By Elena Barberis, CPA
For today’s hospital finance leaders, access, growth and margin can sometimes appear to be competing priorities. In reality, they can reinforce one another when the organization keeps its focus where it belongs: patient care.
The starting point should be the community. A hospital’s Community Health Needs Assessment provides an important roadmap for understanding what services patients actually need and where gaps in care exist. By aligning investments and resources with those needs, hospitals can provide the right care, in the right setting and as efficiently as possible. Growth should not simply mean adding volume. It should mean expanding access to services that improve the health of the community.
That approach also has a direct financial impact. Patients generally do not want to remain in the hospital any longer than medically necessary. When hospitals can deliver high-quality care efficiently, an appropriate reduction in average length of stay (ALOS) can improve the patient experience while reducing the cost of care. The objective is not to discharge patients prematurely. It is to eliminate unnecessary delays and ensure that every day of hospitalization adds clinical value. At Holy Cross Health, our clinical teams huddle daily to review patient care management needs to prioritize and plan accordingly. This also results in better ability to manage expectations and communication with the patient as to what to expect, which increases patient satisfaction.
Achieving this requires hospitals to leverage every available tool for operational efficiency and to work across departments as a team to resolve issues. Financial systems, automation, data analytics and artificial intelligence can provide leaders with better information, streamline processes and identify opportunities to reduce waste. Technology should make routine tasks faster so operators can spend more time on strategy and analysis. Through-put issues are identified, and this helps prioritize capital equipment and staffing needs as well.
Workforce management is equally important. Hospitals must invest in training, education and professional development so employees have the skills and knowledge needed to perform effectively. Developing people creates a stronger workforce, improves retention and builds the operational capabilities necessary to support sustainable growth. Engaging front line staff and recognizing compassionate care and excellent service will set the tone that the patient is our priority and our purpose is to care for them. Our mission as a Catholic-based ministry includes a moment of reflection to kick off key meetings; core values including reverence, justice and integrity; and a commitment to continuously improve through active listening and partnership. Holy Cross Health has been recognized as one of Forbes America’s Best Employers for Healthcare Professionals. Additionally, we are proud of our high colleague engagement scores, which are a constant focus. This creates a culture that enables our colleagues to provide their best in caring for our patients.
Ultimately, this requires empowered leaders at every level. Leaders should operate with high standards and have clear accountability for their areas. Regular reporting should identify both the positives and the negatives—not to assign blame, but to understand performance and identify opportunities for improvement. Most importantly, leaders should be expected to lead the solutions.
Every solution should include a financial perspective. What will it cost? What resources are required? What is the expected return? How will it affect access, quality, workforce and the patient experience?
When financial discipline is integrated into operational and clinical decision-making, margin becomes less about cutting costs and more about eliminating unnecessary costs while improving care.
The hospital CFO of the future is therefore not simply the steward of the financial statements. The CFO is a strategic partner in designing how care is delivered—using community needs, clinical outcomes, operational efficiency, technology and financial stewardship to create a sustainable organization.
When patient care drives the strategy, access creates growth, efficient care improves margin and financial performance becomes the result, not the sole objective.
Elena Barberis, CPA, is Vice President of Finance for Trinity Health Holy Cross Health in Fort Lauderdale, FL and St. Mary’s Health Care System in Athens, GA.
