Wanted: CFO miracle worker

The role of the healthcare CFO is dramatically changing and expanding. Nowhere is this more apparent than in the position specifications that leading organizations are drafting as they search for their next financial leader. Much more than in the past, organizations are requiring their next CFOs to be innovative, strategic, operational, quality-driven, results- and growth-oriented.

These are terms that were either absent or "nice-to-haves" in the past when the role of the CFO was more limited and clearly defined - geared towards "expense management" with an emphasis on technical competency in accounting and keeping the organization's financial ducks in a row. Today, however, terms like innovative and strategic are often the leading requirements for a CFO.

As the CFO role has transformed from a managerial one to a more strategic one, the status of the CFO within the C-suite has grown correspondingly. It has become harder to find "ideal" candidates who bear all the qualities that progressive organizations are searching for. On one end of the spectrum, they are looking for someone who can be surgical in cost containment and streamlining operations. On the other end, they want someone who can assume a visionary role in expanding the patient base and generating new revenue streams.

Witness the following language that I have come across in recent position profiles describing the requirements of today's healthcare CFO:

• A superb financial and critical thinker, one who understands operations and systems integration, yet takes a strategic business view of the market environment.
• An entrepreneurial spirit to support evaluation of organization and market for areas of growth and competition.
• An educated counsel on new business development, joint ventures, acquisition/affiliation of physician practices, mergers and acquisitions and related strategic/operational plans and opportunities.
• A shrewd and skilled negotiator.
• A champion of quality in his/her organization who understands that quality is linked to superior economic performance.;
• A driver of process improvement and techniques such as lean and Six Sigma.
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In short, it seems as if most organizations seek a financial miracle-worker who will be held accountable for both financial and operational performance. It's hard to come by financial leaders who hold all of these qualities.

The ACA and CFOs

Meanwhile, the Affordable Care Act has thrown another layer of intrigue into what is expected of the CFO. Organizations are looking for a CFO who:

• Provides insight and leadership relative to payer negotiations and strategies, particularly relative to pay-for-performance.

• Embraces appropriate investments in clinical quality programs and initiatives that are focused on improving the overall patient and family experience.

• Influences strategy and non-traditional hospital activities, such as helping the system determine key service lines to grow and positioning the organization to take capitated risk arrangements.

• Fosters a culture where excellent patient care and customer service are fundamental guiding principles for all staff.

Language like this seems to be in direct response to the mandates of government reform and highlights the need for a CFO to help organizations navigate changing reimbursement and payment models as well as an increased focus on quality and patient experience.

All these excerpts from recent position descriptions show the outsized expectations that healthcare organizations have for their CFOs today. Those rare candidates who can fulfill most or all of the above requirements are in high demand and have the ability to be selective in evaluating opportunities.

With the dramatic changes we've seen in healthcare in recent years, there are few financial executives who are experts in all facets of their jobs. Hospitals and health systems recognize the changing role of the CFO - as well as other top financial executives - and are willing to hire and develop individuals who can balance a disciplined financial approach with a strategic and operational mindset. CFOs must be ready to expand their toolkits to include creative and innovative approaches to fueling growth, while containing cost and maintaining numbers you can take to the bank.