Laurie Beyer: Routine rounding helps yield financial improvements
If you want to reach Laurie R. Beyer, MBA, CPA, executive vice president and CFO at GBMC HealthCare in Maryland, avoid any time between 9 a.m. and 10 a.m. Tuesday through Friday. No matter what time of year it is, she will be unavailable to take your call during those times because she will be rounding with clinical and administrative teams. That’s how she and her colleagues on GBMC’s executive team gain a close-up understanding of the issues impacting each point of service in the medical center.
By participating in teams for this four-days-a-week rounding, Beyer along with GBMC’s CMO, COO, CNO, CIO, and vice presidents of human resources and philanthropy can rely on their own observations to determine the organization’s current and future needs
“This managing by walking around gives the executive team some new sets of priorities we would most likely miss by just hearing about them second hand,” Beyer said. “We not only get to see how the clinical and operational staff perform on a regular basis, but they get to see us, on their units and in their departments, allowing them access to us. It has proved to be a differentiator on how we are able to make decisions.”
Beyer is a 33-year HFMA member and has been GBMC’s CFO since 2017. Prior to this role she was senior vice president and CFO for 11 years at Union Hospital of Cecil County in Elkton, Maryland. Her healthcare finance career started back in 1986 at the Arthur Anderson CPA firm, where she worked on a variety of hospital audits. This experience led to her moving into the hospital provider side, which has proven to be her calling.
Having worked at urban, suburban and rural hospitals of different sizes and financial depth, Beyer gained an appreciation of the financial struggles attendant to each while still recognizing that access to care is the most important aspect of her job.
“It is very difficult, especially with COVID, to have a positive bottom line in this business,” she said. “Our labor costs are up 30%, supplies costs are also higher than inflation since 2019; yet our reimbursement rates have not come close to keeping pace. We know this is true throughout the industry, but as an independent, 501(c)(3) community hospital, it behooves us to do our best to improve our care and expense areas so that we can maintain our ability to provide the care so needed by our community residents. We will keep up the fight.”
Promoting cost effectiveness of health
The current president and CEO of GBMC HealthCare, John Chessare, MD, MPH, is a pediatrician by training. Since joining GBMC, he has mandated the creation of advanced primary care practices, now numbering 12, throughout the Baltimore region. These practices are primarily staffed by physicians but also include advance practice nurses and are focused on chronic care management and behavioral healthcare through the intervention of diabetes, obesity, hypertension, heart disease and other chronic conditions.
Although expensive to maintain, this program has achieved verifiable results. For the diabetes outcomes, The State of Maryland has statistics that show the GBMC practices have the lowest utilization of high utilizers within the Baltimore market. High utilizers are defined as patients who show up in the emergency department three or more times in a six-month period.
While this an enviable outcome, Beyer also acknowledges “it is very expensive.” But she also is a strong supporter of the approach.
“We are pleased that we can provide good care in our communities; unfortunately the revenues do not offset the expenses,” Beyer said. “We will continue to provide this care, as we continue to determine ways in which to pay for it.”
Beyer’s best HFMA memory
One of Beyer’s best memories came early in her career, in her twenties, when, just after joining HFMA and the Maryland chapter, she attended a chapter event in Ocean City, Maryland, a vacation spot on the Atlantic coast. There she wound up dancing with a man who was a regulator with the Maryland Health Services Cost Review Commission. That led to a lifetime friendship, and ironically, he is now a consumer of healthcare at GBMC. So you never know how HFMA membership can positively impact your life at any moment in time.
4 guiding principles for healthcare financial leadership from Laurie Beyer
Laurie Beyer, MBA, CPA, executive vice president and CFO at GBMC HealthCare in Maryland emphasizes four principles that have guided her approach to financial leadership throughout her career.
1 Recruit and retain highly skilled staff. “I try to surround myself with staff that are smarter than me,” Beyer said. “This helps to make the work go quicker, smoother and more efficiently.”
Effective leaders also make sure staff are highly detail-oriented to ensure decision-making and outcomes will be effective, she emphasized.
2 Build solid relationships with clinical and operational staff. This principle applies to peer teams, Beyer said.
“In my case, it’s myself and the COO, CMO, CIO and CNO — all of us must work in concert to affect the best performance and outcomes,” she said. “Without strong relationships among these leaders, cracks may develop that can cause harm to the clinical and financial results. How would I know where the budgeted expenses were being spent or where the revenues were being made if I did not have a solid understanding of all the areas of the hospital and healthcare operation?”
Beyer stresses that this understanding needs to encompass the clinical provider costs, including costs for physicians and advanced practice personnel, nursing, ancillary services (e.g., lab, radiology, cardiology), facility operations, offsite clinical practices and business services.
3 Understand the healthcare business. “From the ground up, you need to know who is doing what and how it is being done,” Beyer said.
And to gain that knowledge, she said, leaders need to constantly be considering two key questions:
- Are there better ways to do the many things that need to be paid for throughout the organization?
- Without being a micromanager, how can the CFO support the department managers and directors so they can make sure their best efforts are achieving the organization’s goals?
“Success is possible only if we can all have a complete understanding of how the revenues and expenses are produced and advanced,” Beyer said.
4 Gain back by giving back. “Once you have gained a solid understanding of the business, educate your staff so now they know,” Beyer said. “Take the time and make the effort to hold educational meetings throughout the finance division for the managers as well as the staff to explain the elements of the operation, how they fit in and how they impact the financial results.
Building new understanding through these meetings sets the stage for improving results, Beyer concluded.