Called to Authentic Stewardship
“We need to have unwavering commitment and be fearless in our perseverance to do the right thing for the right reason,” says Carol A. Friesen, FHFMA, MPH, vice president, Bryan Health, Lincoln, Neb., and 2017-18 Chair of HFMA.
As Friesen assumes the role of HFMA Chair this month during HFMA’s National Institute (ANI) on June 25-28 in Orlando, she will lead the Association through a period in which the healthcare industry will see continuous transformation and redesign for the communities and nation it serves. Her theme, “Where Passion Meets Purpose,” offers a call to action for HFMA members and other healthcare leaders to reach, learn, participate, and engage in the authentic stewardship of lives, relationships, and resources.
Friesen will share stories to motivate members and healthcare leaders to rethink what stewardship means today in our country and how they can have a positive impact on health care’s transformation.
“Finance professionals and executives must move beyond their comfort levels as resource stewards to contribute to advancing the health of individuals in their communities and our country,” Friesen says. The need for greater resource stewardship becomes even more evident, she says, when one considers that, today, the top 5 percent of healthcare consumers account for almost 50 percent of our country’s healthcare spend.
“We have a serious stewardship dilemma,” Friesen says. “Today’s healthcare realities are directly impacting the lives of every man, woman, and child in this country, and they are indirectly impacting people’s lives through the economy or escalating costs to organizations. What contribution will each of us, as finance professionals, make to write the story for future generations? This is our call to action.”
Friesen believes that every professional working in health care can make a difference, and that leaders should foster collaboration to improve the system and the overall health of the U.S. population. “Our communities and country are depending on us to collaborate with and through others to spread the benefit to many. It starts with each of us doing our part, and ends with winning through collaboration in the lives of others,” she says.
“As finance professionals and trusted advisors, we have a responsibility to collaborate with clinicians, insurance professionals, and community resources to advance the health and lives of those entrusted to us,” she says. “This is the power of one, in relationship with and through others, that makes the impossible possible.”
Leading From Where You Are
Friesen’s career in health care and her leadership journey with HFMA started at the same time. She reflects fondly on her HFMA family, early lessons learned, vast opportunities to serve, and life-changing experiences.
“I was a ‘green’ finance leader looking for resources, a frame of reference, and a safe place to help me grow into the role I held,” she says. At one of the meetings, she was pulled aside and asked if she wanted to be a membership chair for HFMA’s Nebraska Chapter. “They thought it would be a good way to get to know the chapter.” Friesen accepted and soon had a chance to experience her first Leadership Training Conference (LTC).
“It was the experience of a lifetime, and I met some lifelong friends,” she says. “I had no idea at the time those individuals would become my dear friends, but they are. We were a bunch of 20-somethings with a lot to prove—and with limited knowledge and experience. So we built a relationship of trust, and learned from each other.” Friesen is referring to Jim Ulrich, FHFMA, CPA, Vickie Ahlers, JD, and Randy Hoffman, FHFMA, CPA—all of whom served as Nebraska Chapter presidents. In addition, Friesen met Melinda Hancock, FHFMA, CPA, HFMA’s 2016-17 chair, at her first LTC.
“The rest is history,” she laughs.
Advancing From the Chapter to the National Stage
The chapter volunteer experience demonstrates the sweet spot in her idea of “Where Passion Meets Purpose.” Friesen says, “Each year, our Chapters bring to life over 80 percent of the education provided within HFMA. The Chapters’ volunteers and members are truly the hands and feet of our local HFMA.”
Another feature of HFMA that has had a profound effect on Friesen’s professional career is ANI. In fact, she attended her first ANI a week before taking her first role as CEO.
“It was an amazing opportunity,” she recalls. She came with an open mind to learn and to seek knowledge and build confidence as she started her first role. “The keynote speaker’s message seemed to be crafted just for me,” she says. “It was that kind of experience—it felt like a divine appointment.”
Friesen underscores the importance of the HFMA family, education, and experience as an invaluable resource for her career. “I have so much to be grateful for,” she says. “HFMA has helped mold me into the leader and person I am today. It is my privilege and honor to serve and lead this amazing association to give back a small portion of what has been given to me.”
Friesen joined HFMA in 1999, and her involvement at national, regional, and local chapters since then has been extensive. She has served in multiple roles within the Association—from the full slate of Nebraska Chapter leadership roles to the Regional Executive Council as Chair and Region 8 as a representative, and on to the National Board of Directors and its committees and task forces.
Friesen’s service also has been marked with numerous awards, including the Follmer Bronze, Reeves Silver, and Muncie Gold merit awards, as well as the HFMA Medal of Honor. One of her most treasured HFMA accomplishments was receiving Shelton Award for 5 years sustained Chapter Excellence as a Nebraska Chapter leader.
What makes a good leader? Friesen suggests, “A leader is simply someone who goes first, and others are willing to follow.”
Leadership is less about a person’s title and more about the drive to step up, step out, and be a difference maker, she says. “Finance professionals are in the driver’s seat to lead from where they are, individually or as a team. Some days, we let the worries of the endless list of challenges get in our way of living our story and making our mark.”
Friesen also says being a leader means being ready to take action. “Stop waiting for someone else—our government leaders or your organization or your chapter—to make it better for you or your community,” she says. “Make it happen. Write your story. Your legacy is about leading and collaborating with others. It’s simple math—multiply your impact with and through your influence of others to spread the impact to many. It starts with you.”
Building a Career
Friesen describes herself as an “idealistic strategist at heart,” and as such, she has served in a variety of healthcare leadership positions, including CFO, CEO, and currently, vice president of health system services, entrusted with 48 communities and their physicians to collaborate with and serve at Bryan Health. She is driven and inspired by the ability to make a difference, be a catalyst for change, and make a significant impact.
Friesen’s diverse background and experiences have afforded her opportunities to design and construct new facilities, orchestrate operational turnarounds, transform physician and board governance structures, build new service lines from the ground up, achieve NCQA Patient-Centered Medical Home status for communities, advocate for meaningful performance improvement and excellence, collaborate with talented physicians and other leaders, and strive to grow professionally every day.
As vice president at Bryan Health, she is an advocate for advancing the health of Nebraskans and their neighbors. In this work, Friesen and her team collaborate with physicians, governing boards, and leadership teams across the region to advance the health of their communities, one community at a time. It starts with ensuring the health of the delivery system and ends with improving health outcomes and status of the community. Friesen also stays close to her roots, “Once you have a finance and business acumen, it always runs in the back of your mind, as an executive, to help make wise and executable decisions.”
Achieving the Purpose
Friesen shared a recent win, when the Bryan team brought together five communities with a shared purpose to advance the health of their populations with diabetes and impact the top 5 percent of their healthcare consumers. Each organization had been quietly working independently, but to get to the next level, they needed to create transparency, share information about wins and barriers, and work together.
The team began by putting faces and names to their work. They provided tools, data, and support to tee up the right processes for the right patients to be seen at the right time, to achieve the best results. The collaboration made the impossible possible with a significant increase in healthy well-controlled lives.
“We cannot continue to sit back and accept the failures of our system in wasted resources and less productive, quality of lives,” Friesen emphasizes. “We are responsible to do something. It starts with us.”
Without a story, nothing changes, she adds. “What we measure gets improved.”
Early in her career, Friesen says that mentor Anthony Kusek, MD, helped nurture a passion for collaborating with and working alongside physicians. “Every single day, he led with a servant leader’s heart,” she says. “He was a passionate advocate for his patients and the young physicians he mentored. He also taught anyone willing to learn the importance of self-care to enable the best career-long impact and to find grace in situations, when it seems impossible.”
Friesen also credits her physician mentor with seeding the responsibility to collaborate and drive value for the communities who are to be served. “Finance brings its core competency and acumen for measurement, accuracy, and timely storytelling,” she says. “We identify trends, anticipate needs, and project future performance. This contribution is a perfect match with our physician and clinician colleagues who are data-driven problem solvers and executers, too.”
Leading in Turbulent Times
The opportunity to lead HFMA as 2017-18 Chair is gratifying and rewarding, Friesen says. She will serve and lead during a time when the industry recasts itself to significantly improve the story of the patient, as it relates to the patient’s experience, health outcome, use of resources, and quality of life.
“With challenge, comes opportunity,” Friesen declares. “With scarcity of resources, comes shared purpose and strength through collaboration. With a purpose, comes the passion to make a difference. All that’s required is the power of one individual, one team, one event, and one conversation to impact lives forever!”
Friesen underscores the need for all of us to bring the internal fire and passion to improve health care. “We need to have unwavering commitment and be fearless in our perseverance to do the right thing for the right reason,” she says. “When we fall, we will get back up. This fight is worth it; fight the fight together.”
When it comes to improving the lives of a population, we cannot accept failure. This calling is best expressed by Bryan Health’s founder, William Jennings Bryan: “Destiny is not a matter of chance, it is a matter of choice; it is not a thing to be waited for, it is a thing to be achieved.”
Career at a Glance
Vice President of Health System Services, Bryan Health, Lincoln, Neb.
July 2007-September 2013
President and CEO, Crete Area Medical Center/Bryan Health, Crete, Neb.
July 1999-July 2007
CFO, Boone County Health Center, Albion, Neb.
February 1997-June 1999
Director of Finance, Henderson Health Care Services, Henderson, Neb.
Service to HFMA
Board of Directors
Regional Executive Council Chair
Audit & Finance Committee
Charter Volunteer Initiative Task Force
Early Careerist Task Force
National Advisory Council
Region 8 Regional Executive.
Nebraska Chapter positions: president, vice president, secretary, treasurer, director
HFMA’s Founders Medal of Honor
The William G. Follmer Bronze Award
The Robert H. Reeves Silver Award
The Frederick T. Muncie Gold Award
Early Careerist Award, American College of Healthcare Executives