Collaboration between financial staff and clinicians will become increasingly important as healthcare reform changes are implemented. By achieving successful finance-clinician collaboration both on the clinical units and in the boardroom, Johns Hopkins Health System has been able to reduce costs and improve productivity while improving the health outcomes of its patients. Johns Hopkins CFO Ronald Werthman provides insight about the organization's strategy.

hfm: What strategies have you used to foster collaboration between clinical and financial areas?

Werthman: Our executives function as safety executives, whereby each executive sponsors a clinical functional unit for safety rounds. It is the safety executives' responsibility to participate in quarterly safety meetings on the clinical unit and be institutional advocates for required changes. This initiative has been labeled "suits meet scrubs."

Finance also participates in "nurse for a day." Each executive is assigned to shadow a clinical professional for an entire shift, thereby being able to see firsthand the challenges that our clinical professionals are encountering on a daily basis.

Our directors of finance are also involved. This structure has a financial executive at the director level deployed in every clinical functional unit. These directors of finance report dually to the administrator of the clinical functional unit and to the CFO. The communication and transparency with this structural change has been outstanding.

We also collaborate at the board of trustees level. Through board-level committees that focus on quality and safety, the clinical and financial staffs interact on a regular basis.

hfm: As you consider the relationships being developed between clinicians and financial staff, what initiatives have you pursued to reduce costs while taking care not to adversely impact patient care?

Werthman: The finance team provides much of the metrics and benchmark data, and the clinical leadership determines if and where productivity can be improved. Working closely with clinical leadership, the financial team has been able to develop clinical models that not only reduce cost and improve productivity, but also improve the clinical outcome and health status of our patients.

hfm: What role does finance play in quality in your organization? Is finance performing an audit function, reporting and recording, leading the way, or just an interested user of the information?

Werthman: Finance is a key member of the leadership team in helping to develop new clinical models for care delivery that will be incented in a pay-for-performance initiative. Our provider network is primarily located in Maryland, and this state has been under a payer rate regulated reimbursement system for more than 30 years. The incentives within the reimbursement structure have always required a close working relationship between the clinical leadership and the finance team.

hfm: Would you like to add any advice, lessons learned, or thoughts in general from your experiences on clinical and financial collaboration?  

Werthman: With healthcare reform, we are all going to need to focus more on preventive approaches to healthcare delivery and finding ways to minimize or eliminate the acute episode of care by improving the health status of the communities we serve. To achieve the changes needed for the future, we must all be more innovative as we move out of our historic comfort zones. 

Werthman_RonaldRonald Werthman
Vice President, Finance, Treasurer, and CFO
Johns Hopkins
Health System

Photography by Keith Weller

Publication Date: Monday, November 01, 2010

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