By Joan Elizabeth Gee, Vice President and Financial Practice Leader at Tyler & Company with John N. Katsianis, CPA, Senior Vice President and CFO of DeKalb Medical Center in Atlanta
If the flip side of a challenge is an opportunity, then healthcare CFOs have a lot to be optimistic about. According to Becker’s Hospital Review, the top 10 challenges (or opportunities) facing hospitals1 this year relate to:
- Digesting health insurance exchanges (decreased reimbursement, patient enlistment and high-deductible plan collections);
- Readying for ICD-10 going live (was Oct. 1, 2014; TBD as of April 2014);
- Leadership resource allocation given the organization’s scope of strategic projects;
- Keeping the organizational mission alive;
- Transparency with charges, prices and cost of care;
- Physician shortages;
- Patients’ access to care;
- Successful fundraising;
- Workforce relations; and
- C-suite retirement.
Peter Drucker, a management consultant and author, said, “The basic economic resource – the means of production – is no longer capital, nor natural resources, nor labor. It is and will be knowledge.”
After about a year at his new post at 628-bed DeKalb Medical Center in Atlanta, we asked Tyler & Company alumnus, John N. Katsianis, CPA, Senior VP and CFO, to share his insight.
Gee: Please describe the landscape at DeKalb Medical Center when you joined.
Katsianis: When I joined DeKalb Medical Center in February 2013, the CEO (former COO who rejoined the organization in 2011) had recently rebuilt and restructured his team. Senior management (C-suite, senior VPs and VPs) totaled 11 members, most of whom had been with the organization fewer than two years.
Gee: What were some of your biggest challenges?
Katsianis: Since the organization was struggling financially, my first challenge was to conduct a speedy evaluation of the accounts receivables system. Uncovering some of the system’s flaws led to a tough Q4 2013. But as we started making changes that better positioned the organization for financial success, we began to see improvement during Q1 of our 2014 fiscal year.
Gee: What advice would you give to a CFO peer?
- When it comes to your financial state, get to the bottom of what’s true. Focus on improving the revenue cycle, financial management and financial reporting.
- Devote yourself to relationship building. Build your credibility by making an effort in getting to know your team (especially your director- and administrator-level colleagues). Finance is a team sport, and it benefits others to know your intent is to improve the organization.
- Take time to work through any misunderstandings that exist in your organization. Bringing false perceptions to light can help everyone move forward, as well as help you lay a new foundation.
- Lead the charge within your organization so that it may gain confidence with its financial system.
- Empower your operations team so that it may make necessary changes.
Gee: What is your response to changes in the healthcare market and its impact on hospital CFOs?
Katsianis: Medicare is underfunded. The government has limited options — either increase payroll tax to fund the actual cost of the program or cut costs. Encouraging patients and providers to reduce utilization and/or cut prices is the less political of those two options, in my opinion. CFOs need to embrace that driving toward more efficient operations will be a continual goal for the next decade. Learning to play by the rules and deciphering what will keep your organization alive are part of today’s CFO role.
Gee: What has pleasantly surprised you about your position?
Katsianis: When working through the process of interviewing for a new position, you always wonder — are these the people with and for whom I’ll actually work? (I’ve had experiences where this wasn’t true.) It brings me great pleasure to say and report — this time, it is. I work with an outstanding team of people.
Joan Elizabeth Gee, VP, chairs the firm’s Financial Leadership Practice. Her career spans more than 25 years, primarily in C-suite healthcare search. Her specialties include finance and accounting executive recruitment. Reach Gee at 770-396-3939 or firstname.lastname@example.org.
1 Gamble, Molly. “10 Challenges and Opportunities for Hospitals in 2014.” Becker’s Hospital Review. Dec. 16, 2013.