Igniting the spark for healthcare transformation
HFMA Chair Aaron Crane will fuel conversations around ways to address healthcare’s most pressing challenges.
Aaron Crane was 17 when he saw the devastation that fire could bring to a community.
In the summer of 1981, more than 1,300 firefighters battled a blaze in southern Oregon, with reinforcements flown in from Arizona. The blaze burned 8,000 acres in the Fremont National Forest. Another fire consumed 3,100 acres in the Winema National Forest, north of Klamath Falls, with 500 firefighters called to stop the devastation.
For Crane, who grew up in Eugene, Oregon, “It wasn’t that there weren’t damaging fires in my state while I was growing up, but that summer, fire crept closer to my home than it ever had before. I wasn’t prepared for it.”
Crane compares that experience to his work in healthcare, where wildfires in the nation’s healthcare system, from misaligned incentives to disparities in health outcomes and care access, have led to devastating consequences.
These include a population with a 37% higher disease burden than in comparable countries and unsustainable levels of healthcare spending per person.
“As leaders, we’re going to wake up to run faster and harder to deal with these consequences,” Crane said. “We need to make sure we’re focusing on the right problems. We also have to recognize that the healthcare industry in and of itself can’t solve these problems, but we can certainly help a broad range of constituents understand these problems and bring them together to help find a solution.”
This month, Crane will be officially installed as HFMA’s new Chair during a ceremony at the HFMA Annual Conference in Denver. His theme, “Ignite the Spark,” is a nod to his Oregon background. It’s also a reminder that fire isn’t always a destructive force. In fact, even in a forest, some fires — such as controlled burns — can protect the health of the ecosystem.
“It is past time for us to manage the healthcare ecosystem and cultivate a healthy forest,” Crane said. “As healthcare finance leaders, we need to improve our value and transform into a cost-effective, world-class example of sustainable population health. This is our call to action.”
Until this month an executive vice president for the Seattle Cancer Care Alliance in Seattle, Crane witnessed the impact of delayed care on health outcomes, particularly throughout the pandemic.
Making a fire
“About 12 months ago, our physicians began to talk about how much sicker their patients were,” Crane said. “There is a percentage of people out there with cancer today who could really improve their life with just one cancer screening because it would help support earlier diagnosis and better outcomes. It’s not just fear of COVID-19 that has kept people from seeking screenings. It’s also about making sure everyone has access to what they need in healthcare and that they know what type of care is recommended and when.”
For Crane, it’s just one sign of the ways in which healthcare in the United States is like an unmanaged forest. Barriers to care — from disparities in access to care or services to differences in care quality by population, race or ethnicity — represent underbrush or deadwood that puts outcomes at risk. So, too, are inefficiencies in care and processes that impact the cost effectiveness of health, making it difficult for people to manage their health.
“We’ve been sitting on the precipice of something that we know is not working,” Crane said. “We should be doing everything we can to make sure everyone has the right access to what they need to be healthy. Each of us, including in revenue cycle, has an opportunity to do this. We don’t have to be superheroes. We just need to start by doing something.”
A path to population health
Early in his career, Crane developed a passion for population health management.
Following roles as an auditor for Arthur Young and as CFO for Oregon Health & Sciences University, Portland, and Salem Hospital, Salem, Oregon, Crane became CEO of an ACO that was a collaborative of eight healthcare organizations dedicated to improving care delivery in Oregon. A few years later, Crane joined the Seattle Cancer Care Alliance, where he was involved in a partnership with UW Medicine creating population health initiatives for oncologic patients. He also worked with payers creating value-based oncology care models.
“I feel like there’s so much that can be done to help cancer patients through a population health approach,” he said. “It’s been super fulfilling to help ignite those conversations and determine what the real issues are and how we can address them in a collaborative way.”
Crane’s passion for population health is complemented by a deep knowledge of healthcare operations and a strong aptitude for strategic finance.
Roy Orr, who worked with Crane at two hospitals, described Crane as having an ability to review profit and loss statements, balance sheets and performance metrics and make sense of the data in a way that few can.
He recalled a time early in Crane’s career when the hospital’s primary care group was not performing well and was affecting the hospital’s financial performance.
Crane devised a strategy that made it attractive for the physicians to want to regain their independence without triggering other problems for the hospital.
“I called him my Neo,” Orr said, referring to the main character from “The Matrix.”
“Aaron was exceptional in turning that into an important advantage for our organization,” he said.
Crane is also described as a visionary leader who brings a balanced perspective to his work in healthcare. Steven Huebner, CFO for the Seattle Cancer Care Alliance, has worked with Crane in a variety of consulting roles over the past two decades.
“Aaron does not shy away from the tough issues,” Huebner said. “He has really good insight into finance as well as operations, which puts him in a good position to understand the drivers of cost in healthcare as well as quality, access and efficiency. He then uses that understanding to develop solutions that are realistic and that we can implement around.”
Cultivating a healthy ecosystem
When Crane was growing up, his father worked in a sawmill. There were periods when demand for product was low and wages were unstable.
Crane knew he wanted a career that would provide greater financial security. When he graduated college and received two offers in the same week — one in healthcare, the other in another industry — he chose healthcare because he realized hospitals are everywhere, even though the starting salary was 15% less. That understanding combined with his passion for service, which he developed as a teenager, made him think, “This is the industry for me.”
But his passion for the Northwest and its natural beauty remains. It is at the center of his address to HFMA members at the Association’s Annual Conference this month, and it guides his philosophy for the work he’ll lead in the year ahead.
“It is past time for us to manage this healthcare ecosystem and cultivate a healthy forest,” Crane said.
Tammie Jackson, HFMA’s FY21-22 Chair, believes Crane’s wide range of experience makes him uniquely qualified to lead the Association at a time when the industry is rapidly evolving and consumer trust is at stake.
“Aaron is a deep thinker. He is incredibly smart, and he has the ability to understand where the industry is headed and the role our members could play — individually and collectively — in addressing issues such as health equity and cost effectiveness of health,” Jackson said. “He’s also a generous, kind person who cares about people and wants to make a difference.”
Crane is also skilled at building consensus — which is critical, given the need for multistakeholder input in addressing healthcare’s biggest challenges, said Joseph J. Fifer, HFMA president and CEO.
“Aaron has demonstrated the ability to have conversations that go across disciplines because of his close work with providers of care throughout his career,” Fifer said. “He’s also someone who people genuinely like, and I think his message will resonate with our members in the year ahead.”
More than anything, Crane looks forward to igniting the conversations needed to embark on a journey of transformation for improved health, equity and value.
“Engaging people around us to make a difference: That’s the heart of leadership,” Crane said.