Collaborating With Your CEO

Chief financial officers should align their initiatives to others in the C-suite, including the chief mission officer, chief clinical officer, and CEO.

In this interview, Erik Wexler, chief executive of Providence St. Joseph Health’s Southern California region, Irvine, Calif., discusses how CEOs and CFOs can work in concert toward common goals.

On the role of finance in faith-based organizations. “We work very hard to recruit leaders who see their time in our organization as a calling,” says Wexler, who oversees 13 hospitals and numerous outpatient clinics in Southern California. He adds that leaders should have a passion for providing quality care to the poor and vulnerable, by which he means all patients and families dealing with illness.

At Providence St. Joseph Health, leaders refer to interactions with patients and families as “sacred encounters.” “We look to our finance leaders, as much as anybody else, to have important moments with coworkers—and potentially even patients, families, and vendors—that create inspiration for the important work that we do in health care,” Wexler says. “What we can’t do is only recruit people whose sole focus is the numbers. This is not purely about numbers, especially in faith-based care. This is about having the right balance so we are achieving our mission and leading our core values.”

On being a caregiver—even in finance. All of Providence St. Joseph’s Southern California’s 35,000 employees are referred to as “caregivers,” as they are across the enterprise. “That’s true whether you are an accountant or a nurse,” Wexler says. “Compassion and attention to ensuring the best quality outcomes is part of caring for the patient and their family.”

On collaborating with the CFO. At press time, Wexler was in the final stages of hiring a new regional CFO. “CFOs are critical partners in all that we do, including providing clinical care, improving patient satisfaction and employee engagement, and maintaining the financial stability of our organizations,” he says. “Our CFOs have to be as strategically focused as they are operationally focused.” 

This means that CFOs need to make sure their initiatives are aligned to others in the C-suite, including the chief mission officer, chief clinical officer, and CEO.

A good CEO-CFO relationship is built upon a foundation of trust and a commitment to a shared mission, Wexler says. “In my very distant past, I have seen CFOs that only focused on the bottom line. These days, that is fairly dangerous. The willingness to advance the organization using a balanced scorecard approach is essential in that CFO role,” he says. As part of such an approach, metrics for clinical quality, patient satisfaction, employee engagement, and financial sustainability are monitored continually by the CFO and other leaders across the organization.

CFOs also can work with CEOs to ensure integrity and compliance in an organization. “I often look to our CFOs to keep a close eye on compliance so that we don’t fall outside the requirements of our state and federal government,” he says. “This is a really important role that we all play, and I have been grateful for those CFOs who have helped me keep a focus on this and been right by my side.”

On current cost-containment initiatives. Wexler says a major focus for his organization is reducing variation. To engage physicians in this initiative, Providence St. Joseph Health has established systemwide clinical institutes in areas such as orthopedics and sports medicine, cancer, neuroscience, heart health, and digestive health. Within these clinical institutes, physicians share best practices and explore supply standardization across the organization. The health system also has established local, physician-led committees that work with the clinical institutes to implement these strategies.

One recent initiative involved standardizing pacemaker/defibrillators across all system hospitals. “We had a number of different options [from different vendors], and our cost structure seemed fairly high,” Wexler says. Physicians were able to narrow the field and determined they could serve most patients’ needs by sourcing the devices from two manufacturers.

On growth initiatives. The clinical institutes also are essential for the health system’s growth strategy. “Their role is not just to reduce variation and deploy our best practices but also to advance and grow our super-specialty services that we believe are most in demand in our communities,” he says. This includes services such as neurosurgical, cardiothoracic, oncology, and orthopedics.

Expanding outpatient services, including urgent care centers, is another growth strategy. “Clearly, the cost structure of the ambulatory space is more efficient and more appropriate at times than it is in the acute care space,” he says. “We want to be sure that patients are receiving care at the right place and the right time.”

In addition, behavioral health is a major focus for the entire health system, which has committed $100 million to expand inpatient and outpatient mental health services.

Advice for CFOs on working better with CEOs and the rest of the C-suite. “The entire group needs to be connected in a unified fashion, understanding what the objectives are for the short term and the long term,” Wexler says.

He urges CFOs to broaden their scope beyond finance so they can assist their colleagues in achieving goals such as improving physician and employee engagement and boosting patient satisfaction. 

“I want to have a CFO that helps us create discipline so that we remain financially stable,” he says. “But I also want to have a CFO that I can have heartfelt discussions with about how we advance other aspects of our goals—not just those related to finance.”

Laura Ramos Hegwer is a freelance writer and editor based in Lake Bluff, Ill., and a member of HFMA’s First Illinois Chapter.

Interviewed for this article:

Erik Wexler, chief executive, Providence St. Joseph Health, Southern California, Irvine, Calif.

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