Latest / Becker’s Healthcare Podcast / Jon Alford, CFO of UW Medicine and Vice President for Medical Affairs at the University of Washington

Transcript

Jon Alford, CFO of UW Medicine and Vice President for Medical Affairs at the University of Washington · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
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  - understand what it takes to lead a health
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  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where do they go
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  - to pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
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  - Join us November second through the fifth in
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  - Chicago.
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  - For the agenda and event details,
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  - visit beckershospitalreview.com
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  - and click on the events tab in the
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  - upper right.
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  - This is Madeline with the Becker CFO and
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  - revenue cycle podcast, and I'm thrilled to be
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  - joined by John Alford, CFO of UW Medicine
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  - in Seattle and vice president of medical affairs
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  - at the University of
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  - Washington. John, welcome back to the podcast.
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  - Thank you. I appreciate it.
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  - So excited to have you on. But for
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  - those listeners
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  - haven't listened to our previous discussion, do you
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  - mind just sharing a little bit about your
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  - background in health care and more on your
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  - current role at UW Medicine?
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  - Sure.
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  - Little over, twenty, twenty five years in, in
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  - health care finance,
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  - experience in for profit, not for profit, academic
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  - medical centers,
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  - sort of the consulting CPA,
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  - firm areas as well,
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  - and that sort of balanced out between
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  - traditional finance,
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  - operational finance, and, a lot of work, obviously,
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  - in, reimbursement and revenue cycle as well.
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  - Awesome. Anything you can share with us on
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  - UW Madison?
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  - Well, with UW Madison,
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  - I am,
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  - gosh, I guess about five months in, to
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  - my role here. And so settling in and
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  - understanding the
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  - nuances of this organization,
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  - as opposed to other academics or other organizations
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  - out there right now and
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  - and the, hot topics in the Pacific Northwest
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  - as, you know, things can be a little
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  - bit different with each region.
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  - I think,
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  - you know, here, what I found is a
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  - a really strong
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  - research and academic,
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  - focused,
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  - organization
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  - that has a lot of,
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  - tremendous
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  - talent on creating
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  - new ways to deliver health care,
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  - and new health care products,
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  - innovations,
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  - and,
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  - you know, some opportunities maybe to upscale
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  - our infrastructure and and catch up on some
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  - things that,
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  - maybe were kind of neglected more in the
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  - shared services side over the years.
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  - So that's kind of been the journey so
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  - far here.
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  - Awesome. I'm excited to dive into our discussion
• 3:00
  - today. To kick us off, you know, as
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  - you said, he's been in the role for
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  - about five months.
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  - So could you
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  - share what maybe strategic priorities
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  - are demanding
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  - your attention right now on the CFO seat?
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  - What's what's most important to you right now?
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  - Yeah. I think, you know, the the two
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  - biggest things that, I would say have have
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  - been the focuses would be,
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  - first, is really strengthening
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  - collaborations
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  - and partnerships,
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  - with,
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  - other health care entities in the area. We
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  - have strong partnerships
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  - with,
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  - Seattle Children's Hospital here, as well as the
• 3:36
  - Fred
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  - Hutch, cancer,
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  - dinner
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  - and,
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  - you know, really working with them to mutually
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  - strengthen
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  - our presence,
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  - and then working with a lot of, I
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  - would say, rural and,
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  - suburban,
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  - independent hospitals and health systems
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  - to get kind of the right balance of,
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  - you know, flow of when to send the
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  - quaternary tertiary trauma type patients versus when we
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  - can help that patient stay in their their
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  - home area. So all of those partnerships have
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  - been really, really important for us to,
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  - take a a a new look at and
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  - and figure out how we can be better
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  - partners
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  - in those.
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  - And then part of that then is the
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  - other strategic priority, which is, has been going
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  - back to sort of
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  - upscaling and updating
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  - a lot of the,
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  - shared services systems that we have. So looking
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  - at our epic build,
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  - at which we were epic customer number 30,
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  - Our first go live was in 1996,
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  - with parts of Epic. And so looking at
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  - that now and seeing, you know, where we
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  - can
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  - update to their newest platforms, adopt the new
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  - technology they have,
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  - and doing some similar things with Workday for
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  - our ERP system.
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  - The sort of the mantra that I've had
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  - lately is,
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  - you know, we went through periods in health
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  - care where
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  - we did a lot of customization,
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  - and a lot of these programs were,
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  - sort of slanted toward allowing organizations to do
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  - a lot of customization.
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  - And now we're in a period where customization
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  - can actually be working against us, that Yeah.
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  - They need to get back to a base
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  - platform
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  - to be able to implement
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  - new technology
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  - faster as it starts to really come at
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  - us.
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  - Right.
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  - That's wild to hear. Epic's
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  - customer number 30. I mean, you guys have
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  - definitely been a a long time customer there,
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  - and Epic, of course, itself has evolved so
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  - much.
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  - What kind of things are you looking forward
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  - to just in terms of
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  - evolution there with with Epic?
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  - Yeah. So we I I just came back
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  - from the Epic user group meeting.
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  - Mhmm. Hosted there on their campus
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  - and had a chance to really work with
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  - them on understanding,
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  - you know, what modules or parts of Epic
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  - do we not have,
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  - turned on right now and and how we
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  - could maybe go on those that platform to,
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  - you know, to have things more seamlessly integrated.
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  - And, also, you know, they they offer something
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  - called project refuel where you can look at
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  - how much customization
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  - you have
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  - versus their standard bill
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  - and,
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  - you know, what what issues that may be
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  - causing us in inefficiency
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  - either for our providers
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  - or within our billing and revenue cycle.
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  - So kind of looking forward to to looking
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  - at the legacy build that we have
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  - and figuring out again, right, where we can
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  - streamline,
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  - reduce, say, the number of clicks of our
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  - physicians and and APPs,
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  - the number of clicks for our revenue cycle
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  - staff. And then from that, be able to
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  - start adopting some more of the features they'll
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  - be running, you know, rolling out soon, that
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  - are more AI based and automated.
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  - Yeah. The future of AI is so exciting
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  - to think about, and I'm sure that that
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  - was probably so helpful to get to see
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  - some of those tools coming out.
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  - Thanks for diving a little deeper there. I
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  - guess, obviously, we're in the back half of
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  - 2026.
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  - So could you share with me maybe some
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  - of the things that you're prioritizing
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  - ahead of 2027?
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  - Anything top of mind for you there?
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  - Definitely,
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  - you know, we're we're prioritizing,
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  - again, automation. Right? So, one of the things
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  - that we're looking at is as a safety
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  - net health system,
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  - you're representing the only level one trial hospital
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  - in Washington, but also across multiple states,
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  - you know, the impacts of HR one
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  - and what will change from Medicaid eligibility.
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  - That's gonna put a strain on our organization.
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  - And so, you know, looking at how we
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  - can,
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  - reduce
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  - overhead costs to counteract
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  - that loss of reimbursement,
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  - And then on the other side of that,
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  - looking at how we can implement,
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  - functionality both with people and technology and processes,
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  - to be able to maximize
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  - Medicaid eligibility for our our, patients
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  - that end up on our doorstep,
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  - in an emergent or trauma situation,
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  - that we can quickly get them qualified if
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  - they do qualify. So I would say we're
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  - putting a lot of of look
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  - and attention into,
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  - yeah, how to capture those and then, you
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  - know, how to again, just like everyone, how
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  - to lower our overhead,
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  - to be able to survive a little bit
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  - longer in these, tighter reimbursement times.
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  - Oh, yeah. I'm sure a lot of people
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  - can relate to you there.
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  - And you touched on, you know, partnerships and
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  - collaboration at the beginning of discussion. Where are
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  - you seeing the biggest opportunities for smart growth
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  - in 2027?
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  - I think, for us, part of the smart
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  - growth is gonna be continuing to,
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  - get deeper into value based care and population
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  - health management.
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  - Right? So making sure that only,
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  - you know, patients that really, really, really need
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  - to access the high cost care that we
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  - deliver are making it to us. So how
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  - do we partner with other health systems? How
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  - do we partner with employers?
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  - Mhmm. And then, of course, how do we
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  - partner with Medicare and Medicaid
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  - to manage those populations,
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  - you know, through primary care and through, you
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  - know, general specialist?
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  - And then implementing
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  - softwares,
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  - people and processes to be able to, you
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  - know, to make that flow well so that
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  - the patient feels like, they are getting the
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  - best care and avoiding hospitalization.
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  - The employer
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  - has less instances
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  - of their,
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  - employee being out due to
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  - illness or procedures.
• 9:50
  - Obviously, for these employers, it's also, you know,
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  - so there are a lot of self insured
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  - ones. And so
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  - how do we lower the cost for them
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  - of of health care?
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  - And then it really fits in with a
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  - lot of our mission with some of our
• 10:03
  - institutes
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  - that are looking at, like our Institute of
• 10:07
  - Health Metrics,
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  - where we're going through and trying to really
• 10:11
  - focus on healthier populations
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  - and understanding what's driving,
• 10:17
  - poor health and intervene.
• 10:19
  - So really go into that mission of, you
• 10:22
  - know, health care is more than just when
• 10:24
  - you walk in to see a physician or
• 10:26
  - walk in to have a procedure done.
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  - So a lot of partnerships
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  - across operations,
• 10:33
  - clinicians,
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  - and then external to health care,
• 10:37
  - organizations,
• 10:39
  - to kinda make those things happen.
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  - Yeah. That actually kinda segues into my next
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  - question. Again, you know, in your role, no.
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  - It's only been a few months, but have
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  - you kind of figured out as a finance
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  - leader here, you know, how are you partnering
• 10:51
  - differently with these clinical and operational colleagues to
• 10:54
  - help drive this sustainable performance?
• 10:56
  - Just in general too, I feel like with
• 10:58
  - CFOs, you know, they really are becoming bigger
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  - communicators. Right? Like, they're coming out from behind
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  - the desk, not just numbers crunching, they're working
• 11:05
  - with these clinical leaders, operational colleagues,
• 11:08
  - more, you know, on the front line, if
• 11:10
  - you will.
• 11:11
  - And and and you nailed it there. That's
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  - you know, as CFOs, we have to we
• 11:15
  - have to get out of the conference rooms.
• 11:17
  - We have to get out of the Yeah.
• 11:19
  - You know, the back offices
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  - and,
• 11:21
  - really embrace what I I, have kind of
• 11:24
  - learned, which is the art of storytelling.
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  - So we've gotta be able to sit down
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  - with non finance individuals
• 11:31
  - and
• 11:32
  - talk about what's happening and what those impacts
• 11:34
  - are,
• 11:35
  - and and why it means something to the
• 11:37
  - clinicians, why it means something to our patients,
• 11:40
  - why it means something to the employers, again,
• 11:43
  - that are really,
• 11:44
  - covering the, you know, a large share of
• 11:46
  - the cost of health care.
• 11:48
  - So I I'd say it's,
• 11:50
  - you know, taking things like
• 11:52
  - opening folks understand
• 11:54
  - using the story of a patient,
• 11:57
  - you know, what the impact of a change
• 11:59
  - in Medicaid eligibility in HR one is. It's
• 12:03
  - it's one thing to say, oh, well,
• 12:05
  - we're making this change in the federal government,
• 12:07
  - and so dollars are gonna be different. It's
• 12:10
  - very different than when you talk about an
• 12:12
  - individual who
• 12:14
  - shows up with a traumatic event, you know,
• 12:16
  - in a in a trauma ED
• 12:18
  - that's uninsured,
• 12:20
  - and now they're gonna have six, twelve, eighteen
• 12:23
  - months
• 12:24
  - of, you know, issues with their health.
• 12:26
  - And in the past, we could get them
• 12:29
  - Medicaid coverage,
• 12:30
  - which included medications,
• 12:32
  - you know, PT, OT, ST, different therapies outside
• 12:35
  - of the hospital,
• 12:37
  - you know, primary care to help them manage
• 12:40
  - that, and that now they might not. And
• 12:43
  - so talking about that patient's recovery journey and
• 12:46
  - taking it out of just, oh, we used
• 12:48
  - to get a dollar, and tomorrow, we won't.
• 12:51
  - So I think that's the kind of partnership
• 12:53
  - that CFOs need to have right now is
• 12:56
  - connecting things to
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  - everyone else in the community,
• 13:00
  - not just talking about the loss of a
• 13:03
  - dollar,
• 13:04
  - as a a change in policy.
• 13:06
  - No. That's some good advice for sure.
• 13:09
  - My my final question for you here today,
• 13:11
  - you know, when we look ahead three to
• 13:13
  - five years out even, what do you think
• 13:15
  - is a capability or maybe a transformation
• 13:18
  - that might separate
• 13:19
  - certain thriving organizations from those that might still
• 13:22
  - be struggling, just especially with everything going on
• 13:25
  - right now?
• 13:27
  - This one is, one that definitely keeps me
• 13:29
  - awake at night, because it feels like, you
• 13:32
  - know, you're trying to solve the problems of
• 13:34
  - today,
• 13:34
  - and they're coming so fast that, you know,
• 13:37
  - we have to stop and and put a
• 13:39
  - lot of thought into how we're gonna avoid
• 13:41
  - these types of problems in the future.
• 13:44
  - I think the the
• 13:46
  - definitely, the collaboration and building a lot of
• 13:49
  - trust
• 13:50
  - and communication
• 13:51
  - corridors between
• 13:53
  - finance, clinicians,
• 13:54
  - operators,
• 13:56
  - and the public,
• 13:57
  - is definitely one of those that's gonna separate
• 14:00
  - organizations that thrive versus struggle. I think there's
• 14:03
  - gotta be a lot of that that,
• 14:05
  - you know, just,
• 14:07
  - openness
• 14:08
  - and,
• 14:09
  - sharing of ideas.
• 14:11
  - I really think that organizations
• 14:14
  - that are willing to
• 14:16
  - be more innovative
• 14:18
  - quicker and take a little bit of risk.
• 14:21
  - So I like to call it here,
• 14:23
  - we have to create a psychologically safe environment
• 14:26
  - where it's okay to fail as long as
• 14:29
  - we fail fast and remediate.
• 14:31
  - Yeah. So I think a lot of times,
• 14:34
  - health systems get really worried. We're very evidence
• 14:36
  - based,
• 14:37
  - and we wanna trial things for a very
• 14:39
  - long time.
• 14:41
  - Mhmm.
• 14:41
  - And in certain areas, we'll find ourselves in
• 14:45
  - a spot where,
• 14:46
  - you know, we have to do things and
• 14:48
  - and take a little bit more risk to
• 14:50
  - try something
• 14:51
  - and,
• 14:52
  - be allowed to have small failures as long
• 14:54
  - as we identify them quickly.
• 14:57
  - Have those feedback loops. Don't have anyone say
• 14:59
  - that we,
• 15:01
  - you know, hold someone accountable or, you know,
• 15:03
  - in a negative way. We just say, look.
• 15:05
  - The process didn't work. Let's go back. It
• 15:07
  - was a good idea. Maybe we executed it
• 15:10
  - in the wrong way,
• 15:12
  - and and just keep retrying that and and
• 15:14
  - not be afraid to have some failures.
• 15:17
  - Yeah. No. I was literally going to say
• 15:18
  - that. It's always important to not be afraid
• 15:21
  - to have those failures, own your failures, and
• 15:22
  - learn from your mistakes. You know? So that's,
• 15:24
  - again, some great advice there.
• 15:26
  - Well,
• 15:27
  - John, as always, it was such a pleasure
• 15:29
  - getting to chat with you. I appreciate you
• 15:31
  - hopping on the podcast with me and
• 15:34
  - excited to connect with you again down the
• 15:35
  - line or maybe even early next year.
• 15:38
  - Alright. That sounds great. I'm definitely open to
• 15:40
  - it. Awesome. Thanks, John. You have a good
• 15:42
  - one. Thanks. You too.