with 200 to 299 beds: 4.7 days
90. Hospitals with 300 to 399 beds: 4.9 days
91. Hospitals with 400 to 499 beds: 5.1 days
92. Hospitals with 500 or more beds: 5.5 days
Average inpatient surgeries per year
Averages include both hospital and nursing
home units.
93. Hospitals with six to 24 beds: 90
94. Hospitals with 25 to 49 beds: 200
95. Hospitals with 50 to 99 beds: 480
96. Hospitals with 100 to 199 beds: 1,419
97. Hospitals with 200 to 299 beds: 2,893
21
98. Hospitals with 300 to 399 beds: 4,182
99. Hospitals with 400 to 499 beds: 5,710
100. Hospitals with 500 or more beds: 10,236
Average outpatient visits per year
Averages include both hospital and nursing
home units.
101. Hospitals with six to 24 beds: 23,780
102. Hospitals with 25 to 49 beds: 45,249
103. Hospitals with 50 to 99 beds: 66,154
104. Hospitals with 100 to 199 beds: 135,975
105. Hospitals with 200 to 299 beds: 212,085
106. Hospitals with 300 to 399 beds: 271,538
107. Hospitals with 400 to 499 beds: 415,662
108. Hospitals with 500 or more beds: 667,839
Average outpatient surgeries per year
Averages include both hospital and nursing
home units.
109. Hospitals with six to 24 beds: 663
110. Hospitals with 25 to 49 beds: 1,040
111. Hospitals with 50 to 99 beds: 1,708
112. Hospitals with 100 to 199 beds: 3,417
113. Hospitals with 200 to 299 beds: 5,528
114. Hospitals with 300 to 399 beds: 6,934
115. Hospitals with 400 to 499 beds: 9,364
116. Hospitals with 500 or more beds: 15,124
Finance
Average adjusted expenses per inpatient day
Source: Kaiser State Health Facts, accessed in
2017 and based on 2015 data.
Adjusted expenses per inpatient day include all
operating and nonoperating expenses for reg-
istered U.S. community hospitals, defined as
public, nonfederal, short-term general and other
hospitals. The figures are an estimate of the ex-
penses incurred in a day of inpatient care and
have been adjusted higher to reflect an estimate
of the volume of outpatient services.
117. Nonprofit hospitals: $2,413
118. For-profit hospitals: $1,831
119. State/local government hospitals: $2,013
Key ratios
Source: Moodys Investors Service, U.S. Not-for-
Profit Hospital 2015 Medians report, Septem-
ber 2016.
The medians are based on an analysis of audited
2015 financial statements for 340 freestanding
hospitals, single-state health systems and multi-
 22
state health systems, representing 81 percent of
all Moodys rated healthcare entities. Childrens
hospitals, hospitals for which five years of data
are not available and certain specialty hospitals
were not eligible for inclusion in the medians.
120. Maintained bed occupancy: 64.3 percent
121. Operating margin: 3.4 percent
122. Excess margin: 6.1 percent
123. Operating cash flow margin: 10.3 percent
124. Return on assets: 4.8 percent
125. Three-year operating revenue CAGR: 5.8
percent
126. Three-year operating expense CAGR: 5.5
percent
127. Days cash on hand: 211.8 days
128. Annual operating revenue growth rate: 7.5
percent
129. Annual operating expense growth rate: 6.6
percent
130. Total debt-to-capitalization: 33.7 percent
131. Total debt-to-total operating revenue: 34.5
percent
132. Current ratio: 2.0x
133. Cushion ratio: 20.6x
134. Annual debt service coverage: 5.2x
135. Maximum annual debt service coverage:
4.8x
136. Debt-to-cash flow: 2.7x
137. Capital spending ratio: 1.1x
138. Accounts receivable: 48.4 days
139. Average payment period: 64.3 days
140. Average age of plant: 11 years
Hospital margins by credit rating group
Source: S&P Global Ratings U.S. Not-For-Profit
Health Care System Median Financial Ratios
2015 vs. 2014 report, September 2016.
AA+ rating
141. Operating margin: 6.2 percent
142. Operating EBIDA margin: 13.1 percent
143. Excess margin: 8.4 percent
144. EBIDA margin: 14.8 percent
AA rating
145. Operating margin: 4.9 percent
146. Operating EBIDA margin: 10.6 percent
147. Excess margin: 7.2 percent
148. EBIDA margin: 13.3 percent
177. Days cash on hand: 182.5
AA- rating
149. Operating margin: 3.5 percent
150. Operating EBIDA margin: 10.4 percent
151. Excess margin: 6.4 percent
152. EBIDA margin: 12.7 percent
A+ rating
153. Operating margin: 4.1 percent
154. Operating EBIDA margin: 10.3 percent
155. Excess margin: 5.6 percent
156. EBIDA margin: 12.3 percent
A rating
157. Operating margin: 3.6 percent
158. Operating EBIDA margin: 10.6 percent
159. Excess margin: 5.2 percent
160. EBIDA margin: 11.1 percent
A- rating
161. Operating margin: 2.9 percent
162. Operating EBIDA margin: 9.5 percent
163. Excess margin: 3.9 percent
164. EBIDA margin: 10.8 percent
BBB+ rating
165. Operating margin: 0.8 percent
166. Operating EBIDA margin: 6.8 percent
167. Excess margin: 3.4 percent
168. EBIDA margin: 8.7 percent
Days cash on hand and days in accounts re-
ceivable by credit rating group
Source: S&P Global Ratings U.S. Not-For-Profit
Health Care System Median Financial Ratios
2015 vs. 2014 report, September 2016.
AA+ rating
169. Days cash on hand: 426.2
170. Days in accounts receivable: 45.8
AA rating
171. Days cash on hand: 292.9
172. Days in accounts receivable: 49.9
AA- rating
173. Days cash on hand: 258.2
174. Days in accounts receivable: 48.8
A+ rating
175. Days cash on hand: 200.3
176. Days in accounts receivable: 46.2
A rating
178. Days in accounts receivable: 49.1
A- rating
179. Days cash on hand: 156.6
180. Days in accounts receivable: 46.2
BBB+ rating
181. Days cash on hand: 148.7
182. Days in accounts receivable: 47.6
Health IT
HIMSS Analytics EMR Adoption Model,
which runs from Stage 0 to Stage 7
Source: HIMSS Analytics, EMR Adoption Mod-
el, fourth quarter of 2016, the latest available
data for these measures.
183. Stage 7 providers: 4.8 percent
184. Stage 6 providers: 30.5 percent
185. Stage 5 providers: 34.9 percent
186. Stage 4 providers: 10.2 percent
187. Stage 3 providers: 13.9 percent
188. Stage 2 providers: 2.3 percent
189. Stage 1 providers: 1.4 percent
190. Stage 0 providers: 1.9 percent
Affiliations
Source: American Hospital Association Hospi-
tal Statistics report, 2017 Edition.
Part of a group purchasing organization
191. Hospitals with six to 24 beds: 67 percent
192. Hospitals with 25 to 49 beds: 69 percent
193. Hospitals with 50 to 99 beds: 66 percent
194. Hospitals with 100 to 199 beds: 72 percent
195. Hospitals with 200 to 299 beds: 77 percent
196. Hospitals with 300 to 399 beds: 82 percent
197. Hospitals with 400 to 499 beds: 86 percent
198. Hospitals with 500 or more beds: 93 per-
cent
Part of a health system
199. Hospitals with six to 24 beds: 46 percent
200. Hospitals with 25 to 49 beds: 55 percent
201. Hospitals with 50 to 99 beds: 67 percent
202. Hospitals with 100 to 199 beds: 75 percent
203. Hospitals with 200 to 299 beds: 74 percent
204. Hospitals with 300 to 399 beds: 77 percent
205. Hospitals with 400 to 499 beds: 75 percent
206. Hospitals with 500 or more beds: 75 percent
 23

Compensation

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

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

Truven Names 15 Top Health Systems for 2017

By Ayla Ellison

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

To identify the top 15 health systems, Truven

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

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

Cleveland Clinic President and CEO Dr. HCA to Change Its

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

T N
oby Cosgrove, MD, president and CEO of Cleveland Clinic, re- ashville, Tenn.-based HCA Holdings
vealed plans to transition out of his executive roles later this year. board of directors voted to rework the
He will reportedly continue on in an advisory role to the Cleve- companys name, CEO Milton Johnson
land Clinic. said on a May 2 earnings call.
Dr. Cosgrove served as president and CEO of the system for roughly The companys new name is HCA Healthcare
13 years. The Clinics board of directors and board of governors plan to as of May 8.
jointly select Dr. Cosgroves successor by the end of 2017. Officials will
search for another practicing physician to lead the organization. Regarding the change, Mr. Johnson said, Our
new name is more reflective of our mission
Under his leadership, the Cleveland Clinic launched a number of major and the broad spectrum of care we provide
wellness initiatives for patients, employees and communities, including to our communities and the dedication of our
a same-day medical appointment policy, the cessation of smoking on caregivers to our patients in our vast network
all Cleveland Clinic campuses, weekly farmers markets at the Clinic in of inpatient and outpatient facilities across our
the fall and winter months and free memberships to Weight Watchers 42 U.S. markets and the U.K.
and various exercise facilities for all employees, among other programs.
The company will continue to trade under the
Prior to his executive roles with the Cleveland Clinic, Dr. Cosgrove prac- ticker symbol HCA after the change takes ef-
ticed as a cardiac surgeon for nearly 30 years. fect.
It is an honor and a privilege to be a part of an extraordinary and for- HCA has reworked its name several times over
ward-thinking organization that puts patients at the center of everything the years. Prior to HCA Holdings, the compa-
we do, Dr. Cosgrove said in a statement. Cleveland Clinics world-class nys names included HCA Inc., Hospital Corpo-
reputation of clinical excellence, innovation, medical education and re- ration of America and Columbia/HCA Health-
search was created and will be maintained by the truly dedicated care- care. n
givers who work tirelessly to provide the best care to our patients. n
 1,500+ ATTENDEES FROM
ACROSS THE NATION 3RD ANNUAL
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KEYNOTES BY REVENUE CYCLE
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SEPTEMBER 21-23, 2017

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United States of America The Big Fight: My Life In and Out of the Ring CHICAGO, ILLINOIS

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AND HEALTH SYSTEMS
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Information Officer, Henry Ford Health System and Chief Information Officer,
New York-Presbyterian
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The Advisory Board Company; Interim Chief
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JD, Chairperson, McGuireWoods LLP REGISTER HERE
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health-it-revenue-cycle-conference/

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OR 800.417.2035.

Shafiq Rab, MD, Regional Senior Vice Susan Salka, Chief Executive EMAIL Scott Becker or Jessica Cole at
President and Co-Chief Information Officer, Officer, President and Director,
Hackensack University Medical Center AMN Healthcare Services sbecker@beckershealthcare.com or
jcole@beckershealthcare.com
 26
Governor Orders
New Hampshire
Hospital CEO Bob
MacLeod to Resign
CEO/STRATEGY
Over Staffing
Deficiency
By Anuja Vaidya
T
he governor of New Hampshire asked Con-
cord-based New Hampshire Hospital CEO Bob
MacLeod to step down from his post, accord-
ing to a Concord Mirror report.
Here are nine things to know:
1. New Hampshire Gov. Chris Sununu asked Mr. Ma-
cLeod to resign after state officials found that Leba-
non, N.H.-based Dartmouth-Hitchcock has been vi-
olating its staffing contract.
2. In September 2016, New Hampshire officials ap-
proved Dartmouth-Hitchcocks proposal to take over
staffing for the state psychiatric hospital.
3. However, state officials discovered that only 10 psy-
chiatrists are currently providing care at NH Hospital,
even though the contract requires a total of 12 psy-
chiatrists.
4. The two positions fell vacant after the psychiatrists
were promoted to leadership roles. The positions were
not filled.
5. State officials also discovered that the staffing re-
ports they have been receiving from the hospital were
incorrect. The reports show the benchmark for staff-
ing levels as 10, when it should be 12.
6. Dartmouth-Hitchcock received a notice of
non-compliance from the state. The health system has
five days to provide a response.
7. Additionally, the New Hampshire Department of
Health and Human Services is considering an inves-
tigation into whether the staffing deficiency affected
care quality at NH Hospital.
8. Gov. Sununu has asked the state Attorney Gener-
als office to review the states contract with Dart-
mouth-Hitchcock to explore what additional action
could be taken, according to the report.
9. Gov. Sununu asked Don Shumway, former CEO of
Greenfield, N.H.-based Crotched Mountain Hospital,
to take over as CEO of NH Hospital. n
6 Tips for Working With Someone
Who Isnt a Team Player
By Tamara Rosin
W
orking with someone who isnt a team player is not only
frustrating, it can impair the entire teams performance. In
healthcare, where team-based care is central to efforts to
improve coordination and collaboration among providers, the reper-
cussions can be severe for both patients and hospitals.
Heres how to work with a colleague who isnt carrying his or her
weight as a team player, according to a recent article in the Harvard
Business Review.
1. Dont make assumptions. Before jumping to conclusions and
attributing a coworkers poor teamwork to their personality or work
style, do some exploration. Its possible the individual is dealing with
a personal stressful situation that is contributing to distraction or
diminished performance at work, according to the report. Or per-
haps they are dealing with work pressures you dont know about.
Its important to avoid dismissing the person as a slacker or coming
up with your own explanations for their behavior, especially if it in-
volves attributing bad motives to them, said Allan Cohen, PhD, a
professor of management at Babson College in Babson Park, Mass.,
and author of Influence Without Authority, according to the report.
2. Talk to the individual. Start a dialogue with the team member in
question, but approach him or her with friendly questions, not accu-
sations. Helpful questions that indicate your support for the individual
could include: What else are you working on right now? or What
motivates you the most? according to the report.
3. Be inclusive. The issue of a disengaged team member could be-
come exacerbated if the team decides to shun the person who isnt
carrying his or her weight, according to the article. To promote better
cohesion, ask the person out for coffee or lunch and try to get to know
him or her better, and bring a few other coworkers along.
4. Clarify the teams mission. An uncooperative team member
may indicate that something is off with the group. Perhaps the
teams approach isnt working or the mission isnt clear enough.
Revisit the groups shared vision and mission and clarify best meth-
ods for fulfilling them.
5. Clearly define team members roles. Dont assume everybody
knows exactly what their contribution is supposed to be, said Dr. Co-
hen. Its possible the person who hasnt been acting as a team player
simply does not understand what he or she is meant to do.
6. Create new opportunities to motivate. An employee may seem
withdrawn from their work because they desire new opportunities to
grow and develop their skills, according to the report. If that seems to
be the case, see if there is a more suitable role for this individual on
the team. Its also possible to give them other informal roles to better
showcase their skills or offer new learning opportunities, according to
the report. n

Be Professionally Blunt 4
Tips for Developing a Great
Leadership Team
By Brian Zimmerman
D C
rafting and managing a successful leadership team is a soft science with
no fixed blueprint. However, beyond measuring organizational achieve-
ments, the experience of being part of a successful leadership team can
perhaps best be surmised by the colloquialism:I know it when I see it.
A hospital CEO must rely on his or her team of leaders to promote the long-
term vision and culture of an organization, while also completing essential
day-to-day duties. These relationships require trust and diligent upkeep.
During the Beckers Hospital Review 8th Annual meeting in Chicago April
19, Steven Little, president and CEO of Agnesian Healthcare in Fond du Lac,
Wis.; Parveen Chand, COO of Indiana University Health Academic Health
CenterAdult Hospitals in Indianapolis; Christopher Weaver, MD, senior vice
president of clinical effectiveness at Indiana University Health in Indianapolis;
and Julie Blatnik, senior director of clinical operations with Medtronic, dis-
cussed leadership culture and the keys to establishing a great leadership team.
Here are four tips panelists offered during the discussion.
1. Leverage the entire team for daily and long-term goals.
Speaking about his 3-year tenure as COO of Indianapolis-based Eskenazi
Health, Mr. Chand discussed the importance of leveraging the entire team in
terms of long-term strategy and daily tasks.
Part of our work was really segmented in terms of leveraging our entire team,
so deciding the specific roles of the chief nursing officer, the chief strategy
officer, the CFO and deciding who is going to execute [which strategy] ... we
leveraged our team to do both long-term strategy and daily operations.
2. Develop trust and eliminate territorial mentality.
During the discussion, Dr. Weaver spoke about the importance of having lead-
ers who are interested in team goals beyond the scope of their particular field.
Trust is the biggest key for our team, said Dr. Weaver. Weve had great suc-
cess in working together and crossing into each others area[s] ... Were not
territorial at all and I think thats important ... to truly function as a team. Its
about keeping an eye on the same prize.
3. Know when to ask for help.
Ms. Blatnik suggested team members should feel comfortable relying on one
another for assistance, which can be integrated into the organizational culture
by a shared vision.
If we share the same vision and engage, identify and respect each others
diverse talent, we have to know when something is outside of [our] expertise
[and] reach out, said Ms. Blatnik.
4. Be professionally blunt.
During the panel discussion, Mr. Little spoke about the importance of con-
structive disagreement to optimize the decision-making process.
We make better decisions when we dont agree, respectfully and profession-
ally, about why we should be moving in one direction or another, but in the
end recognizing that the majority is going to rule, said Mr. Little. Its about
being professionally blunt and straightforward with each other and not candy
coating difficult issues ... We have difficult problems in the industry. We better
step up and face them and work together in a collaborative way. n
27
OSU Wexner CEO Resigns
Over Faculty Concerns
About Leadership
By Anuja Vaidya
CEO/STRATEGY
olumbus-based Ohio State University Wexner
Medical Center CEO Sheldon Retchin, MD,
resigned in May following complaints about
his leadership from the faculty. He is also stepping
down from his position as executive vice president
of health sciences at the medical center.
Twenty-five Ohio State University College of Medi-
cine physicians and professors signed a letter of "no
confidence" in Dr. Retchin and his executive team at
the beginning of May. The letter notes 100 faculty
members from the college of medicine express ed
the same sentiments; however, not all signed it due
to fear of retaliation.
Soon after, five senior members of the medical cen-
ter's neurological institute also penned a letter de-
tailing concerns about the leadership team.
The two letters include a number of complaints.
They both allege Dr. Retchin and his executives are
unsupportive of physicians, leading to low morale
among staff members and loss of talented physi-
cians. Additionally, one letter contends Dr. Retchin's
leadership strategies are driving a wedge between
the medical center and the OSU Comprehensive
Cancer Center, where Michael Caligiuri, MD, serves
as leader. Ultimately, Dr. Retchin's leadership is hurt-
ing the academic mission of the hospital and med-
ical college, the physicians wrote, according to The
Columbus Dispatch.
In a statement issued by The Ohio State University,
officials thanked Dr. Retchin for his work at the med-
ical center and noted some of his accomplishments,
including the opening of the Jameson Crane Sports
Medicine Institute. The statement also addressed
the letters.
"Although allegations raised in letters sent to the
news media this week were untrue, these letters
may have damaged important relationships neces-
sary for continued future success, and Dr. Retchin
has chosen to move on in the best interests of the
university, himself and his family," the statement
reads.
Dr. Retchin also issued a statement via the universi-
ty, where he states that the allegations in the letter
are not true. "These baseless accusations have dam-
aged me and the university I love. I cannot allow this
to continue and so I have decided that it is in the
best interest of the institution and me and my family
to step aside, effective immediately." n
 28
University of Utah Health Care CEO Dr. Vivian Lee Steps
Down Post-Cancer Center Conflict
By Emily Rappleye
V
ivian Lee, MD, PhD, stepped down
from her roles as senior vice president
for health sciences, medical school
CEO/STRATEGY
dean and CEO of University of Utah Health
Care in Salt Lake City, after a high-profile con-
troversy involving the director of the universi-
tys cancer center.
Dr. Lee announced the news to faculty and
staff April 28: Taking account of the events of
the last two weeks, I believe the best interests
of the university are now served by the deci-
sion I am taking today.
The feud erupted when Mary Beckerle, PhD,
director and CEO of the Huntsman Cancer
Institute was fired over email on April 17. Dr.
Becklerle, who has led the cancer center for 11
years, claims no reason was given for her remov-
al. Billionaire philanthropist Jon Hunstman Sr.,
who helped found the institute, called the move
a power grab, threatened to sue the university,
took out full-page ads in two local newspapers
protesting her firing and threatened to withhold
a $250 million donation, according to KSL.com.
Dr. Beckerle was reinstated April 25.
Study: Executives Who Flatter CEOs Most Also Develop Greatest
Resentment for Them
By Emily Rappleye
W
hile CEOs may like to hear
their top executives sing
their praises, a recent study
suggests they may want to be wary of
managers who never voice dissenting
opinions.
Researchers found when top execu-
tives ingratiate themselves with the
CEO, the process can ultimately lead to
resentment and result in the same ex-
ecutives making negative comments to
the press about the CEO. Unfortunate-
ly, researchers found an even stronger
correlation between flattery and re-
sentment when the CEO was female
and/or a minority and the top manag-
ers were white males.
The study, published in the journal
Administrative Science Quarterly and
featured in Harvard Business Review,
Throughout the ordeal, Dr. Lee declined to pub-
licly comment on the matter. I am aware too
that more than a few have felt there should be
some sort of reply to the very strong criticisms
of leadership and actions, directed especially at
me, she wrote in her resignation announcement
to faculty and staff. This absence is not because
of a lack of strongly held alternative viewpoints
and substantive positions, but rather a clear sense
that the best interests of our university and of our
entire community are to collegially embrace one
another and all move forward together.
Mr. Hunstman said he did not regret Dr. Lees
resignation and called her a one-person wreck-
ing crew, according to KSL.com. He also called
her integrity into question in relation to the ap-
plication of a $12 million donation from Patrick
Soon-Shiong, MD, which is currently under
review by the state Office of the Legislative Au-
ditor General, according to KSL.com.
Dr. Lee responded to the criticisms of her
character in her resignation statement: In a
more private way, it is fair to say that some of
the strong invective directed at my integrity
and character, which was carried in the news
includes survey information from 3,895
CEO and top manager pairs from large
to mid-sized companies that bring in at
least $50 million in annual sales.
They found ingratiation which may in-
clude flattery, compliments and opinion
conformity is often used by top man-
agers to build social capital with CEOs,
potentially gaining board appointment
recommendations or insider informa-
tion. However, this type of ingratiation
can be demeaning for the executives
who make the comments and lead to
behaviors that damage their target
such as making negative comments to
the press about the CEO.
The researchers found negative com-
ments were both direct and indirect. In
their article for HBR, the study authors
gave examples of negative comments
media over the past two weeks, has been dis-
turbing, especially to the younger members
of our family in this close-knit community in
Utah we have come to call home. She added,
I am hoping my decision today will help in
putting that completely in the past.
During her six-year tenure leading the health sys-
tem, Dr. Lee emerged as a leader in driving val-
ue-based outcomes and investigating the costs of
care. Under her leadership, the university recruit-
ed 400 new faculty members and launched ini-
tiatives in neuroscience, diabetes, global health,
precision medicine and genomic sequencing,
among others, according to a statement from
University President David Pershing, PhD.
She has been described by her colleagues as a vi-
sionary leader who maintains high standards for
herself as well as others, Dr. Pershing said in the
statement. Dr. Lee has led a remarkable transfor-
mation of our academic and research operations
and has been at the forefront of innovations in
healthcare delivery at the national level.
Dr. Lee plans to stay on at University of Utah
as a radiology professor. Dr. Pershing plans to
announce her interim replacement soon. n
to journalists, such as the board is
picking up the slack or that the CEO
recognizes their lack of experience.
They found the correlation between
flattery and resentment was strong. So
strong, in fact, that an increase in com-
pliments by one standard deviation
was associated with a one and half to
two point increase in resentment on
a five-point scale. The correlation was
even stronger when white men report-
ed to a CEO who was female or a racial
minority, according to the report.
[O]ur findings suggest that the CEOs
who tend to receive high levels of flattery
and agreement from their managers are
particularly prone to being socially un-
dermined by those very same individu-
als, the authors concluded for HBR. n

Words From the C-Suite: Advice From 4 Executives
By Alyssa Rege
Team-based collaboration is
essential to the future of our
functioning healthcare system
F or one C-suite executive, the intersection of technology and med-
icine will become a crucial part of the healthcare industry in the
next few years, if not sooner. To use that technology effectively, med-
ical professionals from all disciplines must learn to work together for
the benefit of the patient.
Larry Chu, MD,is the executive director ofMedicine X, an initiative ex-
ploring how emerging technologies will advance the practice of medicine,
improve health and empower patients to become active participants in
their own care. Dr. Chu said through his work as a professor of anesthesi-
ology, perioperative and pain medicine at Stanford (Calif.) University, he
witnessed inefficiencies in students ability to interact and problem-solve
together. He said the issue is especially problematic, since an individuals
health is an amalgamation of various provider recommendations. If each
medical professional isnt aware of the recommendations their colleagues
provide, the patient is the one that loses out in the end.
Inter-professional, interdisciplinary, team-based collaboration is es-
sential to the future of our functioning healthcare system[,] and we
cant get there if were not learning and teaching together. In health-
care, we learn in silos. Medical doctors train in medical school, and
we dont know anything about pharmacists. Pharmacists train at
pharmacy school [and] tend not to know anything about nurses.
Nurses train at nursing school [and] dont know anything about
occupational therapists. Yet when were all done, were expected to
work together [We need to spend time] in our curriculum to un-
derstand the misperceptions that arise between the patient persona
and the provider persona, so that we can uncover the roadblocks to
honest conversation that get in the way of participatory healthcare
decisions. We cant have honest conversations if we dont have trust,
and we dont have trust in our relationships because we dont under-
stand each other.," Dr. Chu told Becker's Hospital Review via email. n
Bill Gates hopes Trump will be
pragmatic about foreign health aid
B illionaire philanthropist and Microsoft Founder Bill Gates said
he is counting on President Donald Trump to be pragmatic
when it comes to U.S. foreign health aid.
In an interview with Bloomberg, Mr. Gates said President Trumps recent
proposal to significantly cut the nations foreign aid budget may affect
how much money other nations contribute to fund foreign health efforts.
He speculated that because President Trump recently reversed his posi-
tion on a number of economic pledges, a frank discussion with the presi-
dent may help him see the importance of continuing to fund such efforts.
Ive talked to [President Trump] about HIV and how the U.S. should
be proud of our work [to combat the virus]. This dialogue is important:
Youve seen his pragmatism on a number of things and Im certainly
hoping that these health-related budgets receive some of that atten-
tion Trump wants to be a leader, he wants to have things that hes
actually accomplished. It means talking to him and giving him some
background that he might not have had through his past work. n
29
'First get started, then get smarter'
A mong the numerous business lessons he has learned over the
course of his career, one C-suite veteran said seizing opportu-
nities as they come instead of waiting until youre prepared has
helped him become a successful entrepreneur.
In a conversation with CNBC, Jeff Lawson, CEO of Twilio, a software
development company that allows apps to contact users directly, high-
lighted the importance of taking initiative and taking advantage of op-
portunities as they come. As entrepreneurs, youre expected to fail at one
point or another; how you respond to that failure is what counts.
No one is going to just teach you exactly [what you need to know].
Life is not a paint-by-number sort of deal. We have to figure it out
My grandfather, during the Depression was working in a factory
and he wanted to make more money He went to the owner and he
said, I need to make more money, how do I do that? The guy said
I dont have any other jobs. The only job I have is driving the truck.
Do you know how to drive the truck? My grandfathers answer was,
give me the keys and he got this job and made more money. But
heres the thing he never told his boss: He had never driven a truck
before in his life its a lesson that Ive internalized and brought into
our company its like, you know what, well figure it out. And if we
dont, someone else will The best way to learn something new is to
commit yourself to doing it. n
Algorithms will drive future
health gains
L loyd Minor, MD, dean of the Stanford (Calif.) University School
of Medicine, believes further advances in medicine and health
will be tied to medical professionals ability to interpret massive
amounts of data.
Since taking over as dean of Stanfords medical school, Dr. Minor has
established a department of biomedical data science within the medical
school and announced a partnership with Google. He said his efforts
are part of a larger belief that the future of medicine lies in personalized
health, which focuses on prediction and prevention. Dr. Minor recent-
ly sat down with The Wall Street Journal to discuss the how the medical
school is integrating data science and medicine to mitigate hospital infec-
tions transmitted through poor hand washing.
We know that a lot of hospital infections are transmitted by our hands
and hand washing can be tedious, but it is extremely important. So we
began a project with the folks in computer science to develop an [artifi-
cial intelligence]-based system that can look at the hand-washing stations
outside of an ICU room and determine when a person has washed their
hands. The interlock on the patients room is only opened and triggered
when a person has gone through the appropriate hand washing. Now, it
can be overridden if there is an emergency. But if it is overridden it gets
recorded and there needs to be an explanation of why it was overridden. I
was skeptical at first. I thought you could fool it by not actually rubbing
your hands. Well, it turns out to be pretty darn good [the technology]
is being piloted in the ICUs but not yet driving the opening and closing of
doors. The technology is validating that the hand washing is taking place
and we are getting feedback from others on how it works. n
30 Executive Briefing
Executive Briefing
Sponsored by:
The Real Reason Loyalty Lacks in Healthcare
By Brian Wynne, Vice President and General Manager, NRC Health
H
ealthcare systems have long been relatively successful
at attracting and retaining customers with the if you
build it, they will come mentality or perhaps more
accurately, if you build it, they must come.
Yet with the meteoric rise of healthcare consumerism within the
past few years, most people have an unprecedented number
of choices of provider and care options, including opting out of
care altogether. As a result, creating loyalists in todays health-
care industry is nearly impossible without the right insight into
the wants, needs and expectations of those whom we in the
healthcare industry hope to serve.
The Demand for a Personalized Experience
Consumers are scrutinizing the quality and cost of their health-
care, and theyre more apt and able to look elsewhere when
their providers dont measure up to their expectations. Ac-
cording to a report by Accenture, 7 percent of customers have
switched healthcare providers due to a subpar experience,
which could add up to more than $100 million in lost annual
revenue per hospital.
This number will climb. The value equation in healthcare is al-
ready out of balance. Higher out-of-pocket expenditures for ex-
tremely personal and in many cases life-changing encoun-
ters bring with them extremely high expectations for service
and care delivery; in fact, a recent study by NRC Health found
that 82.3 percent of consumers said hospitals and healthcare
systems should consistently meet or exceed their expectations.
When these expectations are unmet, the switch economy, pre-
viously seen in all other consumer-driven industries, develops.
Since both the risks and the costs of healthcare are high, con-
sumers insist that healthcare systems with which they engage
understand their preferences and offer experiences to satisfy
their needs perhaps even delight them. Consumers demand
that their healthcare be designed and delivered in the same
way that other industries they consume and experience are, like
retail, hospitality and consumer electronics.
Still, few healthcare executives I know would say their services
offer an experience akin to that of a luxury hotel or boutique
spa. Although we know that high cost means high expectation,
there is still hesitance in healthcare to base design on models
proven to work in other consumer-driven industries.
Why? Because most healthcare systems lack a comprehensive
understanding of who their customers are, what they need and
how they want to access care. As a result, those systems are un-
able to consistently provide personalized and coordinated care
experiences throughout their consumers healthcare journeys
and when the experience doesnt meet the expectation, loyalty
becomes an unrealistic and unattainable goal.
31
Customer Confusion = Lost Opportunities
The more frequently consumers visit their healthcare provid-
ers, the more frustrated they become. According to a report by
Prophet and GE Healthcare Camden Group, 81 percent of cus-
tomers are unsatisfied with their healthcare experience.
Whats more, 75 percent of those who frequently use health-
care services three or more times a year and 48 percent of all
other healthcare consumers say theyre frustrated.
For people to fully engage with their healthcare, its imperative
that they understand the process, their coverage and what to
expect from their providers.
Research shows that when consumers first embark on a health-
care journey, confusion is the primary emotion felt. The reasons
for this are intuitive: out-of-pocket costs are a mystery, con-
sumer reviews of care providers remain strangely elusive, ex-
periences are inconsistent from one care provider or facility to
another, hospital consolidations are increasing each year, and
consumers are unsure of inter-hospital relationships and affilia-
tions. And yet, so few organizations ask their customers, How
can we make your experience less confusing? or, How can we
reduce the frustration you feel?
Most healthcare systems lack a
comprehensive understanding of who
their customers are, what they need and
how they want to access care.
A $100-Million Blind Spot
According to the U.S. Census Bureau, the average lifetime val-
ue of an individual healthcare consumer is $1.4 million or $4.3
million for a family of four.
With this much potential spend at stake, the value equation
comes under scrutiny. As mentioned earlier, when the cost of a
service outweighs the experience it delivers, it sets the stage for
consumers to become switchers.
Not only are consumers finding new providers in these cases,
theyre increasingly seeking care from non-traditional care pro-
viders, such as chain pharmacies offering primary care and test-
ing services, borderless digital e-visit providers and alternative
medicine and holistic-healing practitioners. Healthcare systems
need to make a deliberate commitment to offer high-quality,
 32 Executive Briefing

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

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

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

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

8 Things to Know
By Anuja Vaidya

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

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

Athenahealth CEO Jonathan Vanderbilt University Medical

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

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

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

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

The 16 Tech Companies Trump Establishes American

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

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

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

CIOs Greatly Underestimate

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

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

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

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

Why Do Women, Minorities Leave Tech Companies?

4 Study Insights
By Jessica Kim Cohen

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

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

47% of Organizations Say Lifespan Notifies 20k Patients of

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

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

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

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

HIMSS Analytics Unveils 2018 Health IT

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

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

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

Cerner Impersonation Scheme Leader Sentenced to 12 Years in

Prison
By Anuja Vaidya

A
lbert Davis, the leader in a fraud scheme that estab-
lished a fake company impersonating Cerner, was
sentenced to 12 years in federal prison, according
to aKansas City Starreport. Mr. Davis was also ordered to
pay part of the restitution costs.
In October 2016, Mr. Davispledguilty to his involvement
in the scheme. His co-conspirators include Christina Bry-
ant, Richard Bryant, David Hernon and David Tayce. The
individuals created a fake company, calling it Cerner LLC.
They opened a bank account, bought an internet domain
and also produced fake documents, agreements and in-
voices for Cerner LLC. Additionally, they created fictitious
employees, even using names of real Cerner employees.
Before being discovered, the conspirators managed to sell
an MRI to a Texas hospital, created fake invoices and re-
ceived more than $1 million from the hospital. When the
hospital contacted Cerner for assistance with system instal-
lation, they found out that the real Cerner had not been
involved at all.
Mr. Davis lawyers argued that his fierce sense of pur-
pose and drive caused him to fly far off the track and
into the realm of fraudulent criminal conduct, according
to the report. They even pointed to the fact that Mr. Da-
vis is a West Point Military Academy graduate as a testa-
ment to his character. They asked for a lesser sentence
of eight years.
Prosecuting attorneys, however, countered that Mr. Da-
vis had leveraged his West Point degree to gain peoples
trust.
Like his West Point degree, this defendant knew that
Cerner Corporations reputation in the medical commu-
nity would open doors otherwise unavailable to him,
prosecutors noted in a written memorandum, according
to the report. n
 38
8 Things to Know About Nurse Bullying
By Alyssa Rege
T
he nursing profession has consistently ranked No. 1 in Gallups
annualpollof Honesty and Ethical Standards in Professions for
the past 15 years which makes therampant bullying and haz-
ing that persists among nurses that much more surprising.
Judith Meissner, RN, MSN,coinedthe phrase nurses eat their young
in a 1986 article to describe the hostility young nurses face at the hands
of their more experienced coworkers. In a follow-up article published
13 years later, Ms. Meissner said students, new graduates and even
experienced new hires still suffered intense bullying.
According to a 2017blog postby Pittsburgh-based Select International
Healthcare, roughly 85 percent of nurses have been abused by a fellow
nurse and approximately one in three nurses have considered quitting
the profession due to bullying.
Here are eight things to know about nurse bullying.
1. Forty-five percent of nurses have been verbally harassed or bullied by
other nurses, according to a 2017 survey by employment agency RN-
network. Forty-one percent of those surveyed said they have been ver-
bally harassed or bullied by managers or administrators. Some nurses
(38 percent) even reported having been verbally harassed or bullied by
physicians. More than half of the nurses who reported work harassment
indicated they were considering leaving the profession all together.
2. While some forms of bullying nurses experience are overt, like ver-
bal harassment, threats or physical violence, other forms are more sub-
tle. Researchers refer to this subtle harassment as incivility, a form of
bullying commonly brought upon young nurses by their more expe-
rienced counterparts. Renee Thompson, DNP, RN,saidincivility can
take on many forms, including sabotage, withholding information, ex-
cluding others, unfair assignments or downplaying accomplishments.
3. For some nurses, incivility can wreak havoc not only on their self-es-
CMO / CARE DELIVERY
teem, but on the health and well-being of their patients. In an interview
forMarie Claire, 27-year-old Christi who declined to provide her
last name to the publication said about four months into her job
as an intensive care unit nurse at a North Carolina hospital, a group
of nurses refused to help her care for a patient who had suddenly lost
consciousness. A week after stabilizing the patient on her own, a friend
told Christi not to go into her locker and to call a manager. Christi
said she opened her locker and, after lifting her clothes with a tongue
depressor, discovered a bloody syringe.
My first thought was, This could be attempted murder because I
didnt know what was on the needle that I would have contracted if it
stuck me, she told the publication.
4. Nurses who have historically faced bullying or harassment in the
workplace often do not report their concerns. If they do report the
bullying, managers may do little to remedy the situation. During a
September 2016discussionhosted by the Association of periOperative
Registered Nurses and streamed live on Facebook, Linda Groah, MSN,
RN, CEO of AORN,citeda survey in which only 38 percent of man-
agers said they attempted to address complaints of bullying brought
to their attention. Christi toldMarie Claireshe asked management to
investigate the situation involving her locker. She said management re-
fused, stating they [couldnt] fire 14 people for one nurse, according
to the report. Christi said she decided to leave the health facility af-
ter management did not allow her to change shifts or transfer depart-
ments, according to the report.
5. Some researchers speculate that because nursing is generally a fe-
male-dominated profession, competition plays a role in pitting nurses
against one another. Theories suggest that age-old female competition
[in the medical field] has shifted from competing over a man to compet-
ing over status, respect and position in the nursing environment, said Dr.
Thompson. The same behaviors once witnessed between two women
fighting over a man are the ones witnessed today in the behavior of bullies.
6. Given the apparent pervasiveness of the issue, how do hospitals and
administrators begin to combat incivility and bullying? Nurses should,
first and foremost, document any type of harassment inflicted upon
them, Dr. Thompson said. If you are being bullied, start a documen-
tation trail. Keep a small notebook with you and write down dates,
times, witnesses, verbatim comments and any behaviors you believe
undermine a culture of safety and a professional work environment,
shesaid. Keep growing this documentation trail until you are at the
point where you can file a formal complaint.
7. Nurse managers also play a vital role in recognizing and preventing
bullying. According tosome experts, its up to the nurse manager to
[share] information about incivility and its harmful effects and [to]
take the lead in establishing civility charters, co-creating norms of de-
sired behavior, implementing policies and rewarding civility because
their actions set the tone for the types of professional interactions that
are expected in the workplace.
8. Additionally, hospital executives and nurse leaders can imple-
ment protocols outlined under the acronym L.I.S.T.E.N to address
nurse bullying. Those protocols include beginning to investigate the
situation as soon as a complaint is issued and to never share their own
opinion on the issue with any of the participants to remain unbiased. n
CDC Director Calls C. Auris
Fungus a Catastrophic Threat
By Heather Punke
I
n an interview with STAT, Anne Schuchat, MD, act-
ing director of the CDC, pointed to the deadly fun-
gusCandida aurisas a catastrophic threat to society.
C. auris is an emerging, deadly, drug-resistant yeast.
Some strains are resistant to all three major classes of an-
tifungal drugs, making it of particular concern.
The first domestic cases ofC. aurisinfections in the U.S.
werereported in November 2016and as of April 13, 61
infections have been reported in six states,according to
the CDC.
The threat of C. auris should spur officials to attempt to
better contain the fungus and other superbugs, according
to Dr. Schuchat.This is a big threat and a wake-up call, Dr.
Schuchat toldSTAT. It was a problem for Ebola. It was a
problem for SARS. Its a problem for drug resistance.
The CDCrevised its guidelinesto control C. auris in Feb-
ruary.n
 39

KentuckyOne to Cancel Contracts With 25 Employed

Physicians
By Alyssa Rege

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

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

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

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

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

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

CDC Issues New Dr. Peter Pronovost: This Unnecessary

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

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

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

on patients without clear benefits

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

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

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

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

50 Cities With the Largest, Smallest Gender Wage

Gaps for Physicians
By Emily Rappleye

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

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

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

Resignation of 3 Physicians Sparks Great Concern in Small Iowa

Community
By Emily Rappleye

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

How Identifying High-Value PCPs 10 Best and Worst

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

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

involves taking all the information from 8. Utah 55.62

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

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

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

Denial mitigation

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

Build a healthier bottom line.

Visit cerner.com/revworks
2016 Cerner Corporation
 44 Executive Briefing
Sponsored by:
Keys to Painless Conversions: Transition Services and Best Practices to
Prevent Disruption and Return to Baseline
P
reparing for a conversion of any kind is no small task. But
coordinating a conversion that involves transitioning patient
accounting systems must include specific fiscal, cultural and
operational considerations. When these arent accounted for ear-
ly in the preparation process, organizations can run into cash flow
problems later that set collection rates back by several months.
However, with the proper fiscal planning, staff engagement
and executive support, healthcare organizations can minimize
their financial risk and more quickly return to, or exceed, base-
line performance.
Few know this better than conversion-veteran Joe Koons, man-
aging director of revenue cycle for Centra Health, a regional
nonprofit system in Lynchburg, Va. Since August, Mr. Koons has
led efforts to prepare Centras revenue cycle departments for
conversion to Cerners patient accounting system, slated to go-
live March 2018.
Centras size has made planning a conversion particularly com-
plex. Centra provides medical services to patients across a geo-
graphic area roughly the size of New Jersey. Its diverse portfo-
lio spans the full continuum of care, including four acute care
hospitals, more than 50 ambulatory and long-term facilities, a
freestanding ER and a 300-physician medical group. The health
system recorded $1.1 billion in net revenue in 2016. Centra also
oversees a burgeoning health plan covering more than 45,000
residents in south-central Virginia.
The amount of resources behind a conversion of that size is
daunting, Mr. Koons said. The complexity of the system is at
the degree where there are lots of different bill formats and
unique requirements that have to be considered ... and coordi-
nated with the different clinical workflows.
Many hospitals pursue IT conversions to enhance system interop-
erability, improve workflow efficiencies and gain tools to manage
a more complex care environment. Although C-suite leaders gen-
erally agree the long-term benefits of conversion outweigh the
short-term challenges of implementation, a mismanaged conver-
sion can have severe financial consequences that limit an organi-
zations capacity to function, and may even affect patient care.
Having realistic expectations of how a conversion will affect
day-to-day processes can help revenue cycle leaders take ini-
tiative to mitigate financial risk, Mr. Koons said. This article ex-
amines the potential financial effects of a conversion, as well
as four key steps Centra Health took to address and minimize
financial disruption.
Tactics to mitigate financial disruption during conversions
A patient accounting system (PAS) conversion involves the
gradual transitioning of workflows from a legacy system to the
current system while maintaining day-to-day operations.
The internal operation has to continue to move forward [during
conversion], so its a juggling act between maintaining current
operating performance and standing up this new system thats
going to replace all the current workflow, Mr. Koons said.
This juggling act between systems can reduce productivity and in-
troduce opportunities for financial information to slip through the
cracks. Missing claims, missed revenue capture and late patient
billing can result in fewer collections and slower collection rates.
Hospitals with particularly bumpy conversions can see baseline
collections fall 195 percent below baseline performance equiv-
alent to two months worth of collections within nine months of
implementation, according to a 2016 Crowe Horwath study.
Even hospitals with middle-of-the-road conversions have seen
noteworthy disruption to revenue cycle operations, according
to the Crowe Horwath study. Hospitals average benchmarks for
key performance metrics within one month of implementation
included: a 10 day increase in days in accounts receivable, from
52 days to more than 62; an 86 percent increase in days-not-
final-billed; and a 21 percent decline in collection rates.
Although these metrics may appear discouraging, there are
four key actions hospitals can take to mitigate and possibly
eliminate the negative financial consequences of conversion,
Mr. Koons said.
1. Create a revenue cycle governance structure.
To minimize disruption, Mr. Koons recommended organizations
establish a governance framework to ensure revenue cycle KPIs
continue to meet pre-conversion benchmarks.
For example, Centra established a reporting structure consist-
ing of three management tiers to monitor day-to-day opera-
tions as well as high-level strategic progress.
Centras first process management tier the revenue cycle
action team consists of directors from revenue cycle depart-
ments as well as project leaders from Cerner. The action team
is responsible for monitoring a laundry list of performance met-
rics at a granular level, such as gross and net days in A/R, cash
as a percent of net revenue, DNFBs, denials, partial denials and
A/R aging by 90 days by payer, among others. If KPIs deviate
from the expected rates, the action team notifies second tier
management and executes corrective measures to get the de-
partment back on track.
The second and third tiers the revenue cycle finance steering
committee and revenue cycle advisory committee, respectively
examine and discuss high-level implementation strategies and
initiatives to ensure a smooth transition. For instance, the adviso-
ry committee considers and monitors costs associated with con-
version scope, ensuring the project doesnt overrun its budget.
The framework is in place to ensure the scope of the conver-
sion doesnt balloon to the point where it jeopardizes or puts
the project, or the organization, at risk, Mr. Koons said.
Executive Briefing 45

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

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

Debunk the myth:

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

Three good reasons

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

Build a healthier bottom line.

To learn more about the benefits and best practices of outsourcing all or part
of your RCM operations, download the Partnering for Success whitepaper at
cerner.com/partneringforsuccess.

150 Hospital and Health System CFOs to Know | 2017
By Kelly Gooch, Eric Oliver, Alyssa Rege and Anuja Vaidya
B
eckers Hospital Review is pleased to release the 2017 edition of
its 150 Hospital and Health System CFOs to Know list.
The men and women on this list help their organizations navigate
healthcares financial challenges.
To develop this list, the Beckers Hospital Review editorial team re-
ceived nominations and conducted an editorial review process.
Note: Individuals cannot pay for inclusion on this list. Names are
presented in alphabetical order.
Clint Adams. Executive Vice President and CFO of Ardent Health
Services (Nashville, Tenn.). Mr. Adams, a certified public accountant,
has more than 20 years of experience in the financial and healthcare
sectors. Before joining Ardent Health Services in 2003, he served as an
audit senior manager for accounting firm EY and controller for Brent-
wood, Tenn.-based PathGroup, a comprehensive anatomic, clinical and
molecular pathology services provider.
Kedrick Adkins Jr. CFO of Mayo Clinic (Rochester, Minn.). Mr. Ad-
kins has been CFO of Mayo Clinic since 2014. He joined Mayo from Li-
vonia, Mich.-based Trinity Health where he was president of integrated
services for six years. From 1976 to 2007, he held various positions at
consulting firm Accenture, including global chief diversity officer and
country managing director.
Michael Allen. CFO of OSF Healthcare System (Peoria, Ill.). Mr. Allen
has more than 25 years of business and healthcare experience, including
eight years in public accounting and more than 18 years as CFO of var-
ious health systems. He joined OSF HealthCare in 2015 after serving as
CFO of La Crosse, Wis.-based Gundersen Health System for two years.
Jennifer Alvey. Senior Vice President and CFO of Indiana University
Health (Indianapolis). Ms. Alvey joined Indiana University Health in
2011 and currently serves as senior vice president and CFO. Her previ-
ous positions with the health system include treasurer and vice president
of revenue cycle services. She spent five years with the Indiana Finance
Authority, eventually serving as public finance director.
Mark Anderson. CFO of Lane Regional Medical Center (Zachary,
La.). In his current role, Mr. Anderson is responsible for overseeing
all finance, accounting and revenue cycle functions for the medical
center. He has more than 18 years of executive leadership experience.
Prior to joining Lane Regional in 2011, Mr. Anderson was CFO of
Danville (Va.) Regional Medical Center and Memorial Hospital of
Martinsville, Va., and Henry County, a member of Brentwood, Tenn.-
based LifePoint Health.
Rhonda Anderson. Senior Vice President and CFO of Ascension
Healthcare (St. Louis). Before joining Ascension Healthcare in Octo-
ber 2014, Ms. Anderson served as president of the business develop-
ment division and CFO of Milwaukee-based Columbia St. Marys, roles
she had held since 2009. Her experience also includes 20 years at Balti-
more-based Saint Agnes HealthCare serving in the financial division.
In her current role, Ms. Anderson works closely with CFOs across the
Ascension organization.
Charles Ayscue. Senior Vice President of Finance and CFO of Mis-
sion Health (Asheville, N.C.). Before serving as senior vice president
of finance and CFO of Mission Health, Mr. Ayscue was CFO of Chap-
el Hill-based University of North Carolina Health Care. He helped the
University of North Carolina Hospitals improve its overall cash balance
47
by $500 million during his 20-year tenure with University of North Car-
olina Health Care. He has experience developing new revenue streams
for hospitals and implementing cost containment initiatives.
Dara Bartels. CFO of Gundersen Health System (La Crosse, Wis.).
Ms. Bartels has more than 16 years of experience serving in various
health systems and public accounting firms. She joined Gundersen in
2010 as director in finance and was promoted to system controller in
2011 before becoming executive director of finance two years later. She
became interim CFO in September 2015 and took on the role perma-
nently in April 2016. Prior to joining Gundersen, Ms. Bartels spent
more than three years as controller at Moline, Ill.-based Trinity Regional
Health System, now UnityPoint Health Trinity, and six years at West Des
Moines-based UnityPoint Health.
Jill Batty. Senior Vice President and CFO of Cambridge (Mass.)
Health Alliance. Ms. Batty has more than 20 years of experience as a
financial executive and healthcare consultant. She joined Cambridge
Health Alliance in January 2014 as the organizations senior vice pres-
ident and CFO. Before beginning her tenure with CHA, Ms. Batty was
senior vice president of finance and CFO of Cheshire Medical Center/
Dartmouth-Hitchcock Keene (N.H.) where she helped the organization
transition from fee-for-service to population health management.
Gregg Beeg. CFO of Oaklawn Hospital (Marshall, Mich.). A veteran of
the industry, Mr. Beeg maintains more than 27 years of experience in the
healthcare and financial sectors. He was appointed CFO of the hospital
in 2014. Prior to joining Oaklawn Hospital, he held numerous leadership
positions at health systems across Michigan. Mr. Beeg began his career in
finance as an accountant at Michigan Medicine in Ann Arbor.
Chris Bergman. Vice President and CFO of Dayton (Ohio) Childrens
Hospital. Mr. Bergman is responsible for leading Dayton Childrens
Hospitals accounting, revenue cycle and medical records departments.
Prior to joining Dayton Childrens, he served in executive leadership po-
sitions at Cincinnati-based Christ Hospital and Sparrow Health System,
a five-hospital health system in Lansing, Mich. He has more than 35
years of healthcare experience.
Ron Blaustein. CFO of Ann & Robert H. Lurie Childrens Hospital of
Chicago. Mr. Blaustein joined Lurie Childrens in 2006 as the hospitals
first corporate comptroller. He was then appointed to associate CFO in
2010 before being promoted to CFO in 2014. In addition to his work
with the hospital, Mr. Blaustein has served as a board member for the
Near North Health Services Corporation and Almost Home Kids, which
provides transitional care for pediatric patients between the hospital and
home. He currently serves on the boards of Accountable Care Chicago
and Lurie Childrens Health Partners Clinically Integrated Network.
Kimberly Bones. CFO of Baylor Scott & White Medical Center-McK-
inney (Texas). Ms. Bones helped open Baylor Scott & White Medical
Center-McKinney in 2012 and served as senior financial analyst for the
facility before being promoted to the CFO position two years ago. Previ-
ously, she worked at The Heart Hospital Baylor Plano (Texas) and served
as CFO of Baylor Scott & White Surgical Hospital at Sherman (Texas).
Cara Breidster. CFO of IU Health Arnett Hospital (Lafayettte, Ind.).
Ms. Breidster joined IU Health Arnnett Hospital's executive team in
July 2012. She served as the health systems vice president of finance
and corporate controller before being named CFO. Prior to joining IU
Health, Ms. Breidster spent 17 years at Ernst and Young in healthcare
and tax consulting.
 48
Michael Browning. CFO of ProMedica (Toledo, Ohio). Mr. Browning
has more than 25 years of experience in healthcare finance. As CFO of
ProMedica a role he took in August 2016 he is responsible for the
organizations finance department, including accounting, supply chain
management and financial planning. He is a member of the Healthcare
Finance Management Association and has experience in treasury, reve-
nue cycle, managed care and reimbursement.
Colleen M. Blye. Executive Vice President and CFO of Montefiore
Health System (New York City). Ms. Blye oversees the financial strat-
egy, reporting and investments for Montefiore Health System and New
York City-based Albert Einstein College of Medicine, where she is also
responsible for revenue cycle and supply chain performance. Before be-
coming executive vice president and CFO of Montefiore in January 2016,
she served as executive vice president and CFO of Rockville Centre, N.Y.-
based Catholic Health Initiatives of Long Island. She also has experience
in treasury management, financial reporting and information technology.
Mark Bogen. Senior Vice President and CFO of South Nassau Com-
munities Hospital (Oceanside, N.Y.). With more than 35 years of expe-
rience in healthcare and financial operations, Mr. Bogen is responsible
for the South Nassau Communities Hospitals financial planning related
to growth, financing and associated issues. He also coordinates the hos-
pitals relationship with auditors and investment bankers. In addition to
his leadership roles, Mr. Bogen, a certified public accountant, is a mem-
ber of the Healthcare Financial Management Association and Health
Care Compliance Association.
Kevin Brennan. Executive Vice President of Finance and CFO of
Geisinger Health System (Danville, Pa.). In addition to his role as ex-
ecutive vice president and CFO of Geisinger Health System, Mr. Bren-
nan serves as treasurer of the Geisinger Health System Foundation.
He is a member of the Geisinger Assurance Company board of direc-
tors and treasurer of Geisinger Insurance Corp.s board of directors.
Mr. Brennan was appointed voluntary secretary and treasurer of the
Healthcare Financial Management Association for the 2016-17 term,
beginning in June.
Robert Broermann. Senior Vice President and CFO of Sentara Health-
care (Norfolk, Va.). Mr. Broermann was CFO of Tidewater Health Care
when it merged with Sentara in 1998. He was appointed senior vice presi-
dent and CFO of Sentara Healthcare in 2001 and is responsible for 12 op-
erating divisions within the organization. He also belongs to the Virginia
Beach Education Foundation, where he serves as treasurer, and is a fellow
of the Healthcare Financial Management Association.
Mike Browder. Executive Vice President and CFO of RegionalCare
Hospital Partners (Brentwood, Tenn.). Prior to joining RegionalCare
Hospital Partners, Mr. Browder served as president and CEO of Essent
Healthcare, a Nashville, Tenn.-based company that owned and operated
nonurban acute care hospitals before merging with RegionalCare Hos-
pital Partners in 2011. He began his career at EY. He holds advanced
membership to the Healthcare Financial Management Association and
membership to the Financial Executives Institute.
Jim Budzinski. Executive Vice President and CFO of WellStar Health
System (Marietta, Ga.). Mr. Budzinski joined WellStar in July 2008 as
executive vice president and CFO. He helped the system shore up its fi-
nances and credit before overseeing consecutive years of strong financial
performance. He has previous experience as CFO of St. Johns Health
System in Springfield, Mo. now known as Mercy and Sparrow
Health System in Lansing, Mich.
Michael Burke. Senior Vice President, Vice Dean and Corporate CFO
of NYU Langone Medical Center (New York City). Mr. Burke assumed
his role as senior vice president, vice dean and corporate CFO of NYU
Langone Medical Center in 2008. He previously served as senior vice
president and CFO at Boston-based Tufts New England Medical Center
for four years. A 20-plus-year industry veteran, Mr. Burke is also in-
volved with the Association of American Medical Colleges and the pro-
vider advisory board of Minnetonka, Minn.-based UnitedHealthcare.
Daniel Cancelmi. CFO of Tenet Healthcare (Dallas). Mr. Cancelmi
has spent numerous years in the financial and healthcare sectors. He first
joined Tenet as CFO of Philadelphia-based Hahnemann University Hos-
pital, and later transitioned into leadership roles as controller of the health
system, principal accounting officer and senior vice president before be-
coming CFO in 2012. He began his career at PricewaterhouseCooper and
served in the companys national accounting and Securities and Exchange
Commission unit.
Dan Carpenter. Senior Vice President and CFO of UnityPoint Health
(West Des Moines, Iowa). Prior being promoted to senior vice presi-
dent and CFO of UnityPoint Health in January, Mr. Carpenter served as
CFO of UnityPoint Health-Dubuque (Iowa) at Finley Hospital. While at
Finley, he was responsible for creating a shared analytics and business
development team between the health systems Dubuque and Waterloo,
Iowa, locations. He is a member of the American College of Healthcare
Executives and the Healthcare Financial Management Association.
Barbara Carveth. Vice President of Finance and CFO of University of
Colorado Hospital (Aurora). Ms. Carveth joined the University of Col-
orado Hospital in January 2013 and currently serves as vice president of
finance and CFO. Her previous roles include CFO of St. Mary-Corwin
Medical Center in Pueblo, Colo., and CFO of St. Anthony North Hos-
pital in Westminster, Colo. During her time with St. Mary-Corwin, she
oversaw the hospitals fiscal operations.
Paul Castillo. CFO of Michigan Medicine (Ann Arbor). Mr. Castil-
lo joined Michigan Medicine in November 2011 after serving as vice
president of finance and CFO of Pittsburgh-based UPMC Presbyterian
Shadyside. As CFO of Michigan Medicine, Mr. Castillo is responsible for
the integrated financial and clinical operations at the health systems vari-
ous health centers, the Ann Arbor-based University of Michigan Medical
School and the universitys school of nursing, as well as the Michigan
Health Corp.s shared administrative services.
Steve Chen. Vice President of Finance and CFO of San Joaquin Com-
munity Hospital (Bakersfield, Calif.). Mr. Chen began his healthcare
career as a financial management intern at a healthcare facility in Flor-
ida. He became CFO and senior finance officer of Adventist Hinsdale
(Ill.) Hospital in 2000, a position he held until 2008 when he became
CFO of Porter Adventist Hospital in Denver. He then served as vice
president at Denver-based Executive Health Resources for four years
before taking on his current role as vice president of finance and CFO of
San Joaquin Community Hospital.
Michael Coggin. Executive Vice President and CFO of LifePoint
Health (Brentwood, Tenn.). Mr. Coggin was hired as LifePoint Healths
senior vice president and chief accounting officer in 2008, where he was
responsible for the health systems external financial reporting and cor-
porate accounting functions. He received a promotion to executive vice
president and CFO in September 2016. Mr. Coggin began his profes-
sional career as an auditor with KPMG.
Mike Connors. Senior Vice President of Finance and CFO of Cape
Cod Healthcare (Hyannis, Mass.). A certified public accountant, Mr.
Connors joined Cape Cod Healthcare in March 2009. He previous-
ly served as senior vice president and CFO of Brockton, Mass.-based
Signature Healthcare. Mr. Connors has also held leadership positions
at Burlington, Mass.-based Lahey Hospital & Medical Center and Wey-
mouth, Mass.-based South Shore Hospital.
Thomas Corrigan. Executive Vice President and CFO of Christiana

Care Health System (Newark, Del.). Mr. Corrigan joined Christiana
Care Health System in October 2006 as executive vice president and
CFO. He has served as a member of the Visiting Nurses Association
board of directors and chaired the health systems audit committee.
Before joining Christiana Care Health, Mr. Corrigan served as CFO of
ADP Brokerage Services Group and held a number of leadership posi-
tions at Anheuser-Busch Companies, including vice president of finance
of Busch Entertainment.
Carol Crews. Senior Vice President and CFO of Tanner Health Sys-
tem (Carrollton, Ga.). Ms. Crews joined Tanner Health System in 1991
as a staff accountant and quickly made her way to senior accountant,
vice president of finance, senior vice president and CFO. In her current
role, Ms. Crews is responsible for the health systems business-related
activities, including budgets, audits and government filings.
Michael Curran. Executive Vice President and Chief Administrative
and Financial Officer of MedStar Health (Columbia, Md.). Mr. Curran
joined MedStar Health in 2002, bringing with him more than 20 years
of senior healthcare leadership experience. Prior to his work at MedStar,
he served as CFO and treasurer of Philadelphia-based Jefferson Health.
Mr. Curran previously sat on the board of directors for the American
Red Cross, Juvenile Diabetes Research Foundation and Elwyn Institute.
Conrad Deese. CFO of LifePoint Health Eastern Group (Brentwood,
Tenn.). Mr. Deese was appointed to CFO of LifePoints Eastern Group
in April 2016. He began his career at LifePoint as the vice president of
finance for the Eastern Group where he oversaw and directed the finan-
cial operations for LifePoint facilities in the Midwest, Northeast and
Southeast regions. Before joining LifePoint, Mr. Deese spent nine years
at Health Management Associates, eventually serving as CFO and vice
president of operations finance of the Florida-based system.
Anthony C. DeFurio. Senior Vice President and CFO of UCHealth
(Denver). Mr. DeFurio oversees UCHealths financial operations includ-
ing business development, investment and treasury management. He is
also responsible for UCHealths capital and debt structure as the systems
senior vice president and CFO. Before taking on his current role, Mr.
DeFurio was vice president and CFO of University of Colorado Hospital
Authority. Earlier in his career, Mr. DeFurio served as the CFO of the
University of Iowa Hospitals and Clinics in Iowa City.
Robert DeMichiei. Executive Vice President and CFO of UPMC
(Pittsburgh). Mr. DeMichiei joined UPMC in May 2004 and is respon-
sible for the $14 billion integrated health care delivery and finance sys-
tems operations. Prior to joining UPMC, Mr. DeMichiei was CFO of
GE Transportation Systems global service operations. He also spent 10
years with PricewaterhouseCoopers in Pittsburgh. In addition to his
role at UPMC, Mr. DeMichiei is the finance committee chairman of the
United Way of Allegheny County and is a member of the Greensburg,
Pa.-based Seton Hill University board of trustees, among other boards.
Andrew DeVoe. CFO of TriHealth (Cincinnati). Mr. DeVoe joined
TriHealth at the end of 2016 and oversees financial planning, account-
ing systems, budgeting, patient financial services and managed care
contracting. He is also responsible for the external financing and invest-
ments across the health system. Before joining TriHealth, Mr. DeVoe
was senior vice president and CFO for Aria Health System in Philadel-
phia. He spent three years as the CFO of Philadelphia-based University
of Pennsylvania Health System.
Jim Dietsche. Executive Vice President and CFO of Bellin Health
(Green Bay, Wis.). Mr. Dietsche has more than 25 years of experience in
the healthcare industry. He was named to Bellin Healths executive team
in 2005 where he is responsible for all the financial aspects of the health
system as well as regional business development. He also serves on the
board of directors for Bellin-ThedaCare Healthcare Partners, Green Bay
49
Area Chamber of Commerce and the Wisconsin Hospital Association.
Lori Donaldson. CFO of UC San Diego Health. Ms. Donaldson joined
UC San Diego Health in 1990 and served as comptroller before being
appointed to CFO in July 2010. In 2015, the San Diego Business Journal
named her CFO of the Year. She is also an active member of the commu-
nity and is a member of the Bannister Family House board of directors.
Bill Douglas. Senior Vice President, CFO and Treasurer (Riverside
Healthcare, Kankakee, Ill.). Mr. Douglas has been senior vice president,
CFO and treasurer of Riverside Healthcare since 2006. His previous roles
with the health system include vice president of finance and director of
planning and operations. He is a member of the Healthcare Financial Man-
agement Association and American College of Healthcare Executives.
Christopher Dunleavy. Senior Vice President of Finance and CFO of
Brigham Health (Boston). Mr. Dunleavy brought more than 25 years of
experience in financial management and healthcare to his role as senior vice
president of finance and CFO of Brigham Health in May 2016. Prior to join-
ing Brigham, he held a number of executive roles with Vizient; USMD Hold-
ings, the parent company of Irving, Texas-based USMD Health; and Baylor
Jack and Jane Hamilton Heart and Vascular Hospital in Dallas.
Chris Ellington. President of UNC Health Care Network Hospitals
and Executive Vice President and CFO of UNC Hospitals at Chapel
Hill. Before joining UNC in 2008, Mr. Ellington was vice president of
fiscal services and CFO of Appalachian Regional Healthcare based in
Lexington, Ky. He is a member of the North Carolina Hospital Associa-
tion board of directors and is also on the boards of UNC Health Care-af-
filiated entities throughout the state.
Dan Enderson. Senior Vice President and CFO of Centura Health
(Englewood, Colo.). Centura Health named Mr. Enderson senior vice
president and CFO in 2011. His previous experience includes time as
CFO and senior vice president of Huguley Memorial Medical Center in
Burleson, Texas, and regional CFO for the Southwest Region of Adven-
tist Health System, based in Altamonte Springs, Fla.
Jo Ann Escasa-Haigh. Executive Vice President and CFO of St. Jo-
seph Health (Irvine, Calif.). Ms. Escasa-Haigh joined St. Joseph Health
in 2007, eventually serving as executive vice president and CFO of St.
Joseph Health. After St. Joseph Health merged with Providence Health
& Services last year, Ms. Escasa-Haigh took on the additional roles of
executive vice president and interim CFO of the combined system, Prov-
idence St. Joseph Health. Prior to joining St. Joseph, she spent 10 years as
vice president of finance at PacificCare, now part of UnitedHealth Group.
William Bill Fenske. CFO of Rice Memorial Hospital (Willmar,
Minn.). Mr. Fenske has been CFO of Rice Memorial Hospital for the
last 11 years. He has held similar positions at Agnesian HealthCare in
Fond du Lac, Wis., and Winona (Minn.) Health. He is involved with the
Healthcare Financial Management Association.
Steve Filton. Executive Vice President and CFO of Universal Health Ser-
vices (King of Prussia, Pa.). Mr. Filton was a longtime United Health Ser-
vices employee when he was named executive vice president and CFO in July
2003. He was previously UHS vice president, controller and secretary. He
joined the health system in 1985 as a director of corporate accounting.
Steven Fischer. CFO of Beth Israel Deaconess Medical Center (Bos-
ton). Mr. Fisher accepted the CFO position at Beth Israel Deaconess
Medical Center in October 2004. With more than 35 years of experi-
ence in healthcare, Mr. Fisher previously held the CFO position at Bos-
ton-based Caritas Christi Health Care System, now known as Steward
Health Care System. He is a member of the Beth Israel Deaconess Med-
ical Centers board and serves on the standing committee on finance.
 50
Kenneth Fisher. Associate Vice President of Finance for UI Health
Care and CFO of University of Iowa Hospitals and Clinics (Iowa
City). Mr. Fisher became associate vice president of finance for UI
Health Care in June 2007. He was consulting firm Navigants director
before joining UI Health Care. With more than 40 years of healthcare
experience, he plans to retire July 1.
Larry Fitzgerald. Associate Vice President for Business Development
and Finance for University of Virginia Health System (Charlottes-
ville). Mr. Fitzgerald joined the University of Virginia Health System in
1999 where he is currently responsible for management, oversight and
financial resources coordination for the systems medical center. He is
responsible for the health systems fiscal services, investments, access
and registration functions and contract management. Mr. Fitzgerald
also manages funds to support the health systems current and future
operations and expansions.
Amy Floria. CFO of Goshen (Ind.) Health. Ms. Floria has been CFO
of Goshen (Ind.) Health formerly associated with IU Health for
the past eight years. She has worked in the Goshen Health System since
1999. During her tenure, the Goshen Health System hasnt reported a
single layoff. Before her time at Goshen, she was an audit senior associ-
ate at PricewaterhouseCoopers in South Bend, Ind.
Henry Franey. Executive Vice President and CFO of University of
Maryland Medical System (Baltimore). Mr. Franey had more than 30
years of healthcare experience when he took on his current role in Janu-
ary 2009. He is responsible for the nine-hospital health systems financial
services and is involved in the strategic financial and capital planning,
investment and debt management, rate setting and reimbursement and
financial reporting. Before accepting his current position, Mr. Franey
was the senior vice president and CFO for the Baltimore-based Univer-
sity of Maryland Medical Center.
Lawrence Furnstahl. Executive Vice President and CFO of Oregon
Health & Science University (Portland). Mr. Furnstahl has more than
three decades of healthcare experience. He was chief financial and strat-
egy officer at the University of Chicago Medical Center for five years
before joining Oregon Health & Science University as executive vice
president and CFO in 2011.
Steven Glass. CFO and Treasurer of Cleveland Clinic. Mr. Glass
joined Cleveland Clinic in 2002 as controller and chief accounting offi-
cer; he became CFO three years later. He is responsible for the finances
of the entire Cleveland Clinic Health System, which includes 11 owned
hospitals, 18 full-service family health centers and more than 3,000 phy-
sicians. Before joining the Cleveland Clinic, Mr. Glass was Columbia,
Md.-based MedStar Healths vice president of finance.
Robert Glenning. President of the Financial Services Division and
CFO of Hackensack Meridian Health (Edison, N.J.). In his current
role, Mr. Glenning is responsible for maintaining the Hackensack Me-
ridian Healths information systems and technology in addition to his
various financial duties. He previously served as the executive vice pres-
ident and CFO of Hackensack (N.J.) University Health Network. As a re-
sult of his successful leadership of Hackensack-affiliated enterprises, Mr.
Glenning was jointly appointed as an initial board of governors mem-
ber for the South Orange, N.J.-based Seton Hall-Hackensack Meridian
School of Medicine and the Hackensack Alliance ACO.
Greg Gombar. Executive Vice President and CFO of Carolinas Health-
Care System (Charlotte, N.C.). Mr. Gombar joined Carolinas Health-
Care System in 1984 as controller and became CFO the next year. His
previous experience includes seven years as an audit manager and health-
care consultant for Arthur Anderson LLP. Mr. Gombar is a member of
several professional organizations, including the North Carolina Asso-
ciation of CPAs and the Healthcare Financial Management Association.
Craig Goodrich. CFO of Virginia Mason Health System (Seattle).
Mr. Goodrich was promoted to CFO of Virginia Mason Health System
in June 2016. He has more than 30 years of experience in healthcare
and was previously the systems senior vice president for finance and ac-
counting. Before joining Virginia Mason, Mr. Goodrich was a principal
at Arthur Anderson LLP in Seattle.
Michael Gough. Executive Vice President and CFO of Norton Health-
care (Louisville, Ky.). Mr. Gough joined Norton Healthcare in July 2000
as vice president of finance and accepted the CFO position in September
2003. In January 2017, Mr. Gough became Norton Healthcares execu-
tive vice president and CFO. His previous experience includes six years
as CFO of Caritas Health Services in Louisville, Ky., and 11 years work-
ing for Columbia/HCA Healthcare.
Joe Guarracino. Senior Vice President and CFO of White Plains
(N.Y.) Hospital. Mr. Guarracino has been in his position with White
Plains Hospital since January 2017. He also serves as an adjunct faculty
member at New Rochelle, N.Y.-based Iona College. Mr. Guarracino is
a past senior vice president and CFO of the Brooklyn Hospital Center
and Health Quest, a nonprofit family of hospitals and healthcare provid-
ers headquartered in Lagrangeville, N.Y. He serves on the Iona College
board of directors.
Dana Haering. CFO of Lucile Packard Childrens Hospital Stanford
(Palo Alto, Calif.). Ms. Haering has spent more than 20 years in the fi-
nance industry, working primarily with healthcare clients. She was hired
as the controller of Lucile Packard in 2011 and was promoted to interim
CFO in 2013 before officially being named CFO the following year. Prior to
her tenure at Lucile Packard, Ms. Haering was a senior manager at KPMG.
Don Halliwill. CFO of Carilion Clinic (Roanoke, Va.). Mr. Halliwill
joined Carilion Clinic in 1997 and became CFO in 2013. He is guided by
three primary principles as CFO of Carilion Clinic: his resources are the
patients resources; the hospital must achieve financial success to ensure
sustainability; and the hospital must reduce cost to patients over time.
Mr. Halliwill attributes his passion for the position to his deep ties to the
Roanoke community.
Gail Hanson. CFO of Aurora Health Care (Milwaukee). Ms. Hanson
joined Aurora Health Care in January 2011 after a long career in govern-
ment and the healthcare insurance industry. Before joining Aurora, Ms.
Hanson was the State of Wisconsin Investment Boards deputy executive
director and a senior vice president, treasurer and CFO for Blue Cross
Blue Shield United of Wisconsin, which became Cobalt Corporation.
Ms. Hanson has an MBA from the University of Chicago.
Fred Hargett. CFO of Novant Health (Winston-Salem, N.C.). Joining
Novant Health in 2003, Mr. Hargett has progressed through the system
before earning his current title of CFO. He previously served as senior
vice president of financial planning and executive vice president of fi-
nance. Before joining Novant, Mr. Hargett was the manager of health-
care consulting at EY in Charlotte, N.C.
Scott Hawig. Executive Vice President of Finance, Treasurer and CFO
of Froedtert & the Medical College of Wisconsin (Milwaukee). Mr.
Hawig joined Froedtert & the Medical College of Wisconsin in August
2012 in his current role. He also recently took responsibility for supply
chain operations across the health network. Mr. Hawig came to Wiscon-
sin after serving as the executive leader over Durham, N.C.-based Duke
University Health Systems revenue cycle organization. While at Duke,
he oversaw a hospital system with more than $2.8 billion in net revenue.
Mike Heather. CFO of Prime Healthcare Services (Ontario, Calif.).
Mr. Heather arrived at Prime after serving as CFO of Prospect Medi-
cal Holdings, a company focused on coordinating regional healthcare
services. During his time at Prime, Mr. Heather oversaw the companys
 51

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 52
initial public offering in 2005. He has a long history in finance serving as
CFO and then becoming CEO of what is now known as Demand Media.
Tim Heinrich. CFO of Thorek Memorial Hospital (Chicago). Mr.
Heinrich has served as Thorek Memorial Hospitals CFO since Septem-
ber 2014. He has also served as the president of Heinrich & Associates, a
full-service accounting firm.
Dennis Hesch. Executive Vice President and CFO of The Carle Foun-
dation (Urbana, Ill.). Bringing more than two decades of healthcare
experience with him, Mr. Hesch has served as the CFO of The Carle
Foundation since September 2006. At Carle, Mr. Hesch oversees a $1.9
billion, two-hospital integrated delivery system. Before assuming his
current role, Mr. Hesch was a senior vice president and CFO for the
Carle Clinic Association.
Pam Hess. CFO of Saint Vincents Healthcare (Jacksonville, Fla.). Ms.
Hess became market CFO of Saint Vincents Healthcare in July 2016.
She was previously with St. Thomas Health in Nashville, Tenn., where
she served as CFO of St. Thomas West Hospital and St. Thomas Mid-
town Hospital. Both St. Thomas and St. Vincent are members of St.
Louis-based Ascension. Ms. Hess has more than 20 years of healthcare
experience as an auditor, financial analyst and financial director.
Rick Hinds. Executive Vice President and CFO of UC Health (Cin-
cinnati). For the last seven years, Mr. Hinds has overseen finances at UC
Health. In his role as executive vice president and CFO, he is responsible
for the financial leadership of the system as well as the technology, le-
gal, human resources, marketing and supply changes. Before joining UC
Health, Mr. Hinds was the interim CEO of Health Alliance of Greater
Cincinnati, UC Healths predecessor company. He is a life-long resident
of Cincinnati.
Linda Hoff. Senior Vice President and CFO of Legacy Health (Port-
land, Ore.). Ms. Hoff joined Legacy Health in January 2014 after serving as
CFO of Madison, Wis.-based Meriter Health Services now UnityPoint
Health-Meriter and as president of Physicians Plus Insurance Corp., a
healthcare insurer in Madison, Wis. She heads the $1.8 billion systems fi-
nancial department, which has an operating margin of 5 percent.
Allen Johnson. CFO of Truman Medical Centers (Kansas City, Mo.).
Since 1999, Mr. Johnson has led financial operations of Truman Medical
Centers as CFO. Under his tenure, Truman Medical Center has seen a $208
million revenue increase. He was previously director of reimbursement at
Hennepin County Medical Center in Minneapolis for four years and CFO
of Metropolitan Health Plan, a Minnesota-based HMO, for eight years.
Keith Kasper. Senior Vice President and CFO of University of Penn-
sylvania Health System (Philadelphia). Mr. Kasper is responsible for the
University of Pennsylvania Health Systems capital and operating budget
process as vice president and CFO. He also provides financial support to
strategic and operating plans and leads the implementation and over-
sight of customer-focused financial processes and systems. He previously
served as CFO of Hahnemann University Hospital in Philadelphia.
Jim Kelley. CFO of Presence Health (Chicago). Mr. Kelley joined Pres-
ence Health as CFO in May 2016 where he is responsible for manag-
ing Presence Healths finances. Mr. Kelly spent three years as the vice
president of finance at Park Ridge, Ill.-based Advocate Lutheran General
Hospital and the 17 years before that as vice president of finance and
support services at Oak Lawn, Ill.-based Advocate Childrens Hospital.
He also served on the board of directors for Rainbow Hospice, based in
Mount Prospect, Ill., for 10 years.
Greg Klugherz. Senior Vice President of Finance and CFO of Cen-
traCare Health (St. Cloud, Minn.). As CentraCare Healths CFO and
senior vice president, Mr. Klugherz, oversees finance and accounting
services for the health system. He joined CentraCare in 2008 after serv-
ing as CFO and finance director for HealthPartners for 11 years.
Vanessa Kochevar. CFO of St. Mary-Corwin Medical Center (Pueblo,
Colo.). Ms. Kochevar joined St. Mary-Corwin Medical Center, part of
Centennial, Colo.-based Centura Health, in August 2013. She was pre-
viously the CFO at Deaconess Hospital in Oklahoma City and CFO of
St. Marys Regional Medical Center in Enid, Okla., Summerlin Hospital
Medical Center in Las Vegas and Spring Valley Hospital Medical Cen-
ter in Las Vegas. Community Health Systems awarded Ms. Kochevar its
Outstanding Achievement Award in 2012.
Anne Krebs. CFO of Butler (Pa.) Health System. Ms. Krebs joined
Butler Health System in 2001. She was previously the vice president of
finance at the former St. Joseph Hospital in Kirkwood, Mo. She was also
the vice president of finance at Lurie Childrens Hospital in Chicago and
a senior auditor in KPMGs Chicago office.
JoAnn Kunkel. CFO of Sanford Health (Sioux Falls, S.D.). As Sanford
Healths CFO, Ms. Kunkel oversees finances for one of the largest health
systems in the country, with 45 hospitals and nearly 300 clinics. She
joined Sanford Medical Center in 1995 and was appointed CFO of the
system in 2012. Sanford Health has 28,000 employees with more than
1,300 physicians.
Angela Lalas. Senior Vice President of Finance for Loma Linda (Ca-
lif.) University Health. Ms. Lalas joined Loma Linda University Health
in January 2006 and was promoted to senior vice president of finance
in January 2015. She has previous experience as a senior tax consultant
at Deloitte and senior associate at McGladrey, now known as RSM, an
audit, tax and consulting services provider. Ms. Lalas has been an Amer-
ican Institute of CPAs and The Chartered Institute of Management Ac-
countants chartered global management accountant since June 2013.
Kathy Lancaster. Executive Vice President and CFO of Kaiser Foun-
dation Hospitals and Health Plan (Oakland, Calif.). Ms. Lancaster
joined Kaiser Permanente in 1998 and held several strategy and financial
planning roles before accepting the CFO position in 2005 after hold-
ing senior leadership roles for Prudential Insurance Co. In her current
position, Ms. Lancaster oversees the controllers office, treasury, capital
planning, enterprise shared services and financial operations.
Phyllis Lantos. Executive Vice President, Treasurer and CFO of
NewYork-Presbyterian Hospital (New York City). Ms. Lantos is the
executive vice president, treasurer and CFO of NewYork-Presbyterian
Hospital as well as CFO of the NewYork-Presbyterian system. Prior to
joining the system in 2000, Ms. Lantos served as deputy COO at Yale
University School of Medicine in New Haven, Conn., and vice presi-
dent of financial management services at Montefiore Medical Center in
Bronx, N.Y. She serves on the Healthcare Financial Management Asso-
ciations board of directors.
Dennis Laraway. CFO of Memorial Hermann Healthcare System
(Houston). Mr. Laraway joined Memorial Hermann Healthcare System
as CFO in 2011. He oversees the finances of the systems 16 hospitals
throughout the greater Houston area. Before his tenure at Memorial
Hermann Health System, Mr. Laraway was the vice president and CFO
of St. Josephs Hospital in Phoenix. He is currently an adjunct professor
at Rice University in Houston.
Ralph Lawson. Executive Vice President and CFO of Baptist Health
South Florida (Coral Gables). Mr. Lawson oversees the finances for
Baptist Health South Florida, a nonprofit healthcare organization. Pri-
or to his tenure at Baptist, he spent 17 years at professional services
firm Deloitte, with eight years focused on healthcare. Mr. Lawson
served as national chair of the Healthcare Financial Management As-
sociation from 2012-2013.

Kevin Lenahan. Senior Vice President and Chief Finance and Ad-
ministrative Officer of Atlantic Health System (Morristown, N.J.).
Mr. Lenahan joined Atlantic Health System in 1995. He was named vice
president of finance and CFO in June 2010 and then promoted to his
current role in December 2015. Mr. Lenahan developed Atlantic Health
Systems first risk-based contract, which took effect in 2015, and led the
team to develop the systems ACO, which was the first in New Jersey.
M. Scott Lieberenz. Senior Vice President and CFO of Childrens Hos-
pital Los Angeles. Mr. Lieberenz joined Childrens Hospital Los Angeles
in 2016. His responsibilities include overseeing the hospitals account-
ing, financial reporting, financial planning and budgeting. He previously
served as senior vice president of financial services for Greenville, N.C.-
based Vidant Health where he led the systems ICD-10 implementation.
He is a member of the Healthcare Financial Management Association.
Darryl Linnington. CFO of McAlester (Okla.) Regional Health
Center. Mr. Linnington, a certified management accountant, has more
than two decades of experience in healthcare. Most recently, he served
as CFO of facilities affiliated with Community Health Systems and Iasis
Healthcare, both based in Franklin, Tenn., and Plano, Texas-based Triad
Hospitals, which merged into CHS.
Neil Lubarsky. Senior Vice President for Finance and CFO of Thomas
Jefferson University Hospital (Philadelphia). Mr. Lubarsky, a certified
public accountant and chartered global management accountant, has held
his position as CFO of Thomas Jefferson University Hospital for nearly
two decades. In addition to his current role, he serves as treasurer of the
Philadelphia International Medicine board. Earlier in his career, Mr. Lu-
barsky served as a financial officer at other Philadelphia-area healthcare
organizations and as a senior manager at PricewaterhouseCoopers.
Robert Lux. Vice President, Treasurer and CFO of Temple Universi-
ty Health System (Philadelphia). Mr. Lux has been Temple University
Health Systems vice president, treasurer and CFO since 1996. His pre-
vious positions include assistant controller, controller and associate vice
president and CFO of Temple University Hospital. Mr. Lux has also served
as head of the finance committee of health maintenance organization
Health Partners Plans of Philadelphia and as a member of the Hospital
Association of Pennsylvanias statewide committee on public payer policy.
Richard Magenheimer. CFO of Inova Health System (Falls Church,
Va.). Mr. Magenheimer joined Inova Health System in 1987 as vice pres-
ident of financial operations and was promoted to CFO in 1992. Before
joining Inova, he was vice president of financial controls and director of
finance for West Coast operations of American Medical International,
an investor-owned international hospital management company.
Stacey Malakoff. Executive Vice President and Treasurer of Hospital
for Special Surgery (New York City). Ms. Malakoff began her tenure at
Hospital for Special Surgery in 1990 as director of reimbursement. Since
then she has been executive vice president, treasurer and CFO, as well as
interim controller and interim vice president of finance with the nations
oldest orthopedic hospital. She previously served as a manager in the
audit division of EY.
Peter Markell. Executive Vice President of Administration and Fi-
nance, CFO and Treasurer of Partners HealthCare (Boston). Mr.
Markell joined Partners HealthCare in 1999, before which he served as a
partner with EY in Boston. In his current role, Mr. Markell oversees the fi-
nances of the systems academic medical centers, community and specialty
hospitals, a managed care organization, community health centers and a
physician network, among other entities in the Partners network. He cur-
rently serves as vice chairman of the board of trustees at his alma mater,
Boston College, and director with Eastern Bank in Boston.
53
Tim Maurice. CFO of University of California Davis Health System (Sac-
ramento). Mr. Maurice has overseen all financial operations of the Univer-
sity of California Davis Health System as CFO since 2011. Before then, he
was vice president and CFO of St. Johns Regional Medical Center in Ox-
nard, Calif., and St. Johns Pleasant Valley Hospital in Camarillo, Calif. He
previously spent time as CFO of Good Samaritan Community Healthcare
in Puyallup, Wash., and Saint Joseph Mercy-Oakland in Pontiac, Mich.
Kenneth McGhee. CFO of Loretto Hospital. (Chicago). Prior to join-
ing Loretto Hospital, Mr. McGhee was CFO of Pinnacle Hospital in
Crown Point, Ind. He previously spent 10 years as the director of finance
for Chicago-based Michael Reese Hospital, which is now closed, and five
years as the director of finance Jackson Park Hospital in Chicago.
Patrick McGuire. Executive Vice President and CFO of St. John Prov-
idence Health System (Warren, Mich.). Mr. McGuire has worked for
St. John Providence Health System, part of St. Louis-based Ascension
Health, since 1986. During his tenure, he has seen the health system
grow from one hospital into a five-hospital health enterprise with fa-
cilities throughout five counties in southeast Michigan. He helped lead
Ascension Health Michigan Ministries through negotiations as a unified
group with Blue Cross of Michigan on a new three-year agreement.
Craig McKnight. Executive Vice President of Finance and CFO
of Phoenix Childrens Hospital. Mr. McKnight has served as CFO of
Phoenix Childrens since 2010. He has more than 30 years of healthcare
financial management experience, previously serving as executive vice
president and CFO of Centennial, Colo.-based Centura Health.
Jim McNey. Senior Vice President and CFO of North Kansas City
(Mo.) Hospital. Mr. McNey has served as CFO of North Kansas City
Hospital since 2004. Mr. McNey previously was senior vice president
and CFO of Valley Baptist Health System, which has locations in
Brownsville and Harlingen, Texas. In addition to his current duties as
CFO, he is a board member for Kansas City-based Meritas Health and
Gashland Physicians Group.
Mark Meyer. Executive Vice President and CFO of Grady Health Sys-
tem (Atlanta). Mr. Meyer joined Grady in 2012, after serving as vice pres-
ident and CFO of Texas Health Presbyterian Hospital of Dallas. He previ-
ously served as vice president of finance at Dallas-based Methodist Health
System. He has more than 20 years of experience in healthcare finance.
Jennifer Mitzner. Senior Vice President and CFO of St. Joseph Hoag
Health (Irvine, Calif.). Ms. Mitzners duties as senior vice president
and CFO of St. Joseph Hoag Health include overseeing financial per-
formance of the integrated care network that comprises numerous hos-
pitals, urgent care centers and medical groups. She previously served as
senior vice president of corporate services and CFO of Hoag Memorial
Hospital Presbyterian in Newport Beach, Calif. Additionally, she worked
in the healthcare advisory practice at KPMG in Orange County, Calif.
Dan Moncher. Executive Vice President and CFO of Firelands Re-
gional Medical Center (Sandusky, Ohio). Mr. Moncher has spent
roughly 30 years in healthcare, the last 20 of which were spent at Fire-
lands Regional Medical Center, where he now serves as executive vice
president and CFO. Previously, he was regional vice president and CFO
of Mercy Hospital in Tiffin, Ohio, and Mercy Hospital in Willard, Ohio.
John Mordach. Senior Vice President of Finance and CFO of Rush
University Medical Center (Chicago). Mr. Mordach has served as CFO
of Rush University Medical Center since 2011. Previously, he was senior
vice president, CFO and treasurer of Loyola University Health System,
based in Maywood, Ill. His past positions include vice president of fi-
nance at the University of Chicago Medical Center and senior vice pres-
ident and CFO of Edward Health Services Corp., now Edward Hospital
& Health Services, in Naperville, Ill.
 54
Daniel Morissette. Senior Executive Vice President and CFO of Dig-
nity Health (San Francisco). Mr. Morissette serves as senior executive
vice president and CFO of Dignity Health, a nearly $15 billion health
system. Before he joined Dignity Health last year, Mr. Morissette served
as CFO of Stanford (Calif.) Health Care.
Kenneth Morris. Senior Vice President, Treasurer and CFO of Duke
University Health System (Durham, N.C.). Mr. Morris joined Duke
University Health System in 2000 and now serves as senior vice presi-
dent, treasurer and CFO. His previous experience includes time as CFO
of Mission Health in Asheville, N.C., and of Loyola University Health
System in Maywood, Ill. Mr. Morris also previously served as assistant
vice presidentfor finance at Loyola University Health System and at Tu-
lane University in New Orleans.
Dominic Nakis. Senior Vice President, Treasurer and CFO of Advo-
cate Health Care (Downers Grove, Ill.). Mr. Nakis joined Evangelical
Health Systems in 1995, the same year it merged with Lutheran General
HealthSystem to become Advocate Health Care. He was named senior
vice president, treasurer and CFO of Advocate Health Care in 2006. He
previously worked in the healthcare practice at EY.
Brett Norell. Vice President of Finance and CFO of Holy Family Me-
morial (Manitowoc, Wis.). Mr. Norell has spent 15 years in the health-
care industry. He assumed his current position at Holy Family Memorial
in May 2015. Mr. Norell spent several years at Milwaukee-based Chil-
drens Hospital of Wisconsin before taking on his current role. He is an
American College of Healthcare Executives fellow.
John Orsini. Senior Vice President and CFO of Northwestern
Memorial HealthCare (Chicago). Mr. Orsini has more than three
decades of healthcare finance experience. He served as executive vice
president and CFO of Winfield, Ill.-based Cadence Health prior to its
merger with Northwestern Memorial HealthCare in 2014. He became
senior vice president and CFO of Northwestern Memorial HealthCare
when the merger closed. His previous positions include CFO of Chica-
go-based Presence Health and corporate vice president of finance and
treasurer for San Diego-based Scripps Health.
Todd Ostendorf. CFO of Childrens Hospitals and Clinics of Minne-
sota (Minneapolis). Mr. Ostendorf has more than 25 years of experience
in finance leadership. He was appointed CFO of Childrens Hospitals
and Clinics of Minnesota in 2016. Previously, he was CFO of Robbin-
sdale, Minn.-based North Memorial Health Care and led two subsid-
iaries within Minnetonka, Minn.-based UnitedHealth Group as CFO.
Eric Peburn. Executive Vice President and CFO of Halifax Health
(Daytona Beach, Fla.). Mr. Peburn joined Halifax Health in 1996 and
became executive vice president and CFO of the system in 2007. Before
taking on the CFO role, he served as corporate controller, director of
finance and assistant administrator. He also previously served as an au-
ditor for EY.
Blaine Petersen. CFO of Loyola University Health System (Maywood,
Ill.). Mr. Petersen has more than three decades of leadership experience
with healthcare organizations. He was named CFO of Loyola Universi-
ty Health System in 2016. Previously, he served as CFO of Boise, Ida-
ho-based Saint Alphonsus Health System and vice president of financial
services for Catholic Health Initiatives, based in Englewood, Colo.
Alice Pope. Senior Vice President and CFO of HonorHealth (Scott-
sdale, Ariz.). Ms. Pope has roughly 25 years of experience in finance,
with 20 years in healthcare finance specifically. Before taking on her cur-
rent role as senior vice president and CFO of HonorHealth, she served
as CFO of Wellmont Health System in Kingsport, Tenn. She previously
served as senior vice president of finance, managed care and revenue
cycle at Wellmont, as well as vice president and CFO of Kingsport-based
Holston Valley Medical Center, a Wellmont hospital.
Jim Porter. CFO of St. Bernard Hospital (Chicago). Mr. Porter has
been CFO of St. Bernard Hospital since 2015. Previously, he served as a
regional CFO for Chicago-based Presence Health, and CFO of the Saint
Joseph and Saint Francis Hospitals within the system. He also has served
on the finance committee of Family Health Network, a nonprofit provid-
er-sponsored health plan based in Chicago.
Scott Posecai. Executive Vice President and CFO of Ochsner Health
System (New Orleans). Mr. Posecai joined Ochsner Clinic in 1987 and
became CFO in 1995. He was named CFO for the Oschner Clinic Foun-
dation in 2001, after Ochsner Clinics merger with Alton Ochsner Medical
Foundation, and became CFO of the system in 2006. He is responsible
for accounting, financial planning and analysis, reimbursement, managed
care contracting and revenue cycle health information management.
William Pugh. Senior Vice President and CFO of PinnacleHealth
System (Harrisburg, Pa.). Mr. Pugh joined PinnacleHealth in 2007.
Throughout his tenure, he has played a role in the organizations pro-
posed affiliation with Pittsburgh-based UPMC and the acquisition of
four hospitals from Franklin, Tenn.-based Community Health Systems.
Mr. Pugh has around three decades of CFO experience.
Connie Prewitt. CFO of Billings (Mont.) Clinic. Ms. Prewitt serves as
CFO of Billings Clinic, Montanas largest healthcare organization. She is
responsible for financial management of the organization, including pa-
tient financial services, accounting and budget. Throughout her career,
she has focused on providing strategic vision, project management and
personnel management for both physician multispecialty groups and
hospital organizations.
Edward Prunchunas. Executive Vice President of Finance and CFO of
Cedars-Sinai Medical Center (Los Angeles). Mr. Prunchunas has held
the CFO role at Cedars-Sinai for nearly 20 years. He previously served
as the academic medical centers director of finance and vice president
of finance. In the past, Mr. Prunchunas served as CFO of Northridge
(Calif.) Hospital Medical Center and spent time with EY.
Michael Reney. Senior Vice President for Finance and CFO of Da-
na-Farber Cancer Institute (Boston). Mr. Reney has held the CFO role
since 2015. Prior to joining Dana-Farber, he was controller, executive
director of finance and CFO of Boston-based Brigham and Womens
Hospital. He also spent time as senior vice president for finance and
CFO of Boston-based Brigham and Womens Health Care and assistant
controller at Boston-based Massachusetts General Hospital.
Mark Rich. CFO of Steward Health Care System (Boston). Before tak-
ing on the CFO role, Mr. Rich was executive vice president for corporate
strategy at Steward. In this role, he led the health systems acquisition
efforts. Mr. Rich previously served as CFO of Boston-based Caritas
Christi Health Care. Private equity firm Cerberus Capital Management
acquired Caritas Christi Health Care in 2010 and established Steward
Health Care System the same year.
Craig Richmond. Senior Vice President and CFO of The MetroHealth
System (Cleveland). Mr. Richmond has roughly 20 years of healthcare
experience, and he joined MetroHealth in 2010. Mr. Richmond served
as the systems vice president of revenue cycle and associate CFO before
taking on his current position in 2014. During his tenure, he has headed
a $10 million, systemwide implementation of Epics revenue cycle suite.
Chuck Robb. Senior Vice President of Finance and Administration
and CFO of Saint Lukes Health System (Kansas City, Mo.). Mr. Robb
has served as CFO of St. Lukes Health System since 1999. He gained
experience as CFO of Saint Lukes Hospital, the systems flagship facility.
Mr. Robb serves as a board member for the Missouri Society of Certified
Public Accountants, with his current term expiring June 30.

Kevin Roberts. Senior Vice President and CFO of BJC HealthCare
(St. Louis). Mr. Roberts joined BJC HealthCare in 2008 as senior vice
president and CFO. He previously served as senior vice president and
CFO of University Hospitals in Cleveland and treasurer of Cleveland
Clinic Foundation for a total of roughly 20 years.
Richard Rothberger. Corporate Executive Vice President and CFO
of Scripps Health (San Diego). Scripps named Mr. Rothberger CFO
in 2001. He is responsible for corporate financial and capital planning,
payer contracting, revenue cycle, real estate and construction as well as
financial operations for the four-hospital nonprofit system. During his
tenure, Mr. Rothberger played a key role in the systems financial turn-
around beginning in 2000 through 2005.
Steve Roussel. CFO of Baylor Scott & White Medical CenterIrving
(Texas). Mr. Roussel joined Baylor Scott & White Medical CenterMcK-
inney in 2011, where he was responsible for financial planning and bud-
geting as well as directing and coordinating nursing and ancillary services.
He was recently named to his current role as CFO of Baylor Scott & White
Medical CenterIrving. Mr. Roussel has previous experience as senior
vice president of finance and compliance officer for Baylor Scott & White
Medical CenterWaxahachie, where he helped improve hospital opera-
tions through financial management and increased staff productivity.
William Rutherford. Executive Vice President and CFO of HCA
Healthcare (Nashville, Tenn.). Mr. Rutherford joined HCA Healthcare
in 1986 as a staff auditor and assumed his current position with the com-
pany in 2014. He rose through the ranks, serving in a number of leader-
ship roles such as director of operations support and CFO for the Georgia
division. He left HCA from 2005 to 2008 to start a training and education
company, where he gained experience in private equity ventures.
Randolph Safady. Executive Vice President and CFO of Christus
Health (Irving, Texas). Mr. Safady joined Christus in his current posi-
tion in 2011. Previously, he served as executive vice president and CFO
of Centennial, Colo.-based Centura Health for four years. At Centura,
Mr. Safady was instrumental in repositioning the health systems finan-
cial operations and its conversion to Meditech platforms. He previously
served as senior vice president and CFO of Adventist Midwest Health, a
region of Altamonte Springs-based Adventist Health.
Fred Savelsbergh. CFO of Baylor Scott & White Health (Dallas). Mr.
Savelsbergh joined Baylor Health Care System in 1982 as a corporate
staff accountant. He assisted in the formation of Baylor Scott & White
Health, which was created by the merger of Scott & White Healthcare
and Baylor Health Care System, in 2013. He assumed his duties as CFO
of the combined $8.4 billion system in 2014.
Donald Scanlon. Chief of Corporate Services and CFO of Mount Sinai
Health System (New York City). Before Mr. Scanlon was appointed CFO
of Mount Sinai Health System in 2013, he served as executive vice presi-
dent and CFO of Mount Sinai Medical Center for 10 years. Since taking
on his current duties, he completed a $370 million financing for the Icahn
School of Medicine at Mount Sinai to support the Leon and Norma Hess
and Norma Hess Center for Science and Medicine. He previously served
as senior vice president of finance at NewYork-Presbyterian.
Matthew Sells. CFO of Shenandoah (Iowa) Medical Center. Mr. Sells
has served as CFO of the hospital since 2013. He is currently interim
president and CEO in addition to fulfilling his CFO duties. Mr. Sells pre-
viously served as CFO of Brown County Hospital in Ainsworth, Neb.,
and spent time working at KPMG.
Lance Sewell. CFO of South Lake Hospital (Clermont, Fla.). Mr.
Sewell has served in his current role since October 2007, prior to which
he was director of finance at the hospital. He previously served as assis-
tant CFO of Ochsner Medical Center-Baton Rouge (La.), formerly Sum-
mit Hospital. South Lake Hospital is a part of Orlando Health, a $2.6
billion nonprofit organization.
55
Robert Shapiro. Executive Vice President of Finance and CFO of
Northwell Health (New Hyde Park, N.Y.). Mr. Shapiro assumed the
CFO position at Northwell Health in 2000. Before then, he was vice
president of financial operations and director of finance/assistant ad-
ministrator of the health system. He is also an adjunct professor of
health system finance at New York City-based Hofstra University.
Roger Sharma. Executive Vice President and CFO of Citrus Valley Health
Partners (Covina, Calif.). With more than 20 years of healthcare finance
experience, Mr. Sharmas most recent role prior to his current one was serv-
ing as senior vice president of financial operations for City of Hope, a can-
cer treatment and research center in Duarte, Calif. He has also previously
worked at St. Mary Medical Center in Long Beach, Calif., and California
Hospital Medical Center in Los Angeles. He is an inaugural fellow of the
Health Leadership program at Coro, a leadership training organization.
Richard Silveria. Senior Vice President of Finance and CFO of Bos-
ton Medical Center. Mr. Silveria joined BMC in 2010. As senior vice
president and CFO, he is responsible for the medical centers financial
framework including treasury and managed care. His previous roles in-
clude serving as corporate director of revenue finance for Boston-based
Partners HealthCare and vice president of managed care finance for
Lawrence (Mass.) General Health System.
Daniel Smith. Vice President of Finance and CFO of The Johns Hop-
kins Hospital (Baltimore). In addition to his current roles, Mr. Smith
serves as senior vice president of finance for The Johns Hopkins Health
System. He served as a healthcare consultant to Johns Hopkins in the
1980s and officially joined the staff in 1983. He previously served as se-
nior director of finance at Johns Hopkins Bayview Medical Center in
Baltimore and CFO of Johns Hopkins Home Care Group.
Shannon Sock. Executive Vice President of Strategy and CFO of Mercy
Health (St. Louis).Mr. Sock came to Mercy in 1999 after working for con-
sulting firm CSC Healthcare. Mercy named Mr. Sock to his current roles in
February 2014. He has overseen Mercy initiatives related to EHRs and virtual
care, as well as strategic planning, business development and innovation.
Eddie Soler. Senior Finance Officer of Adventist Health System (Al-
tamonte Springs, Fla.). Mr. Soler serves as senior finance officer of Ad-
ventist Health System, where he oversees the systems three division CFOs
and works closely with Chief Clinical Officer Loran Hauck, MD. He was
previously executive vice president of finance at Adventist and CFO of
Orlando-based Florida Hospital and the systems Florida division.
Anthony Tony Speranzo. Executive Vice President and CFO of As-
cension (St. Louis). Prior to his current role as executive vice president
and CFO of Ascension, Mr. Speranzo served as senior vice president and
CFO of Ascensions healthcare division. He joined Ascension Health in
2002 after serving as managing director at U.S. Bancorp Piper Jaffray.
Earlier in his career, Mr. Speranzo spent 11 years at the St. Joseph Health
System in Orange, Calif., serving as vice president of finance and opera-
tions before being promoted to senior vice president and CFO.
Bernadette Spong. CFO of Orlando (Fla.) Health. Ms. Spong has
served as CFO of Orlando Health since 2015. She previously served as
senior vice president and CFO of network hospitals for University of
North Carolina HealthCare in Chapel Hill and CFO of UNC Rex Health
Care in Raleigh. The health systems bond rating has been upgraded from
A3 to A2 by Moodys Rating Agency since Ms. Spong took over as CFO.
Paul Staton. Senior Vice President of Finance and CFO of UCLA
Health (Los Angeles). Equipped with more than 28 years of experience
in healthcare finance, Mr. Staton is senior vice president of finance and
CFO of UCLA Health System. After serving as the health systems con-
troller, he became CFO in 1996 and oversees financial operations for the
health system, the UCLA Faculty Practice Group as well as the David
Geffen School of Medicine at UCLA.
 56
J. Dean Swindle. President of Enterprise Business Lines and CFO of
Catholic Health Initiatives (Englewood, Colo.). Mr. Swindle joined
CHI in 2010. Before then, he spent more than 11 years at Winston-Sa-
lem-based Novant Health, including time as Novants executive vice
president and CFO, and president of ambulatory services. Mr. Swindle
previously led Concord Medical Center in Baton Rouge, La., as CEO.
Michael Szubski. Senior Vice President and CFO of University Hospitals
(Cleveland). Mr. Szubski has led financial operations at University Hospi-
tals, an 18-hospital system, since October 2008. He previously served as the
health systems COO, in addition to sitting on the Deans Advisory Council
for Baldwin Wallace University School of Business, based in Berea, Ohio.
J. Britton Tabor. Senior Vice President and CFO of Erlanger Health
System (Chattanooga, Tenn.). Mr. Tabor has been Erlanger Health
Systems senior vice president and CFO since 1986. Before joining Er-
langer, Mr. Tabor was an auditor for Chattanooga-based Hazlett, Lewis
& Bieter, which merged with Atlanta-based Mauldin & Jenkins in 2013.
Throughout his career, Mr. Tabor has taught at Knoxville-based Uni-
versity of Tennessee and Chattanooga State Community College at the
undergraduate and master levels.
Vincent Tammaro. Executive Vice President and CFO of Yale-New
Haven (Conn.) Health System and CFO of Yale New Haven Hospital.
Mr. Tammaro joined Yale-New Haven Health System in 2002 as director
of financial reporting. He climbed the ranks and served as senior vice
president of corporate finance for the health system for four years before
his promotion to executive vice president and CFO in April 2016.
Jeff Taylor. Senior Vice President and CFO of St. Lukes Health System
(Boise, Idaho). Mr. Taylor has been with St. Lukes Health System since
1994, serving as director of finance and controller before his promotion
to senior vice president and CFO in 2008. Prior joining the health sys-
tem, he was a senior manager in Deloitte & Touches Boise office.
Karen Testman, RN. CFO of MemorialCare Health System (Fountain
Valley, Calif.). Ms. Testman joined MemorialCare in 1998. She served
as CFO of Orange Coast Memorial Medical Center in Fountain Valley,
Calif., and Saddleback Memorial Medical Center in Laguna Hills and San
Clemente, Calif., as well as senior vice president of financial operations
for the health system, before being named CFO in 2013. Ms. Testman
has previous professional experience in public accounting and nursing.
Jonathan Tingstad. Vice President and CFO of Seattle Cancer Care
Alliance. Mr. Tingstad has served as vice president and CFO of Seattle
Cancer Care Alliance, a network of health systems and hospitals for can-
cer research and care, since 1999. Before then, he was CFO at Medalia
Healthcare in Seattle. Mr. Tingstad began his career at KPMG in 1990.
Thomas Todorow. Executive Vice President and CFO of Childrens
Hospital of Philadelphia. Mr. Todorow was named executive vice presi-
dent and CFO of Childrens Hospital of Philadelphia in 2001. Previously,
he was senior vice president and CFO of Wellesley, Mass.-based Harvard
Pilgrim Healthcare.
Michael Tretina. Senior Vice President and CFO of Bayhealth (Do-
ver, Del.). Mr. Tretina has served as CFO of Bayhealth since November
2013. He was previously vice president and CFO of Mary Greeley Med-
ical Center in Ames, Iowa, and senior vice president of finance for St.
Vincents HealthCare in Jacksonville, Fla. Mr. Tretina is a fellow of the
American College of Healthcare Executives.
Doug Vanderslice. Senior Vice President and CFO of Boston Chil-
drens Hospital. Mr. Vanderslice joined Boston Childrens in 2013 after
spending nine years as vice president and CFO of St. Louis Childrens
Hospital, part of BJC HealthCare. He also spent three years as CFO of
BJCs home care and behavioral health service lines and 12 years as con-
troller and director of patient financial services with Childrens Medical
Center of Dallas. Mr. Vanderslice began his career on the audit staff of
Deloitte & Touche in Dallas.
Charles Chuck Weis. Executive Vice President and CFO of Si-
nai Health System (Chicago). Mr. Weis is a longtime employee of Si-
nai Health System; he began his tenure as executive vice president and
CFO in 1982. He is an adjunct faculty member in the University of Illi-
nois-Chicago School of Public Healths hospital administration program.
He is also a member of the Illinois Hospital Association Policy Council.
Gary Weiss. Executive Vice President, CFO and Treasurer of North-
Shore University HealthSystem (Evanston, Ill.). Mr. Weiss joined
NorthShore in 2001 and was named CFO in 2007. He spent more than
two decades at Chicago-based Bank One, ending his time there as senior
vice president of the commercial bank business line.
Jim Wentz. CFO of KentuckyOne Health (Louisville). Equipped with
more than 30 years of experience in the healthcare industry, Mr. Wentz
was named CFO of KentuckyOne in August 2016. His previous expe-
rience includes five years as CFO at University of Mississippi Medical
Center in Jackson and financial leadership roles with UT Southwestern
Medical Center in Dallas and Oakland, Calif.-based Kaiser Permanente.
Ken Wheat. Senior Vice President and CFO of Eisenhower Medical
Center (Rancho Mirage, Calif.). Mr. Wheat has been senior vice presi-
dent and CFO of Eisenhower Medical Center since 2013. He previously
served as vice president of operations and finance for Tenet Healthcares
12-hospital Texas region and CFO of Desert Regional Medical Center,
a 367-bed hospital in Palm Springs, Calif. He serves on the Rancho Mi-
rage Chamber of Commerces board of directors.
Vinson Yates. Senior Vice President and CFO of OhioHealth (Co-
lumbus). Mr. Yates joined OhioHealth in 1987, serving as president of
OhioHealth Grant Medical Center in Columbus and vice president of
finance at both OhioHealth Riverside Methodist Hospital in Columbus
and OhioHealth Grant Medical Center. He was promoted to senior vice
president and CFO of the system in 2013.
Laura Zehm. Vice President and CFO of Community Hospital of the
Monterey (Calif.) Peninsula. Ms. Zehm joined the 286-bed Commu-
nity Hospital of Monterey in 1982 and became CFO in 1996. She also
serves as CEO of Central Coast Community Mutual Insurance Com-
pany and Aspire Health Plan two insurance products she helped de-
velop. She previously served as chairperson of the Healthcare Financial
Management Associations board of directors.
Kris Zimmer. Senior Vice President of Finance for SSM Health (St.
Louis). Mr. Zimmer joined SSM Health in 2003, after serving as CFO
of Norton Healthcare in Louisville, Ky. He has also served as CFO of
Mount Carmel Health System in Columbus, Ohio, and Southeastern
Ohio Regional Medical Center in Cambridge. He serves on the federal
advisory panel on hospital outpatient payment, which advises the HHS
secretary and CMS administrator.
Bert Zimmerli. Executive Vice President and CFO of Intermountain
Healthcare (Salt Lake City). Having joined Intermountain in 2003,
Mr. Zimmerli has provided financial oversight for the health system,
its health plans and business development strategies for more than a
decade. Previously, he was executive vice president and CFO of Hous-
ton-based Methodist Hospital System, oversaw various responsibilities
with Memorial Hermann Healthcare System in Houston and worked as
a partner at EY's Houston office. n
Executive Briefing 57

Whats missing from your

GPO Partner Strategy?
 58 Executive Briefing
Supply Chain Optimization: How Mercy Leaders Took an Idea on a
Napkin to $1B in Savings and Are Now Doing it for Others
D
ecreasing reimbursements amid
rising operational costs can
threaten a healthcare organiza-
tions bottom line.
Supply chain costs continue to represent
the second largest operating expense for
hospitals and health systems after labor,
according to a 2014 Market Realist report.
Efforts to effectively allocate finances for
supplies are challenged by pressure to
satisfy physicians demands for prefer-
ence items. A 2016 survey from Premier
found 98 percent of C-suite leaders cite
standardizing physician preference items
as a major concern they expect to ad-
dress in the near future.
Many healthcare executives are identify-
ing the supply chain as an area of strategic
opportunity to cut costs and improve the
bottom line, but they dont always have
the right tools to do so. Organizations of-
ten lack the time, money and resources
necessary to standardize products, up-
date ordering practices or find the most
cost efficient items for their facilities.
A solution is born
In the late 1990s, leaders at St. Louis-based
Mercy set out on a quest for operational
efficiency. Their journey and the devel-
opment of their supply chain organization
Resource Optimization & Innovation (ROi)
started with notes on the back of a napkin.
They envisioned a more strategic opera-
tional approach that internalized and inte-
grated key functions within the supply chain
and group purchasing process. Those
dreams were recognized in 2002, when
Mercy officially founded ROi as its own ac-
countable supply chain organization.
From 2002 to 2011, ROi exclusively ran
Mercys supply chain and kept adding ser-
vices to its offering to help drive down costs
for Mercy, says Greg Firestone, vice presi-
dent of strategic customer relations for ROi.
We found a lot of opportunity to increase
supply chain efficiencies and to improve
the quality and safety of care delivery.
Sponsored by:
ROi operates the end-to-end supply chain
activities including self-distribution and
logistics for the 43-hospital system on a
daily basis. Over the past 15 years, ROi has
helped Mercy save more than $1 billion,
according to Mr. Firestone.
ROis first step to achieve these cost sav-
ings was setting up its own consolidated
service center to take control of Mercys
supply chain.
We felt like we could deliver the prod-
ucts to our own facilities in a more efficient
manner, says Mr. Firestone. ROi also built
its own self-contracting portfolio to better
manage supply costs by building closer
relationships with industry suppliers.
After working with Mercy for nearly a de-
cade, ROi has established a large breadth
of knowledge and first-hand experience
by executing critical elements of the sup-
ply chain, says Mr. Firestone. Mercy and
ROi commercialized their supply chain
and GPO services in 2011 to help other
healthcare providers recognize similar op-
erational improvements and cost savings.
The accountable supply chain organization
now provides multiple cost management
and supply chain services to more than 240
hospitals and about 2,800 non-acute facili-
ties across the country. Services include:
1. Contracting and sourcing
ROi offers a very broad contract portfolio
for its member organizations, with a special
emphasis on physician preference items.
These items represent 35 percent to 50
percent of total supply costs, depending
on the health system, says Mr. Firestone.
Since Mercys size and scope drives a
large demand for physician preference
items, ROi can commit to purchasing
a high volume of these products from
suppliers, which results in sustainable
controlled costs. Our model has fostered
highly collaborative relationships with
physician preference item suppliers that
allow us to gain commitment from key
stakeholders, says Mr. Firestone.
2. Manufacturing and packaging operations
ROi implemented a self-distribution
model that allows the supply chain or-
ganization to manufacture and distribute
its own products at much lower costs, ac-
cording to Mr. Firestone. Services include
custom procedure trays, pharmaceutical
repackaging, medical device reprocess-
ing, private label products and, most re-
cently, IV compounding.
There are many supplier companies that
do not manufacture their own products,
which provides us the option to go di-
rectly to the source of manufacturing to
create our own private label at a substan-
tially reduced cost.
Mr. Firestone says this helped ROi and
Mercy achieve a 10 to 30 percent cost re-
duction for supplies. We essentially re-
turn a mass majority of these cost savings
over to our member facilities, he says.
3. Consulting
ROi also offers GPO members supply
chain optimization consulting free of
charge, says Mr. Firestone. Consultants
with extensive clinical and operational
expertise visit provider locations in per-
son, helping them develop more efficient
inventory management processes within
their facilities and build collaborative re-
lationships with physicians.
If organizations are interested in setting
up a consolidated service center, weve
also gone in and shown them how to do
that after conducting a feasibility study,
says Mr. Firestone.
Case study: Mercys custom procedure
tray operations
One of the best examples of ROis initial
success with Mercys supply chain was its
transformation of the health systems cus-
tom procedure tray operations.
In 2007, each of Mercys hospitals man-
aged its own unique pack program, yet
there was no effective way to manage item
usage. The lack of structure and organi-
zation contributed to a large amount of
Executive Briefing
waste throughout the health system. After
conducting a Six Sigma project, ROi dis-
covered Mercy was losing about $30.71
per pack an average of six items per pack
were thrown away without ever being used.
A year later, ROi built a 6,000-square-foot
custom procedure tray production facili-
ty inside its existing consolidated service
center in Springfield, Mo. The supply
chain organizations strategic contracting
and sourcing team had to contract with
150 vendors to access 900 unique items
used in the packs. ROi standardized exist-
ing packs and created new packs tailored
to end users preferences to eliminate un-
necessary waste. These improvements led
to a 10 percent reduction in custom pro-
cedure tray costs for Mercy.
Prior to implementing its own custom
procedure tray operations, Mercy used
93 unique custom packs about 90,000
times annually. Now, ROi offers more than
600 unique custom packs used more
than 500,000 times a year by Mercy and
other health systems across the country.
Most, if not all, of our commercial cus-
tomers purchase packs from us, so
theyre experiencing the same benefit as
Mercy, says Mr. Firestone.
The secret to a successful GPO
In addition to greater customer savings
on procedure trays, Mr. Firestone be-
lieves ROis GPO members receive nu-
merous benefits from the organizations
uniquely integrated structure and role in
the healthcare industry.
He highlighted five ways ROi ensures
sustainable cost savings and satisfaction
for its GPO members.
1. Provider-owned perspective
Truven Health Analytics named Mercy
among the top five large health systems
in the country in 2016. After handling
the day-to-day supply chain operations
of such a large-scale, prominent health
system for more than a decade, Mr. Fires-
tone says ROi is well positioned to share
its breadth of supply chain knowledge.
We bring a real-life, practicable applica-
tion of running a supply chain, he says.
We can take the lessons weve learned
from running Mercys supply chain and
transfer it over to our members.
ROi believes in the power of provider collaboration to transform health care. A recognized leader in healthcare supply chain management through a vertically integrated
supply chain model, ROi was founded more than a decade ago by Mercy, one of the nations largest nonprofit healthcare systems. We now serve fellow providers across the
U.S. that share a passion for supply chain excellence. As a provider-owned accountable supply-chain organization, our insights and goals are uniquely aligned with todays
healthcare organizations that must find new ways to provide better care at lower cost. ROi works alongside fellow providers of all sizes to deliver a range of cost management
and end-to-end supply chain solutions with significant results. We are the only provider to be ranked by Gartner as a top 10 healthcare supply chain for eight straight years.
Mr. Firestone says ROi leverages best
practices in sourcing, contracting, stan-
dardization, utilization and supply chain
management developed at Mercy so its
member organizations can achieve the
same level of success.
2. Vertically integrated service offering
Unlike many other GPOs, ROi manufac-
tures its own custom procedure trays, IV
compounding solutions and other prod-
ucts, including its own private label. By
leveraging its self-manufacturing capa-
bilities, along with strategically sourced
branded products, ROi offers member
hospitals additional savings on lower
cost products that still promote clinical
value and efficacy.
Were always looking for other opportu-
nities to further vertically integrate, Mr.
Firestone says. Were always searching
for processes that generate a substantial
amount of spend for an organization so
we can attack those cost areas and start
to reduce dollars.
3. Clinically integrated supply chain
ROi offers 11 service line committees
that physicians, other clinicians or sup-
ply chain stakeholders from member
hospitals can join to weigh in on the de-
cision-making process when looking at
supply and device contracts. The com-
mittees have monthly phone meetings to
discuss not just the price at the pump,
but utilization and standardization op-
portunities for everything from med/surg
supplies to pharmaceuticals to capital
equipment, according to Mr. Firestone.
They also place a strong emphasis on
managing physician preference items
and purchased services categories.
We think clinical integration is critical
throughout the decision-making process,
he says. Weve found if we involve physi-
cians considerations from the very begin-
ning, we get much better commitment on
the purchases and better overall compli-
ance, which in turn drives lower pricing and
cost from a manufacturers perspective.
4. Guaranteed sustainable cost savings
ROis unique contracting and self-distri-
bution strategy allows it to offer guaran-
teed cost savings to its members, accord-
ing to Mr. Firestone.
59
Mr. Firestone is so confident in ROis
ability to transform a healthcare organi-
zations operational supply chain struc-
ture and inventory management, he feels
comfortable telling new ROi members
upfront not only what theyll save in the
first year, but each and every year for the
duration of their partnership.
We believe an organization should be
held accountable for what they say they
can deliver, he says. We are very com-
fortable putting ourselves at risk to offer
guaranteed savings.
5. No fees for service
ROi wants to be very transparent with its
GPO costing model so members know the
exact benefits theyll receive from day one
and understand thats not going to change,
says Mr. Firestone, who likens fee-for-ser-
vice GPO models to extra airline fees.
You buy your ticket, get on the flight and
they charge you for an in-flight meal, he
says. Nobody likes to be on the receiv-
ing end of that.
ROi uses the simplest costing model pos-
sible, in which new members know exactly
what theyre going to get out of the part-
nership and are aware of the potential
revenue generation and cost savings. The
GPO also shares back a portion of collect-
ed administrative fees with its partners and
avoids any service or membership fees.
Conclusion
The innovation behind ROis integrated
supply chain and group purchasing ser-
vices is homegrown by a health system.
That said, it offers substantial opportuni-
ties for health systems to achieve supply
chain efficiencies, eliminate waste and
lower costs, all while providing quality
patient care.
ROi hopes to keep up this level of innova-
tion with new service offerings and projects
in its pipeline. Mr. Firestone says the com-
pany is looking into offering clinical ana-
lytics capabilities to aid hospitals in supply
chain decision-making. ROi is also building
a 110,000-square-foot custom pack facility
to increase manufacturing capacity and ex-
pand the service across the U.S.
We look at ourselves as a continuous im-
provement engine, says Mr. Firestone. We
constantly ask ourselves: How can we do
the same things today, better tomorrow? n
 Delivering the 5 missing pieces
60 Executive Briefing

to complete the puzzle for a

Successful GPO Partner Strategy.

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

5

Remembering Chuck Lauer
By Scott Becker and Molly Gamble
C Readers, Friends
huck Lauer, 86, was a legend in the healthcare arena. He passed
awayApril 30after a battle with leukemia. It is an understatement to
say he will be greatly missed.
For 29 years, Chuck served as the publisher ofModern Healthcareand grew
that magazine into greatness. He oversaw the publications editorial direc-
tion and served as vice president of publishing before he attempted to re-
tire fromCrain Communicationsin 2007. Retirement didnt work out well,
and Chuck soon rebounded to his business interests and community work.
As beloved as he was in healthcare, Chuck was first and foremost a de-
voted family man. He tirelessly gave his time and prodigious energy to
everyone and everything, but most of all his family his beloved wife,
Maggie, his children and his grandchildren. He always spoke of them
with such love and pride.
Chuck mentored so many people throughout his life. He was a longtime
unpaid mentor to Beckers Healthcare, and to many of us personally, until
we literally forced him to take a paycheck. He was always looking to help
more. His advice transcended generations and boundaries, from editorial
to sales to healthcare and leadership of all sorts. As I watched Chuck work
and relate to people into his 80s, I often thought, My God, I want to be
Chuck Lauer when I grow up, says Publisher Scott Becker.
Throughout his career, Chuck wrote several books and hundreds, if not
thousands, of articles. His moral fiber and decency was apparent in his
writing, and he never failed to advocate for patients. Chuck also served
as a corporal in the U.S. Army during the Korean War, and he devot-
ed a great deal of his writing to lessons he learned and people he met
throughout his service.
Chuck, as publisher of Modern Healthcare and then a special writer
for Beckers Hospital Review, understood healthcare as few really do
the complexity, importance, the passion and the emotion, says Chris Van
Gorder, president and CEO of San Diego-based Scripps Health. His edi-
torials were challenging and yet supportive as only those on the inside of
healthcare would understand. His writings demanded good leadership
and management in healthcare, and he prided himself in recognizing
the good in healthcare leadership. Ill never forget the day he presented
me with a Beckers Leadership Award. I think he enjoyed presenting it as
much as I did receiving it. And I could tell he expected even more of me
going forward. Ill miss his writing as much as I will miss him.
We cant remember Chuck without recalling his unique spirit and brand
of energy. Chuck was a friend to all, and a generous one at that. An intro-
duction from Chuck Lauer was the golden pass to business relationships,
said Mr. Becker. He loved his sports ice hockey and golf, particularly
and his kids sports. He enjoyed spending time with his family in the sun
ofNaples,Fla.He was a natural networker and a sight to be seen when
meeting people and introducing friends to one another. He was young at
heart and never without his sense of humor.
Having worked with Chuck for nearly a quarter century, I can say that the
success he had never went to his head, says Todd Sloane, a former se-
nior editor atModern Healthcare. He was one of the warmest people you
could meet and would go out of his way to help anyone who asked for it.
Like hundreds of others who knew him, we at Beckers Healthcare are so
grateful for the friendship we shared with the legendary Chuck Lauer. We
are better for having known him, and he will be sorely missed. n
61
Chuck Lauer, in
the Words of His
and Colleagues
By Kelly Gooch and Molly Gamble
PRACTICE MANAGEMENT
T
he healthcare industry said goodbye to a giant
on April 30 with the passing of Chuck Lauer,
86, former publisher of Modern Healthcare.
Here, readers, friends and colleagues share the ways
Chuck touched the industry, their work and their
lives.
Chuck was a natural, gifted communicator and
always ensured that all of us in this field stayed in-
formed and connected.
Terry Akin, CEO of Cone Health (Greensboro,
N.C.)
Chuck was a kind, compassionate and thoughtful
leader. Through his writing, he frequently reminded
us that although healthcare is a business, our work in-
volves the most vulnerable aspect of peoples lives and
we have a special obligation to be respectful in all we
do. He will be greatly missed.
Teri Fontenot, President and CEO of Womans
Hospital (Baton Rouge, La.)
Im not sure there are many in the healthcare indus-
try who dont know or know of, Chuck Lauer.He
has been such an incredible influence to leaders
throughout the country, over many years.His quick
wit, his unapologetic quest for basic humanity, the
love he openly shared with all of us about his family
dogs included his country, and those serving in
the military, his transparency about his own health-
care experiences, always naming individuals and in-
stitutions who exceeded expectations but never call-
ing out publicly if someone did not, and his focus on
other-centeredness. It was not about Chuck, never
was. Such a profound lesson.
THOUGHT LEADERSHIP
I particularly enjoyed Chucks gift of the written lan-
guage.I still have copies of many of his oldModern
Healthcare columns, dog-eared as they may be, in-
cluding his last one, December 2008. Ill quote the
last two sentences:
Please tell some people in your lives just how much
you love them and remember to laugh, think and
cry.Its all part of living a great life.
And, indeed, a great life he has lived. Blessed to
know you, Chuck.
Julie Manas. President and CEO of HSHS Sacred
Heart Hospital (Eau Claire, Wis.)
 62
I had the honor of knowing Chuck Lauer for about 20 years. And,
during the past several, we met for lunch a couple times a year at vari-
ous Chicago area restaurants to catch up on our lives, swap stories and
discuss the status of healthcare in the U.S. He was a great mentor and
friend to my entire family, took my daughter Liz under his wing and
has been an incredible influence in her career in healthcare.
I could go on and on about the kindness and generosity of this great
man. Instead, let me put it this way: In my 43 years in business, I have
never met a more decent, credible and genuine person. He is a singular
Mt. Rushmore.
Jack Querio, Senior Vice President of Sales, Entrotech Life Sciences
I am very sad to learn of Chucks passing. His imprint on healthcare
will never be forgotten, along with his contribution to making this
world a much better place. I always looked forward to his role as mod-
erator for IDN Summits, in which he brought out the very best in the
healthcare leaders who would join him on stage. My condolences to his
family, and may he rest in peace.
Bob Acosta, Director of Business Development for Healthcare Ser-
vices, Konica Minolta Business Solutions
His articles were both enlightening and humorous at times. His ded-
ication and emotional attachment to the healthcare field could be felt
in every article he wrote. They were short, to the point and so valu-
able to us when we were just entering the healthcare field back in the
1980s. I never personally met Mr. Lauer, but felt close to him just by
the passionate method he so eloquently expressed in his articles con-
cerning patient care. He was certainly one of a kind, and well all miss
him dearly.
Rick J. Leinen, CFO of Montgomery County Memorial Hospital
(Red Oak, Iowa)
As a publisher and columnist, Chuck was old school. He believed in
journalism and the separation of church and state, meaning editorial
was king and advertising was there to support it, with profit a result of
doing great journalism.
Having worked with Chuck for nearly a quarter century, I can say that
the success he had never went to his head. He was one of the warmest
people you could meet and would go out of his way to help anyone who
asked for it.
He loved life and loved healthcare. He knew everyone in the healthcare
business and had legions of admirers in the industry. He worked right
up to the end of his life, even as he battled cancer, and kept his sense of
humor all the way through.
Todd Sloane, Former Senior Editor at Modern Healthcare
THOUGHT LEADERSHIP
While I have a number of warm memories of Chuck, one stands out as
a special experience. At a Beckers CEO Roundtable several years ago,
Chuck was the moderator of a CEO forum. I approached the front of
the room to say hello and greet some of my former colleagues. I had re-
tired from my CEO role at Sinai Health System by then. Chuck looked
up with Scott Becker, and they both said, You need to be on this panel!
As much as I resisted, they insisted. It turned out to be one of my most
enjoyable sessions. Chuck and I managed to get into a little humorous
riff in the middle of a serious discussion on organizational manage-
ment. Teasing each other in front of a crowd of CEOs and senior leaders
echoed the warmth and charm that Chuck brought to all his friends and
acquaintances. And, by the comments from several in the audience, I
certainly was not alone in feeling that special connection with him.
I will miss him dearly. He was a good friend, a thoughtful advisor and
a very special human being.
Alan Channing, Former CEO of Sinai Health System (Chicago)
Chuck, as publisher ofModern Healthcareand then a special writer
forBeckers Hospital Review, understood healthcare as few really do
the complexity, importance, the passion and the emotion. His editori-
als were challenging and yet supportive as only those on the inside of
healthcare would understand. His writings demanded good leadership
and management in healthcare, and he prided himself in recognizing
the good in healthcare leadership.
Ill never forget the day he presented me with a Beckers Leadership
Award. I think he enjoyed presenting it as much as I did receiving it.
And I could tell he expected even more of me going forward. Ill miss
his writing as much as I will miss him.
Chris Van Gorder, President and CEO of Scripps Health (San Diego)
Chuck was a very close friend for more than 35 years. We both spent
time together for years at Health Insights and HRDI, and supplement-
ed those relationships with many phone calls each month and some
rounds of golf. To say he was an icon in the healthcare industry does
not do justice to the respect others had for him. He was Mr. Modern
Healthcare, a pillar of integrity and a genuinely fine human being.
With the passing of Chuck, I lost a very close and dear friend. Now I
must find strength in what remains behind.
Tony Alibrio, Corporate Officer and Division President at Marriott
International
Chuck spoke at the Healthcare Planning, Marketing & Public Rela-
tion Professionals of
New Jersey Annual meeting in 2007. As the editor
ofModern Healthcarefor 29 years, Chucks column had a following. He
retired fromModern Healthcareprior to his talk at HPMSNJ, but his key-
note set attendance records for HPMSNJ that I think have still not been
broken. I went back through my notes and found his presentation.
Here is an excerpt:
Success is often understood to mean achievement in work - how high we
climb the career ladder. But that definition falls short. For success includes
all of life, and far more than what we do; it describes what we are. A suc-
cessful person is not just productive but positive: not just a go-getter but
a giver. A successful person seeks excellence. Not only in the workplace
but in social, emotional, intellectual, physical and spiritual dimensions
as well. Nothing ranks higher than possessing a personal character than
reflects time-tested virtues and values: honesty, resiliency, perseverance,
kindness and the full slate of other essential traits.
We were better people after Chucks presentation. God bless you,
Chuck. Thanks for all that you did for HPMSNJ and for inspiring us
as leaders.
Anthony C Stanowski, President and CEO of the Commission on
Accreditation of Healthcare Management Association
Chuck was a true icon who contributed enormously to healthcare and
to many of our careers. He cared deeply about everyone and made you
feel so welcome. I was truly honored to co-chair Beckers conferences
with this extraordinary leader who touched all our hearts and souls.
There will never be another Chuck. He will be greatly missed.
Rhoda Weiss, PhD, National Co-Chair, Beckers Healthcare Spring
and Fall Conferences

What a class act. Chuck was the guy who knew everyone in the room
from the CEO of the largest healthcare system in the country to the
name of the waiter and he treated everyone the same, his yardstick was
respect and kindness. When Chuck would stop and speak with you, with
the unmistakable Chuck Lauer radio voice, he would look you in the
eye and really listen; you felt like you were the only person in the room.
Comparing notes over the years I discovered Chuck was a medic in the
Korean War, as was my father, and his love of his family and colleagues
was only rivaled by his love of his country. Interestingly enough if there
was the rare time we didnt see eye to eye on an issue he could also give me
the look Id get from my own father signaling me to throw in the towel!
Chuck will be missed but certainly not forgotten by a long shot. Hell
have a ripple effect on the healthcare industry for many years to come;
he was our industrys LinkedIn.
Neil Thorpe, Strategic Account Manager - U.S. at Halyard Health
(Phoenix)
Chuck Lauer was a giant among healthcare journalists.He was a true
professional who had incredible insight and knowledge of the indus-
try. He was a prolific writer, public speaker and career coach who also
happened to be a great guy and a good friend. All those who knew
and worked with him will miss him greatly, but were buoyed by many
fond memories.
Michael Dowling, President and CEO of Northwell Health(New
Hyde Park, N.Y.)
I believe every industry, if you look hard enough, has a finite num-
ber of sage, experienced leaders leaders with a passion and a heart
for making that industry and the world for that matter a better
place.Chuck Lauer was in my bookone of these people. Through a long
career of service in healthcare, he inspired others to learn more and do
more. His objective was always to lift up others and help them fulfill their
vision and dreams.My interactions with Chuck were always filled with
kindness and respect, with uplifting remarks and encouragement.In the
world of healthcare, he will be sorely missed.Thank you, Chuck, for your
many contributions to our industry. May you rest in peace.
Paul Stewart, President and CEO of Sky Lakes Medical Center
(Klamath Falls, Ore.)
Imagine the old-fashioned speech cadence of radios Paul Harvey
combined with the hail-fellow-well-met brio of a man who wore the
badge of salesman with a pride that came from working to win over
the loyalty of every single customer. Then add in a lifetime of industry
knowledge and infuse it all with the genuine warmth and caring of
a devoted family man who saw everyone in healthcare as part of his
extended family. That was Chuck Lauer.
Did I say healthcare? Really, it was hospitals that captured Chucks
heart. Chuck was a key part of the transition of Modern Hospi-
talsintoModern Healthcare. That was before my time, but when I met
Chuck back in the spring of 1982 as a Chicago Tribune financial re-
porter whod had the healthcare beat unexpectedly thrust upon him,
Chuck quickly tutored me in that and a great deal more industry
history. Crains, the publisher ofModern Healthcare, was based just a
few blocks away from the Trib, and Chuck and his then-editor, Don
Johnson, served as mentors and, eventually, friends. It was an era of
colorful personalities, when congressmen, industry lobbyists and jour-
nalists could take in dinner and a Las Vegas show together without
anyone batting an eye. Everyone was Chucks pal, though he was no
naif; privately, he knew exactly who was doing what with (or to) whom.
63
I freelanced the main story forModerns Healthcare Hall of Fame is-
sue while on leave from the Trib in 1986, briefly considered becoming
Chucks editor when the position became open and then returned to
the Trib before leaving journalism some years later to write a book and
then go into full-time consulting and part-time academic endeavors.
Chuck and I still corresponded and sometimes saw each other.
His energy, optimism and commitment to using his voice to make
thingsbetter through books, articles, speeches, blogs and every oth-
er communication form known to man was an inspiration. Chucks
writings were filled with love whether for his country, his wife and
kids, the latest in a series of loyal family dogs or the healthcare (one
PRACTICE MANAGEMENT
word, please!) industry. He will be missed.
Michael Millenson, President of Health Quality Advisors
The legacy left by Chuck Lauer is one of wisdom, insight and friend-
ship.I ran into Chuck a few years ago at a Beckers conference in Chi-
cago. As we got on the elevator together at the Ritz Carlton, Chuck
had just finished readingThe Wall Street Journaland when he threw it
down the trash chute at the hotel, he accidentally threw his cell phone
with it.With the help of the staff at the Ritz, we recovered his cell phone
but it was always a fun event to recall and brought us closer together.I
will miss him for his laughter, his graciousness and his genuine love for
life.Healthcare has lost a great leader and the nation has lost a great
American.
Bill Sexton, CEO of Crossing Rivers Health (Prairie du Chien,
Wis.)
I had the privilege of participating in a panel discussion that Chuck
moderated at last years Beckers conference. Chuck was an absolute
pleasure to team with, both in our preparation for the panel and the
discussion itself. He was on his game, asked us excellent questions, of-
fered wonderful insights, and was a true gentleman.
I will always have fond memories of his energy, enthusiasm, and pas-
sion for healthcare! Our sincerest condolences to the Lauer family and
his many friends.
Don Barbo, Managing Director at VMG Health (Dallas)
Much has been said about Chuck and all of it is true! It was my
privilege to call Chuck a friend and a colleague over several decades.
Whether it was professional advice or personal mentoring he always
had pearls of wisdom that helped you think through the issue at hand.
Those pearls captured in his many articles are still in my possesion and
in many cases in my adult childrens possesion as I passed them along
to them.
His most powerful pearl was in the calls he placed to me after my heart
attack. He said Let GoLet God.words I still live by sixyears later.
THOUGHT LEADERSHIP
I was privileged to return those calls during his recent struggles. We
both loved hockey, golf and dogs, and I was delighted to have played
golf with him this past January in Naples. It was quite the group. Ed
Eckenhoff, Tony Alibrio, Chuck and myself.the laughter that day
was the best medicine.
Thanks for all you did for us and this industry. It is good to know we all
have another angel in heaven looking after us. God Bless you Chuck!
Brian Grissler, President and CEO of Stamford (Conn.) Health
System
The highlight for the many years that I subscribed toModern Health-
care while Chuck served as editor was reading his editorial column.
More often than describing some temporary crisis in reimbursement
 64

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

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

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THOUGHT LEADERSHIP
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Raising the Nations Guts Quotient 5 Thoughts on
the Future of Healthcare From Cleveland Clinic CEO
Dr. Toby Cosgrove
By Tamara Rosin
W
hen Delos Toby Cosgrove, MD,
president and CEO of Cleveland
Clinic, was a high school junior,
his father took him to visit a family friend
who was a college professor.
Naturally, the conversation turned into, What
do we need to do to get Toby into college, Dr.
Cosgrove told the audience during a keynote at
Beckers Hospital Reviews 8th Annual Meeting
in Chicago. Rhoda Weiss, PhD, speaker, author,
consultant and co-chair of the meeting, moder-
ated the conversation. The professor said he was
not interested in Dr. Cosgroves IQ, but rather
his GQ a term that neither Dr. Cosgrove nor
his father had heard before.
Its guts quotient. In retrospect, that turned out
to be a really important thing for me, he added.
Guts refers to ones perseverance or grit in the
face of setbacks or in anticipation of challenges.
Dr. Cosgrove went on after college and med-
ical school to serve as chief of U.S. Air Force
Casualty Staging Flight in Da Nang, Republic
of Vietnam. He joined Cleveland Clinic in
1975 as a cardiac surgeon and has served as
CEO of the system since January 2004.
Dr. Cosgrove, who today leads an $8 billion
health system with facilities across the U.S.,
Abu Dabi and soon in London, said it has
been his GQ that has driven his ability to pro-
pel his career and the Cleveland Clinic for-
ward. Despite the uncertain future of health
reform, the rest of the industry must cultivate
higher GQ to not only survive, but to thrive
in a changing healthcare landscape.
Here are five thoughts from Dr. Cosgrove on
how to succeed in the future of healthcare.
1. Teach clinicians to be team play-
ers. I realized some time ago that doctors
are not trained to be team players, said Dr.
Cosgrove, yet none of us has the individual
power of the doctors who used to go to pa-
tients houses with a black bag and deliver the
cure alone. Healthcare today is dependent on
a huge number of players.
Team-based, highly coordinated care is a cen-
tral component of Cleveland Clinics care deliv-
ery strategy. Physicians, nurses, dentists, physi-
cian assistants and other providers often come
together in one building for team training. The
health systems leadership also evolved its phy-
sician-based departments into disease-based
institutes to facilitate greater collaboration be-
tween formerly disparate groups of clinicians.
65
Dr. Cosgrove said it also occurred to him that ing offered a position. Smoking is not permit-
every staff member of the health system has a ted anywhere on the health systems campus.
PRACTICE MANAGEMENT
role on the care team. Everyone from the bus
He is equally committed to lowering the rates
drivers and cafeteria workers to the chief of
of obesity, the effects of which cost the nation-
staff and neurosurgeons are caregivers, he said.
al healthcare system billions of dollars per year.
Calling each individual a caregiver has had
We give a lot of lip service to population health
innumerable positive effects on the systems cul-
and wellness, but its important to actually make
ture, morale and employee satisfaction.
it a part of the culture, said Dr. Cosgrove.
2. Invest in IT.Health systems must invest in
4. Deliver care in the most cost-effec-
sophisticated IT systems if they want to keep
tive settings. There is little question were
up with the explosion of knowledge going on
over-bedded in the U.S., said Dr. Cosgrove.
in healthcare right now, said Dr. Cosgrove.
In the last 20 years, weve gone from 1 mil-
When the Cleveland Clinic was formed in lion beds to 800,000 beds across the country,
1921, the total amount of knowledge dou- and were still at an average of 65 percent oc-
bled every 150 years, he said. Now the total cupancy. The increasing rate of outpatient
amount of knowledge is doubling every 73 procedures combined with shorter lengths of
days. There are 5,600 medical journals turn- stay is going to lead to even higher over-bed-
ing out 900,000 articles every year. And one ding in the U.S., he added.
human genome has 3 billion data points. So I
Consolidation enables hospitals to focus on their
think we are going to be very dependent on IT
most successful service lines, pare down super-
going forward to help us manage this explo-
fluous or underutilized services and provide
sion of knowledge.
care in the most cost-effective settings, said Dr.
Cleveland Clinic has partnered with both IBM Cosgrove. Not every hospital has to do the most
Watson and Microsoft to support staff and technical things, he said. Community hospitals
medical education. Both technology systems can do deliveries and handle emergencies, while
promise to revolutionize the way data is stored, academic medical centers, which have higher
processed and optimized to support education overhead costs and specialize in more complex
and clinical decision making. With Microsofts care, can take the more difficult cases.
augmented reality technology, medical stu-
There are two aspects that are integral to the
dents can use holograms of human bodies and
success of greater partnerships and consoli-
organs instead of cadavers, which, if anything,
dation between facilities, Dr. Cosgrove noted:
would benefit the social lives of first-year med-
interoperability between disparate EMRs and
ical students so they dont have to constantly
efficient transportation.
smell like formaldehyde, Dr. Cosgrove said.
5. Do not underestimate the devasta-
3. Make population health manage-
tion of the opioid epidemic.This is one
ment a strategic priority for pa-
of the great tragedies of our time and not many
tients and staff. The momentum behind
THOUGHT LEADERSHIP
people realize how bad it is, said Dr. Cosgrove.
population health management efforts to
I recently visited the Vietnam memorial in
mitigate the cost of chronic disease manage-
Washington. There are 53,000 names on that
ment under value-based care and lower re-
memorial. Last year there were 53,000 deaths
imbursements has surged in recent years. Dr.
caused by drug overdoses. We have a Vietnam
Cosgrove emphasized these efforts must be
War going on in our country every day.
targeted at staff in addition to patients.
Dr. Cosgrove said the Vietnam War ultimately
By the time Dr. Cosgrove became Cleveland
ended due to highly negative public opinion.
Clinics CEO, he had a long time to observe
People saw the body bags every night on the
the ravages of smoking, he explained. He saw
evening news. Everyone understood it. But not
the physical effects of smoking firsthand as a
everyone understands the magnitude of the is-
cardiac surgeon, and lost his father, a smoker,
sue right now and its getting worse. Increasing
to emphysema. That, combined with the fact
public awareness of the problem, combined
that smoking is the most preventable cause of
with improving the approach to combat it by
cancer, spurred Dr. Cosgrove to implement a
medical professionals and law enforcement,
hiring ban on smokers in 2007. If a candidate
are the first steps the U.S. must take to control
tests positive for nicotine, he or she must com-
the epidemic of opioid abuse. n
plete smoking cessation treatment before be-
 66
The Health System CEO's Affiliation Playbook: 5 Thoughts From a
CEO Who Has Executed 50+ Agreements
By Michael Dowling, President and CEO of Northwell Health
A
s hospitals and health sys-
tems seek ways to fortify
their organizational strat-
egies amid the transition to val-
ue-based care, the drive to forge
new partnerships will continue.
Although analysts forecast the
consolidation trend will carry on,
strategic organizations are increas-
ingly realizing the value of estab-
lishing other relationships, such as
affiliations and joint ventures.
The local forces at play in a given region are a significant de-
terminant of an organization's need to merge with, acquire or
be acquired by another hospital or health system. And while
transactional deals will always be necessary, ongoing finan-
cial pressures stemming from the transition to value-based
reimbursement and the overall emphasis on population
health management have prompted healthcare leaders to
partner with their like-minded peers to deliver better, more
cost-effective care.
The key is figuring out where your organization can do a bet-
ter job working with a partner than alone, and more impor-
tantly, who to collaborate with.
In some cases, this has led to the union of unlikely bedfellows
organizations that were formerly competitors are, in some
cases, coming together to pursue a joint goal. In other cases,
hospitals and health systems may benefit from establishing
partnerships with pharmaceutical companies, medical de-
vice makers, retail clinics or even nonhealthcare entities. For
example, Northwell Health has worked with The Ritz-Carlton
and Tiffany & Co. as part of our efforts to improve the patient
experience and our operational processes.
As with all relationships, the most positive and high function-
ing are symbiotic; both partners must satisfy and comple-
ment the other. They must also at the most basic level get
along. Here are five more ideas on successful partnerships,
affiliations and joint ventures.
THOUGHT LEADERSHIP
1. Know what you need and what you can offer. Partner-
ships create opportunities to expand into new markets and
broaden your reach. But when it comes to selecting a part-
ner, it's important to clarify what it is they have that you want
and visa versa.
For example, we have a strategic affiliation with Cold Spring
Harbor (N.Y.) Laboratory, a premier cancer research facility on
Long Island. They have an international reputation, with sev-
eral Nobel laureates in their ranks. We needed to strengthen
our cancer research, and they needed a clinical partner that
would allow them to connect with patients. We entered into a
long-term partnership in 2015. Even though we're very differ-
ent organizations, we both benefit from the relationship.
2. Don't overemphasize the short-term benefits. Focus as
much on the short-term benefits of a partnership or affilia-
tion as you do on your goals for five or 10 years down the
line. Most relationships hit a rough patch in the beginning,
but if you give up on the partnership because your troubles
are making you doubt the viability of your short-term goals,
you're being too impetuous. In other words, success takes
time. Take steps to solve short-term complications, but hang
in there and try to make it work.
3. Be open to new partners. Keep an open mind when it
comes to discussing new relationships with different part-
ners even those that don't seem to make much sense in
the beginning. The rapid pace of change in healthcare and
our collective pursuit of innovation oblige us to at least listen
to others' ideas and consider new possibilities.
"If your organization is looking
for a long-term partner not
just a fling the two entities
must mesh culturally."
4. Don't get stuck in an abusive relationship. New part-
ners might hit a rough patch or need to adjust their com-
munication style to meet one another's needs, but it is also
important to know when it's better to cut your losses and call
it quits. If a relationship becomes abusive or dysfunctional,
and there is no longer any benefit for being involved, then
it's time to re-evaluate the situation.
5. Determine whether you're truly compatible with
a potential partner. If your organization is looking for a
long-term partner not just a fling the two entities must
mesh culturally. When considering a potential partner, ask
yourself if there is mutual respect on both sides. Do those
who are in charge of communication and collaboration work
well together? Is the relationship riddled with conflicts or is
it smooth sailing? Keep in mind, however, that conflicts are
not necessarily a symptom of an impending breakup. Some-
times the issue can be resolved by changing the people or
metrics at hand.
Most importantly, there must be ongoing and open commu-
nication. Two partners can disagree, but in most cases they
can work it out. n

Corner Office: Temple University Hospital CEO Dr. Verdi
DiSesa on Fatherhood and Health System Leadership
By Tamara Rosin
D
espite years of higher education and
clinical training, many of the most
important lessons Verdi DiSesa, MD,
has learned come from his family.
Dr. DiSesa has kept advice from his father
close to heart throughout his education and
career. And as a father of four sons himself, he
has realized many of the lessons he's learned
as a parent are applicable while leading others
in his roles at Temple University.
Dr. DiSesa serves as senior vice dean for clinical affairs at the Lewis Katz
School of Medicine at Temple University, president and CEO of Temple
University Hospital and COO of Temple University Health System in
Philadelphia. He is also a professor of surgery at the medical school. He
was named CEO of the hospital in January 2016 and has held his other
roles at the institution since April 2011.
After graduating from the University of Pennsylvania School of Medi-
cine in Philadelphia, Dr. DiSesa trained in internal medicine at the Hos-
pital of the University of Pennsylvania in Philadelphia. He then went
on to complete his internship and residency in general surgery and a
fellowship in cardiothoracic surgery at Brigham and Women's Hospital,
Children's Hospital of Boston and Harvard Medical School in Boston.
A board-certified cardiothoracic surgeon, Dr. DiSesa also earned his
MBA from the Wharton School of the University of Pennsylvania.
An established researcher and author, Dr. DiSesa's research and clinical
interests include postoperative cardiac surgical management, including
the use of inotropic agents, and clinical and experimental heart trans-
plantation. He has authored and co-authored multiple book chapters,
as well as nearly 150 original papers. He is a current or past editorial
board member of the Annals of Thoracic Surgery, the Journal of Cardiac
Surgery and the European Journal of Cardiothoracic Surgery.
Here, Dr. DiSesa took the time to answer Becker's seven questions. Re-
sponses have been lightly edited for length and clarity.
What's one thing that really piqued your interest in health-
care?
My uncle and great uncle were surgeons and my family heritage in-
clined me toward medicine. Additionally, in college I helped a friend
who had a sprained ankle. I knew how to wrap ankles from playing
sports, but there was something about laying strong but gentle hands on
someone to help them heal that appealed to me. That small incident was
a big contributor of my interest in medicine on top of my family in the
background telling me this is a worthwhile thing to do.
From taking care of one patient at a time to running systems, I've been for-
tunate to leverage my knowledge and have the chance to affect so many
people. I do miss treating patients. I stopped practicing about eight years
ago because cardiac surgical patients require a doctor who has the ability
to respond to them any time, day or night, and my administrative duties
wouldn't allow that. But by helping to run a health system, I have the op-
portunity to make a positive contribution beyond a single patient at a time.
What do you enjoy most about Philadelphia?
There is a lot to like. I've lived in the Northeast most of my life. New
67
York City and Washington, D.C., aren't far away. I like the climate and
geography. It's pretty we have four real seasons. There's also a fair
amount of diversity, both culturally and otherwise. I've raised four sons
in Philadelphia. There are great educational opportunities, both in pub-
PRACTICE MANAGEMENT
lic and private schools.
If you could eliminate one of the healthcare industry's
problems over night, which would it be?
There are obviously a lot of problems. If I had to pick, I would say to
standardize credentialing for providers and standardize the metrics that
determine how we're paid, rather than every payer saying here's what
you have to do to be credentialed or here is the idiosyncratic way we
want to be billed or paid. If the requirements could be streamlined and
standardized, it would be easier for everyone and save a lot of money
because all of that work requires a lot of infrastructure.
What do you consider your greatest talent or skill outside
of the C-suite?
Fatherhood. Some of the skills I've learned as a parent are helpful in
what I do now like how to help folks work together, grow and devel-
op. How to give them enough rope so they can come up with their own
solutions but not so much as they hang themselves. This is how I ap-
proached being a father to four sons. They're nice kids young adults
now. I'm proud of the results so far.
How do you revitalize yourself?
I exercise pretty regularly. I also like to read, especially history and biogra-
phies. I've gotten into cycling in this phase of my life. I have a sore knee so
I can't run on the road anymore, but I can cycle, which allows me to travel
and to see the world at a human rate of speed. It's also very important to
me to stay involved in our kids' lives. One is married now and another is
getting married, and one is in law school and another in medical school.
What's one piece of advice you remember most clearly?
I have two, and both came from my dad, who died a while ago when
he was too young. The first is the importance of giving an extra effort.
This is what separates the good from the outstanding. He taught me this
when I was in school and I think that it still applies today.
The other is if you're doing something, don't think nobody ever saw.
Someone always sees. Not only does someone always see, but nowadays,
someone always records it.
THOUGHT LEADERSHIP
Another piece of advice I would offer others is don't write an email you're
not prepared to see on the front page of The New York Times tomorrow.
What do you consider your greatest achievement at Tem-
ple University Hospital so far?
I think we've done a good job in the past year of improving engagement
of our medical staff and employees. Since I'm a physician, I think we've
been able to bridge the connection between the hospital administration
and medical staff. We've held focus groups as well as periodic town hall
types of meetings, and our employee engagement scores have improved
significantly they're up 10 percentage points from a couple of years ago.
We also implemented Epic last August and we're going to survive that,
I think. We haven't had any big catastrophes. The Epic team said it was
one of the better go-lives that they've done. Now with the EMR we are
starting to take advantage of new capabilities, such as data collection
and analysis and process improvement. n
 68

Hospital and Health Systems Executive Moves

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

Hospital and Health System Transactions

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

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70
Care and divested two hospitals to Clinton, Tenn.-based Curae
Health May 1.
Brentwood, Tenn.-based Quorum Health Corp., and the
Walker County Hospital District in Texas mutually agreed
to terminate a deal proposed last year for Quorum to acquire
Huntsville (Texas) Memorial Hospital.
Baptist Memorial Health Care, a 17-hospital system in
Memphis, Tenn., and Jackson-based Mississippi Baptist
Health Systems finalized their proposed merger agreement.
Mercyhealth in Rockford, Ill., revealed plans to form a com-
prehensive partnership with the Ann & Robert H. Lurie Chil-
drens Hospital of Chicago.
Franklin, Tenn.-based Community Health Systems sold
125-bed Stringfellow Memorial Hospital in Anniston, Ala., to
The Health Care Authority of the City of Anniston.
The respective boards of directors of HealthEast, a four-hos-
pital system in St. Paul, Minn., and Fairview Health Services,
a seven-hospital system in Minneapolis, approved the orga-
nizations plans to merge, effective June 1.
Hackensack Meridian Health, a 13-hospital system in Edi-
son, N.J., and Paterson, N.J.-based St. Josephs Healthcare
revealed plans to form a jointly owned home health services
agency and a hospice services agency.
Yale New Haven (Conn.) Health System and Putnam,
Conn.-based Day Kimball Healthcare inked an agreement
to become community partners and enhance the breadth of
clinical care services available at Day Kimball.
Winston-Salem, N.C.-based Wake Forest Baptist Medical
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access to cardiac rehabilitation services.
After a four-year fight to gain federal regulatory approval for
their proposed merger, Santa Barbara, Calif.-based Cottage
Health and Sansum Clinic, also in Santa Barbara, called off
the deal.
Cedars-Sinai Medical Center, an 886-bed academic medi-
cal center in Los Angeles, revealed plans to affiliate with 446-
bed Torrance (Calif.) Memorial Medical Center.
New Orleans-based Tulane Medical CenteracquiredCov-
ington, La.-based Lakeview Regional Medical Center, ef-
fective May 7.
Columbus (Ga.) Regional Health and Piedmont Health-
care, a seven-hospital system in Atlanta, signed a letter of
intent to enter into exclusive negotiations to form a potential
partnership.
Danville, Pa.-based Geisinger Health System and 25-bed
Jersey Shore (Pa.) Hospital and Foundation signed an
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Buffalo, N.Y.-based Catholic Health System and BryLin Behav-
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sions to form a potential affiliation.
Kenosha, Wis.-based United Hospital System revealed
plans to affiliate with, and assume the brand name of,
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