Breaking ground

Kenneth Feinberg's Profile

Healthcare seems to be in the news constantly these days as the government and private companies try and figure out how to "fix" the industry.  For accounting and finance professionals in the healthcare industry, we see on a daily basis what is right and what is wrong with the system.  But for us it isn't the lofty goal of affordable heathcare for all Americans that concerns us as much as trying to deal with rising costs and decreasing reimbursements.  Whatever our political views on universal healthcare, our jobs are focused on the viability and success of the organizations with which we are involved.

I am currently employed by a large, regional pharmacy that services the long term care community as well as specialty pharmacy.  Since we operate on very thin profit margins it is essential to track every penny to make sure that we are financially healthy while still providing quality service to our patients.  I know that there are many other professionals like me in the industry who are dealing with many of the same issues.  I think it's very important that we have a forum to communicate and share ideas.  A place where you can go to get information and help from people who are dealing with the same issues that you are.

I invite you to share your thoughts, ask questions or make suggestions.

Answers

Member's Profile

I note the healthcare provider industry continues to grow and there are many positions available. I've always noticed hospitals and clinics are almost like closed societies. You either started there or you didn't. You never hear of, say an ex GE or Boeing guy taking a lead role at HCA for example, even though the quality issues might be very similar. Seems there could be so much efficiency to be gained by cross pollenization.

I have a CPA and MBA, and I have many years experience including mid-level and divisional CFO roles in manufacturing including pharma manufacturing. That includes exposure and involvement in some pretty high tech and high control operating issues. What would I need to do to become capable of taking a job as a hospital or clinic CFO or an associate? Any way to step back and gain the magical knowledge to cross into that society?

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Member's Profile

From my experience (although I've never held a position at either), clinics and hospitals are so overly concerned with reimbursement issues that they make prior experience in that area a number one priority.

While the reimbursement issues can be quite complicated, a top level finance executive shouldn't be expected to know every detail in order to succeed, that's what you have your staff for. Quite often the expense side is ignored; the conventional wisdom is that if you bill correctly and are able to collect, everything will be okay. The truth is that as reimbursement continues to be cut managing expenses become critical. Many healthcare executives aren't as experienced with managing expenses and profitability so the industry would be well served to look outside for expertise. A well run organization sould be willing to look outside "the ususal suspects" in order to make changes.

If you're finding it difficult to find an organization like that remember the hospitals and clinics aren't the only ones seeing growth. There are retail organizations, pharmacies and medical supply companies, that are trying to juggle growth with increasing costs and decreasing reimbursements. There are also service organizations such as home health agencies as well as the nursing home industry that continue to grow. And giving the tremendous amount of M&A activity that continues to happen in these industries, any experience you have in building company value or analyzing acquisition targets will be useful as well.

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I made the transition into healthcare from a mixed background; consulting, retail/wholesale, services as CFO, Controller, and Consultant. I too have my CPA, CMA and MBA which also played into the decision to hire me. Most importantly, I believe it was my strong belief in self and can-do attitude that gave them the confidence to hire a guy from "outside". I agree that there is much in the accounting realm that does translate from one industry to the next. It is the nuances that provide the complexity. Revenue recognition is more complicated due to third party payors, contractual allowances, charity care, and bad debt. The multi-specialty physician group practice presents a number of challenges for reporting.

As I read your posting, I was reminded that there are not-for-profit board positions that you can use to gain exposure to healthcare with little risk. Like me, you may need to take a step back to Controller in order to transition into healthcare. It has been for me a rewarding, interesting move which I am happy to have made.

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This discussion thread was started in March 2010. That is probably a complete product life-cycle in some technological industries. Yet the topic of "fixing" the healthcare industry is more relevant now than then. Medical practices are being impacted daily by changes in their external environment.

Government controls are a constant but should CFOs look to others for systemic controls or create them for their firms? Mr. Feinberg has touched on one key issue, IMHO. Cost-controls are within the purview of the CFO and can balance any reductions experienced in revenue.

The next step after stanching the bleeding is to increase revenues. We can't take the patient out of the ER, however, until the patient is stitched up and ready to walk. A frightening metaphor, perhaps, but consider the condition of many medical practices.

One of the reasons that this discussion thread did not continue was that it not stay on topic. I am requesting that Mr. Feinberg (and all other interested parties) indicate some choices about which line-items should be controlled first, then next, etc. Let's have a debate about cost controls BUT let's keep the topic within medical practices and not meander off onto job searches.

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