Robert Fromberg
Editor-in-Chief, HFMA
At a recent event, I found myself sitting next to the CFO of a nearby hospital. I asked her what I always ask healthcare CFOs: “Why are you in healthcare finance rather than in some saner industry?”
She told me that she used to be in banking. Then one day she was visiting a friend in the hospital, watching a man sweeping the floor. She told me, "I thought, he’s providing more community benefit than I am." She realized she wanted to do more for the community. And the place she knew she could do that was in a hospital.
As this story shows, community benefit is at the heart of why financial managers choose to work in health care.
Yet having a desire to benefit the community is not enough. Not-for-profit organizations have to quantify and report that benefit—a complex undertaking with high risk in an uncertain regulatory environment.
Recently, I was listening to HFMA President and CEO Dick Clarke speak at HFMA’s Executive Summit about the regulatory burden that hospital financial leaders cope with—primarily the Medicare payment system. He said that HFMA members tell him that they don’t so much mind complex systems that they have to implement, as long as they are able to understand the logic and purpose of the system and as long as it is administered fairly.
In the March issue of hfm, the cover story, “Community Benefit: How Much Is Enough” by Howard A. Levenson, explains--as far as possible--the logic and purpose of the federal government’s desire to quantify community benefit. He describes the path that led to enhanced scrutiny of not-for-profit hospitals’ levels of charity care, and what Form 990 tells us about “government’s mood.” And the feature story “Schedule H: What Hospitals Should Do to Prepare” by Jeni Williams takes us through the specific actions needed to improve data collection and reporting related to community benefit.
The bad news is that in health care, the path to community benefit has enough twists and turns and pitfalls to challenge even the most dedicated professional. The good news is that the professional strength of financial managers is the capability to cope with—even thrive on—complexity. For the former banking executive, the path started in a hospital waiting room. And that path winds through Schedule H of Form 990. But the path truly leads to improving lives in our communities.
