An Exciting Day in the Life of a CFO

OrWhy are there no TV shows

about CFO’s?

Daily Tasks

• Go get Coffee• Check the Stock market, call personal stock broker• Go to Meetings, get more coffee, go to the bathroom (depends on age)• Play on the Computer, check news on the internet (Kardashian in Bozeman)• Go to Lunch, get more coffee and go to the bathroom (age thing again)• Take the deposit to the bank (2 hours a day, combine with lunch)• Answer Phone messages (Never answer the phone!), no more coffee• Read the Wall Street Journal (miss meetings if it interferes with reading)• Go Home

Goals of the CFO

• Leave the Organization Better Off (Finance)• Work Every Day to Bring Value to the Patients (Service)• Monitor Industry Trends, Develop Strategy (Growth)• Pay Attention to the Details, Operations (Quality)• Invest in Staff (People)

Finance

• Develop 5 year financial forecasts• Use benchmarks, have goal to reach benchmarks in X years• Create Alignment over the goals• Board, Senior Leadership, Department Manager Consensus• Annual Evals of Managers has the Budget as a component

• Develop annual budgets/business plans in correspondence with 5 year forecasts• Monitor Results

Service: Bring Value to Patients

• Value = Quality/Cost (Increase Quality, Decrease Cost, Value goes up)• Monitor Charges, competitive with other like hospitals• Wyopricepoint.com• Place Charge information on Web Site, make available to public

• Control Salary Expense (Salary and Benefits are half the cost)• Put in place a Productivity system, monitor and use for budget targets

• Have budget variances as part of manager’s annual evaluation• Support Lean activities, help departments achieve their benchmarks

Monitor Industry Trends, Develop Strategy (Growth)

• Rural ACO’s (bundled payments)• 96 hour Rule, Two Midnight Rule• Hospital prices rise 0.4% in February, Yr over Yr (AHA Article)• SGR Fix• ICD-10• Effect of Quality Reporting, Meaningful Use on Medicare Payments• Medicaid Expansion• Government Broke, Entitlements and Debt service will consume all Tax Revenue

in a few years.• Payer Strategies• Computer Conversions, Physical Plant Expansions, New Services, Equipment

Pay Attention to the Details (Quality)

• Review Data Daily• Post Closing Review• Get answers to the variances• Scorecards of the important items in each Department (know what

items drive the Ratios)• 90 Day Action Plans addressing the Variances to Benchmarks• Audit Transactions when Variances indicate a Problem• Make Revisions, Insist on the Best for the Patients

Invest in Staff (People)• Staff Drive the Quality, Service, Growth, and Finance• Review Turnover Rates, work with Departments to Lower Turnover• Conduct Annual Employee Satisfaction Surveys

• Take Results Seriously, Action Plans to address poor results

• Monthly Rounding on Direct Reports (discussion is not about department performance) • Tendency to forget this when involved in a large project

• Send Thank You notes to Staff• Send one every Monday morning

• Monthly Operational Review with Direct Reports• Use as a Coaching Opportunity

• Don’t skimp on Equipment or Education staff needs to do job

Always Remember Why we are in Healthcare