Abstract

The new actors, a new stage, new roles, and new threats in health care, it is time to define new roles for chief financial officers (CFOs) and financial executives more than a supporting player in the unfolding drama of our industry. A tsunami of cost containment has hit, and spending on performance improvement is key to survival. Survival of our current financial crisis will require great financial leaders. Fairly or unfairly reflecting reality, many in the quality and patient safety leadership positions bemoan that the role of the CFO has been to say BNo[ to spending on performance improvement. Yet, changes in health care will mandate new coalitions and new partnerships between players who are often on opposing sides of budget debates. The next generation of great hospital leaders may come from the ranks of our finance leaders, who can help translate core values into bottom line performance by educating themselves in the financial impact of performance improvement. There are a number of Bgreenlight[ issues with great potential for performance improvement, which include performance envelopes, chasing zero infections, impact scenarios, legal myths, quality teams and financial know-how, changing revenue assumptions, readmission red-ink revenue, coding issues, evidence-based point estimates, delegated purchasing risk, vendor risk, cost of technology adoption, cost of leadership failure, and purchaser gain sharing. The surfers (and survivors) of the BNo Outcome No Income Tsunami[ will align their teams on a common platform, develop talent, ignite passion, and put the strokes of hard work into action. The art of improving-at-improving will demand a new-found respect of all. Great CFOs could be at the center of the winning teams. It is a defining moment for chief financial officers (CFOs) and financial executives. Health care is having more than just the yearly crisis du jour. Survival of our current financial crisis will require great financial leaders. Heretofore, finance teams and their financial leaders, have been supporting actors; however, they are being thrust into the spotlight center stage and are becoming the key decision makers and influencers of Bgreenlight[ decisions for investment in patient safety and quality. Taken from the movie industry, this term refers to the action of final commitment of funds to a project that triggers mobilization of a team to action. In current conditions, their vote can either kill or Bgreenlight[ a project. There are key greenlight issues that must be considered and that can be refined by safety reams to enhance the probability of success at obtaining investment and,more importantly, saving lives. Finance executives will have to take on new skills and knowledge to survive the waves of change that are befalling their hospitals and organizations. The new actors are quality drivers at Centers for Medicare and Medicaid Services (CMS), purchasers, policy makers, and the press. Their impact is creating a new script and new roles for hospital executives. The new stage is health care reform, the national recession, and transparency. The issues of access, cost reduction, and quality failures will play out at the local levelI.at your level. The roles for CFOs will be to develop into educators, diplomats, implementers, negotiators, cheerleaders, and even inspirational leaders. They must become investment advisors in performance improvement. In the words of Warren Buffett,

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