Thayer County Health Services CFO on strategic financial planning in healthcare

Sajid Khan

Cameron, Thank you very much for taking the time out of your busy schedule for this Interview. Can you begin by sharing your perspective on the role of CFO in an organization such as Thayer County Health Services?

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Cameron

Thayer County Health Services is a Critical Access Hospital with several Rural Health Clinics in southeast Nebraska. We employee slightly more than 150 people, and the role of CFO is responsible for operational oversight of one third of the staff, in addition to the traditional role of serving as financial advisor to the Board of Trustees and CEO.

In our organization, the CFO is a change agent responsible for leading initiatives to improve operational and financial efficiency, both within departments that report through the CFO, as well as in departments that report through the Chief Executive Officer and Chief Nursing Officer.

At our organization, the role of CFO used to be more focused on controlling the budget and overseeing the accounting staff and business office, however, that role has expanded rapidly into the area of adding value through strategic financial planning and assisting with analysis when making business line decisions.

As I network with CFO’s in other industries, I have found it common for the role of CFO to be in the process of becoming a strategic business partner. To borrow a concept from a colleague of mine, Gary Cokins (with his permission), the emphasis is no longer focused as much on counting the beans (valuation), as it is on growing the beans (creating value). Gary wrote about this concept in an article titled “Can Accountants Grow Beans Too?”

(http://businessfinancemag.com/blog/can-accountants-grow-beans-too)

Sajid Khan

What are some of the critical challenges faced by small hospitals these days?

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Cameron

I would tell them it is up to you to make your own path, so don’t wait for someone else to lay it out for you. It does not matter if you are in finance, information technology, or operations, do everything you can to personally contribute to the bottom line on both the revenue and expense side of the income statement (regardless of whether you are held directly accountable for the result).

Third, declining rural populations are causing a decrease in patient volume, and to help offset this fact, education initiatives for the remaining patient base is required. Many rural hospitals can provide the exact same treatment by the exact same specialist physicians that a patient would receive in an urban hospital, due to technology advancements such as Telemedicine and cooperative initiatives with specialists traveling to rural hospitals to provide patient care.

Sajid Khan

How effectively are small hospitals innovating these days?

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Cameron

It is a constant struggle, but community hospitals are successfully innovating out of necessity to survive and due to increased regulations. For example, the adoption of Electronic Medical Records and the associated changes in software and processes help hospitals qualify for financial incentives through the Meaningful Use program regulated by the Centers for Medicare and Medicaid Services.

As well, changes to medical record coding and insurance billing are on the horizon with the transition from ICD-9 to ICD-10 standards, and this requires further adoption of more sophisticated software and interfaces. And in order to implement best practices and the continuous improvement of existing processes, some community hospitals are even looking to adopt quality management systems, such as ISO 9000.

Sajid Khan

What is the biggest challenge that keeps you up at night?

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Cameron

I would tell them it is up to you to make your own path, so don’t wait for someone else to lay it out for you. It does not matter if you are in finance, information technology, or operations, do everything you can to personally contribute to the bottom line on both the revenue and expense side of the income statement (regardless of whether you are held directly accountable for the result).

The journey to a C-level position is different for each person, and the best opportunities are found in the projects that nobody else wants to tackle. Start wherever you are, look for the most critical and difficult problems to be solved, and then volunteer to dig in, especially if those projects are outside your comfort zone.

Prove your worth by learning to think like your future manager/supervisor. For example, if you want to be CFO, then learn to think like the CEO. Your role is to support the individual you report to, and the best way to do that is to learn to think like they do.

Sajid Khan

Anything else you would like to share with our readers.

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Cameron

Thank you for your time and for the opportunity. One final thought I would like to leave with your readers: At the end of the day, everyone is in sales. I have found that it does not matter how many hours you work, how great of a job you think you did, or what obstacles you had to overcome.

The bottom line to being a success is to close the deal and to communicate that accomplishment clearly to the appropriate audience. For example, a poor board meeting presentation can feel like wasting a month’s worth of hard work, and a good presentation will make all the difference.

Sajid Khan

Could you please share your leadership Style? Does your leadership style vary with the role?

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Cameron

My leadership style varies depending on the circumstances and personnel, however, I try to be consistent with presenting myself as a coach, mentor, and counselor. I focus on asking questions, listening, and acting as a sounding board. Most often, the directors that report to me (or their line staff) are in the best position to develop and implement the most impactful solutions.

I find it much more effective to help these individuals think through solutions rather than try and come up with all of the answers myself. This approach also helps develop our leadership staff’s strategic thinking skills and business acumen, so that over time, less of my input is required, and I have time to focus on other priorities.

From a delegation standpoint, one of my mentors taught me early in my career to focus first on those tasks that only I can complete and then delegate everything else possible. The demands on my time pull in too many different directions for me to be effective with any other approach.

Sajid Khan

What advice would you offer for other finance executives who aspire to follow you career path?

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Cameron

I would tell them it is up to you to make your own path, so don’t wait for someone else to lay it out for you. It does not matter if you are in finance, information technology, or operations, do everything you can to personally contribute to the bottom line on both the revenue and expense side of the income statement (regardless of whether you are held directly accountable for the result).

The journey to a C-level position is different for each person, and the best opportunities are found in the projects that nobody else wants to tackle. Start wherever you are, look for the most critical and difficult problems to be solved, and then volunteer to dig in, especially if those projects are outside your comfort zone.

Prove your worth by learning to think like your future manager/supervisor. For example, if you want to be CFO, then learn to think like the CEO. Your role is to support the individual you report to, and the best way to do that is to learn to think like they do.

Sajid Khan

Anything else you would like to share with our readers.

‍

‍

Cameron

Thank you for your time and for the opportunity. One final thought I would like to leave with your readers: At the end of the day, everyone is in sales. I have found that it does not matter how many hours you work, how great of a job you think you did, or what obstacles you had to overcome.

The bottom line to being a success is to close the deal and to communicate that accomplishment clearly to the appropriate audience. For example, a poor board meeting presentation can feel like wasting a month’s worth of hard work, and a good presentation will make all the difference.