In this Business Profile, Doug Fenstermaker, managing partner and executive vice president of health care, Warbird Consulting Partners, shares strategies to leverage outsourced CFO expertise to lead special projects or fill interim roles while recruiting is underway.

FenstermakerTell me a little about your organization.  

Warbird provides CFO and other senior leader healthcare expertise as well as on-demand project teams to assist diverse industry clients in managing a full range of financial, organizational, and operational issues in addition to offering accounting and financial advisory services. We team with hospitals, medical group practices, and public and private healthcare companies to improve performance, comply with complex regulations and bond covenants and restrictions, reduce costs, recover from distress, leverage technology, and stimulate growth. Services fall into a few distinct areas. 

CFO network. Warbird’s Healthcare CFO Consulting Network is a national alliance of accomplished hospital and health system finance executives who work with incumbent CFOs on specific projects and initiatives. Members of the alliance are seasoned practitioner consultants who can provide everything from strategic guidance on navigating reform-related opportunities to peer-to-peer mentoring to hands-on assistance with major initiatives, such as practice acquisition. The mission of the CFO Consulting Network is to help make CFOs successful. 

On demand services. Warbird also offers on-demand interim strategic and financial management talent until an organization is able to fill the position permanently. Common roles we step into include CFO, controller, revenue cycle leadership, and patient accounting leadership. In addition, we offer project management solutions. We can consult on all aspects of finance and accounting as well as complex regulatory issues related to Medicaid, Medicare, and healthcare reform. The project management team delivers superior project oversight, deliverables management, and quality assurance to ensure client satisfaction.

Warbird also has a healthcare IT consulting division that can assess, optimize, and remediate IT problems with an eye toward better financial performance and results. Warbird’s work in this area can provide project management to guide revenue cycle, clinical systems, and other hospital/physician IT projects. Additionally, we have a Business Solutions Network that provides access to a very select group of vetted and referenced healthcare niche business services from companies around the United States to help providers address very focused accounting and finance issues. 

What are some of the biggest challenges you see affecting healthcare organizations? 

The biggest challenge over the next three to five years will be the ability to adjust to the magnitude of changes occurring due to healthcare reform. Significant change in strategic and operational direction will be needed as care continues to transform from inpatient settings to outpatient, community-based settings. 

Also, financial pressures are significant. Hospitals are feeling not only the pain of reduced inpatient volumes but also declines in third-party payer and Medicare reimbursement. In this difficult environment, hospitals must completely reexamine the types and structure of services they are providing to best deliver high-quality care with efficiency and address market change with agility. 

How do Warbird's services address these kinds of needs? 

There is no substitute for having a cadre of senior CFOs with breadth and depth of experience to draw on for viable and creative solutions during this period of industry transformation. 

Warbird’s CFO Network represents individuals with expertise in varied types of healthcare organizations, who offer the needed perspective to enhance decision making and leadership. For example, we recently worked with a rapidly growing Midwest physician practice that had just acquired another 600 physicians. The organization lacked the financial infrastructure to support this level of growth. By drawing on the guidance of a Warbird CFO who has successfully navigated similar situations, the organization’s leaders are now moving quickly to put systems in place to generate the financial statements they need to maintain integrity and communicate effectively with an affiliated health system. 

We’ve also worked with a number of hospitals that are experiencing technical defaults on bonds because their financial operations have triggered financial ratios that violate the bond covenants. We help them identify and execute a plan to improve those ratios and assist in communicating that plan to bond holders. Warbird has tools to help forecast the impacts on financial ratios of specific improvement initiatives undertaken by the hospital or system.

In some instances, organizations are finding that it is taking an inordinate amount of time to recruit a “strategic” CFO. With the pace of industry change, organizations cannot afford financial strategy to be on hold, so they will frequently engage one of our CFOs on an interim basis to both manage operations and assist with troubleshooting and the financial strategic framework. 

Are there any key considerations for healthcare leaders when choosing to bring on this kind of talent? 

We find that large and small organizations often experience different types of needs. In a large system, for example, they may hire one of our CFOs to expand their own bandwidth for day-to-day operations for a period of a few months while the incumbent CFO focuses on key strategic priorities.

In medium and smaller organizations, the challenge is more often lack of the bench strength they need if they lose a key individual. A search can frequently take six to nine months, so it’s helpful to lock in someone with very little learning curve to manage board, investor, and rating agency relationships as well as general financial operations as needed until the position is filled.

In all sizes of organizations, leaders benefit from engaging a CFO with expertise that precisely fits their projects and challenges. Warbird’s CFOs come from various settings, including physician-driven organizations, children’s hospitals, academic medical centers, and small, medium, and large integrated systems. Some Warbird CFOs are ACO and physician relationship experts, and others excel at transferring assets to different uses, directing outsourcing strategies, performing SWOT assessments, leading complex managed care negotiations, or overseeing post-turnaround implementation. In all cases, Warbird’s CFOs help incumbent CFOs expand their own bandwidth to do more at a faster pace with the quality only a tenured CFO can bring. 

Any other advice for healthcare leaders? 

The important thing is that you select the talent you need. To get full value out of this type of service, it’s important to carefully consider what you may need to drive the types of results you are seeking within a specific time period. Having this sense of specific business direction allows us to match the right individual to the organization and supports a good cultural fit. Because we are CFOs ourselves, we understand the role and function of the CFO in achieving timely deliverables and can “speak your language.” As we strive to help make CFOs successful, we can help them each achieve their annual and longer term goals and objectives quickly and efficiently.

How can readers learn more about the experience and expertise of Warbird CFOs?

Visit our site and review the case studies and thought leadership pieces in the section “Healthcare Strategic and Financial Services.” There is an excellent case study on how we helped Boston Children’s Hospital increase international market share. You’ll also learn how we provided a customized healthcare finance team to Trinity Mother Frances Hospitals and Clinics (Tyler, Texas) to help the organization keep pace with key financial initiatives that were underway when its CFO retired. 

Our CFOs are recognized thought leaders and keep current in the industry. All of them are active members of the Healthcare Roundtable for CFOs and some are members of the Health Management Academy’s CFO Forum and HFMA. These organizations help the Warbird CFOs remain current in all of the healthcare industry’s issues and business needs. We also are frequent contributors to thought leadership articles in the media on topics that range from ACOs to government affairs to physician-administrator relations. Many of these articles can be accessed on our website under “Healthcare News.” 

HFMA is the nation’s leading membership organization for more than 40,000 healthcare financial management professionals. This Business Profile is funded through advertising with leading solution providers. 

This published piece is provided for advertisement purposes. HFMA does not endorse the published material or warrant or guarantee its accuracy. The statements and opinions of those profiled are those of the individual and not those of HFMA. References to commercial manufacturers, vendors, products, or services that appear do not constitute endorsement by HFMA.

Publication Date: Friday, August 01, 2014