Theresa Mouton:  CFOs need to be able to lead through chaos

October 30, 2023 5:02 pm

As a 34-year healthcare finance veteran, Theresa Mouton, MBA, has seen her share of changes within the industry. Currently the Western Region CFO for Steward Health Care, Mouton oversees 17 hospitals across five states. In a career that has taken her from investor-owned health systems to not-for-profit hospitals and back again to the investor-owned side, she has been able to tackle the full range of financial challenges facing healthcare providers, from payment shortfalls and billing denials to managed care contracting underpayments and vendor inflexibility.

Theresa Mouton

Through all these challenges, Mouton — who is a 19-year member of HFMA’s Arizona Chapter — maintains an upbeat attitude, with the belief that there are many ways to get the results mandated by health system leadership. And she indicated finance leaders should stand ready to take things that are broken, assess the reasons and act accordingly. But just as important, she said, they should delight in doing so, even when things get chaotic.

 If you are doing something like managing hospital CFOs across 17 facilities, you are bound to experience chaos sometimes, and you have to love it, Mouton said.

 “I love the crazy,” she said. “I love the dynamics; I love the change.”

Communication is paramount

Several of the hospital-based CFOs reporting to Mouton are newly installed, many being CFOs for the first time. So she encourages them to keep open communication with her.

“They let me know when they need help,” Mouton said. “I can provide them with resources, answer questions, give them guidance. I can also assist with a specific problem within their organization by assessing the situation and giving them the training and knowledge required. It helps to get them where they need to be.”

The importance of the CEO/CFO partnership

Mouton considers herself to be primarily a teacher and problem solver. But she also serves as a strategist and advisor to the CEOs.

“I view the CEO/CFO connection, its partnership and its relationship, as critical,” she said. “If that doesn’t work, you are never going to be successful.”

Mouton sees the hospital CEOs as captains of the ship and herself as the navigator.

“So, when we are approaching troubled waters, when pirates are getting ready to jump on board, I keep them advised of the challenges that lie ahead — whether they might arise from changing rules and regulations or unprofitable service lines,” she said. “Then, if the captain still wants to crash the ship into the iceberg, it is my job as navigator to advise them, ‘Hey, that is not where we need to go!’”

Promoting cost effectiveness

While attempting to reduce cost while improving clinical and patient outcomes and satisfaction, Steward Health has developed its own internal travel agency. The goal is not only to reduce cost but also, just as important, to create a greater interconnectivity between the organization and its employees.

Mouton said Steward would prefer to have “owners rather than renters” (e.g., agency nurses). So given its size, the health system has made a concerted effort to recruit and retain its own people.

Steward’s size gives it the advantage of allowing nurses, for example, to move from one region to another, without exiting the Steward ecosystem, Mouton explained. Its travel agency can provide nurses with what they need to make such a move. And results are visible through analytics such as employee retention percentage rates and turnover percentage.

Favorite HFMA memories

Because Mouton has moved several times to different areas of the United States throughout her career, she has colleagues across the country. She said she values the way HFMA has allowed her to reconnect with these friends and associates regularly through HFMA national and regional events. She always has looked forward to attending and participating in HFMA’s Annual Conference almost every other year and delighting in the experiences. 

5 guiding principles for healthcare finance leaders from Theresa Mouton

1 Be flexible. Laws change, regulations change, policies change. Always have a back-pocket strategy ready. Because realities on the ground can shift quickly, you have to be prepared to change the way you operate or are structured to accommodate such shifts. Create new ideas and new ways to get the job done. Imagine the changes we have seen in just the past few years, such as AI and telemedicine. Now imagine the changes that will present themselves in the next few years, and you can see the need for flexibility.

2 Invest in education. Education and mentoring are keys to growing your team. For example, I have frequently started a new CFO position and encountered someone whose skills are not aligned with their role. With the right mentoring and education, they can be pulled out of
their comfort zone and become highly successful within the organization. Training all the staff is essential. We cannot hold someone accountable if they do not know what they are doing.

3 Make sure communications are transparent. We always need to explain the why. Associates need to understand why they are performing their tasks. Sometimes unpopular decisions need to be made, and it is imperative that the reasons be communicated openly and effectively. If they understand why the change is needed, they are more likely to back the plan, which will allow the organization to move forward.

4 Build strong partnerships with the stakeholders. That includes physicians, employees, vendors and the community. It means having interconnections, not just relationships. For example, be sure to share financial information with  physicians so they can understand how the organization is doing. And share internal data regarding their procedural costs and clinical outcomes compared to their peers. Don’t just tell — show! Also, have vendors put skin in the game. Where possible, create contractual goals that the vendor needs to meet, such as cost savings per procedure. This will more fully integrate the vendors into the organization.

5 Make full use of your teams’ skills. Understand the top five skills of every team member and encourage them to use those skills in their everyday work. This idea comes from, “StrengthsFinder 2.0,” a book by Tom Rath of Gallup Press, which expounds on ideas developed by Don Clifton, recognized as the “father of strengths psychology.” By operating in your “strength zone,” you and your team can more effectively and efficiently accomplish difficult tasks and demonstrate results. Using the strengths of each team member creates a balanced portfolio to successful task completion. For example, knowing you are not good at writing policies and procedures can spur you to find someone else on the team who has that skill, thereby allowing for better allocation of resources.


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