CFO Outlook for 2013 Grim

Karen Minich-Pourshadi, for HealthLeaders Media , December 27, 2012

Marlene Weatherwax
CPA, vice president and CFO
Columbus (Ind.) Regional Hospital
Total licensed beds: 325

Editor's note: Marlene Weatherwax also offered her 2012 outlook last year.  We asked her to tell us how this year panned out and how it compares to what she anticipates will happen in 2013.

What are the key areas you'll be watching in 2013?

Technology. This was on the top of my list last year and it is again. We implemented our new IT system in 2012 and we've now got a good start on meeting meaningful use and we're going to continue on a path to get to the highest level of meaningful use and get the incentive funds. For the most part that's going to be a positive, although implementing it has introduced a lot of change and that can be painful.

Healthcare reform. It's hard telling exactly what will really happen, but like most hospitals we're trying to come to terms with what we believe will help fix healthcare no matter what the federal government does to try to change the model of care. It's an impetus to get on with the work to change the model of care through better physician alignment and to realign incentives that work with the patient-centered medical home and to keep overutilization down and reduce unnecessary utilization.

ICD-10. It's getting closer, assuming they don't move the deadline again, and we need to start working toward that or it could really have more of an impact on us than we realize. I think trying to understand the outcomes reporting is going to be a challenge; it might have a negative impact on us before we realize the benefits. Last year I put value-based purchasing on my top-three list, but this year I'm not sure it's among them. We've got a lot of other areas to concentrate on.

Which strategic undertakings from 2012 do you feel could greatly influence the organization in 2013?

Without question it's the 2012 changeover in our IT and the implementation of an EHR and computerized physician order entry. We did a "big bang" approach and replaced 40 systems; we had some disappointments but we're gaining ground and it will be interesting to see where we go with it.

In 2013 we've got some upgrades to do and some more modules to add and we have to implement the full version of our EHR for our physicians, but we're done on the nursing documentation side.

The other area we are working on is physician alignment. We have to decide whether we're going to have clinical integration with a formal FTC opinion or do some sort of ACO or risk-based contracting, and that will go well beyond 2013. But next year I think the direction we'll head will gel for us.

Healthcare reform is driving a lot of changes in the model of care; how are these changes influencing your physician recruitment effort or compensation structures for 2013?

The whole clinical integration and risk-based contracting comes with the value proposition of figuring out how we reward the physicians for driving improvements. We've been looking at a few models and in 2013 we'll work those in as part of other care initiatives. The one compensation model we're looking at is more of a scorecard approach, and the funds are coming from gainsharing. So if we're able to drive costs down for payers and employers, it would create an incentive pool that could then be redistributed based on scorecards. We think our new IT system will help us get access to the data we'd need to do that successfully.

Reprint HLR1212-8

This article appears in the December 2012 issue of HealthLeaders magazine.

Karen Minich-Pourshadi is a Senior Editor with HealthLeaders Media.
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