Latest / Becker’s Healthcare Podcast / Robert Chestnut, SVP and CFO at LMH Health

Transcript

Robert Chestnut, SVP and CFO at LMH Health · Becker’s Healthcare Podcast

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  This is where health care leadership comes together.
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  Becker's sixteenth annual meeting brings more than 3,500
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  hospital and health system executives and nearly 800
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  speakers to Chicago April.
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  This year's event includes keynote conversations with Dallas
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  Cowboys legend Troy Aikman and former president George
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  w Bush. 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. We're looking forward to hosting you
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  in Chicago.
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  This is Madeline Ashley with the Becker CFO
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  and revenue cycle podcast, and I'm excited to
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  be joined today by Robert Chesnutt, senior vice
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  president and CFO of LMH Health. Robert, thanks
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  so much for joining me.
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  It's great being here. Thanks.
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  So excited to have you on today. And
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  before we kick things off, for, for listeners,
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  do you mind just sharing a little bit
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  about yourself and and l
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  Sure. So I,
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  I've been in this role for a little
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  less than two years. Prior to that, I
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  was on the board of trustees for eleven
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  years, so I have kind of an interesting
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  perspective.
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  LMH Health is here in Lawrence, Kansas. We
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  sit about forty five minutes outside the greater
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  Kansas City area.
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  We are the,
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  we have our university here, the University of
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  Kansas, so we have 26,000
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  undergraduates here.
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  Our community is about a 100,000,
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  and we have a service area
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  that's about a 125,000.
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  We're a 174
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  bed hospital.
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  We do employ
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  the majority of our,
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  physicians in our our
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  service area.
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  So we have all of the service lines,
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  orthopedics,
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  cardiology,
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  urology,
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  and so forth, and then, obviously, a very
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  large primary care,
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  division. So,
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  it's pretty much a health system,
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  not just a
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  hospital.
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  And thank you so much for sharing. And,
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  again, as I mentioned, so excited to have
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  you back on the podcast. I believe you
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  and I connected,
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  in late July, early August for podcast. So
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  excited again to to dive deeper in here
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  today and Mhmm. Hear how things are going.
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  And as you know, the the industry continues
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  to change. Probably even in the last few
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  months since we connected last, we've seen so
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  many changes, ebbs and flows.
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  So could you share some of the broader
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  challenges you're closely following right now in the
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  industry
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  and why you're keeping an eye on these
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  from a finance perspective?
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  Sure. I think immediately,
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  we're looking at what the impact's,
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  going to be on our market with
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  the ACA subsidies.
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  It's hard to know exactly where that's all
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  going to end up. We do have some
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  exchange,
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  patients in our in our market,
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  and so we really won't know until,
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  their first encounters in 2026,
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  if they've changed insurance, if if they now
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  are going
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  to not have any insurance. So I think
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  that's probably the largest one. We do have
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  a pretty robust
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  financial counseling group here,
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  at the hospital. So it's really,
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  we try to be proactive in that, but
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  part of it's just that's a big unknown
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  right now. So so that's a big trend.
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  I think the second trend we're looking at
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  is trying to gauge
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  what our inpatient census is gonna be over
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  the winter.
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  Typically,
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  as you know,
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  I'm sure it's true at most hospitals that
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  you have,
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  your your highest census is probably starting now
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  through, let's say, February or March.
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  Our census has been up,
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  during the even the summer, so we're kind
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  of wondering
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  what is that going to mean our census
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  is gonna be even that much higher in
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  the winter or not? So that kinda impacts
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  our staffing models and what we have to
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  open and and how we're doing that. So
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  that's kind of on the ground, a a
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  real,
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  macro
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  trend that we're trying to figure out.
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  So those are two things right now that
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  we're really focused on.
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  Yeah. And you you know, I wanna circle
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  back because you touched a little bit on
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  just the the financial counseling group that you
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  have right now and, you know, everything around,
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  like, the this ACA subsidies and just question
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  marks and unknowns.
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  Could you share a little bit about what
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  those group meetings look like? And maybe for
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  some of our listeners who would who would
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  be interested to to figure out maybe a
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  solid plan right now amid all this unknown.
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  Well, I think that, we're probably slightly unique
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  simply because as a sole community hospital, we're
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  the only game in town. So we feel
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  a real obligation to provide that service to,
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  you know, all of our patients. And Yeah.
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  Whether it be
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  navigating Medicare Advantage plans,
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  whether it be navigating, as you know, on
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  the on this back end of 2026,
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  I think that we will have
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  a lot of of,
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  involvement
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  in Medicaid enrollment
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  and the fact that they're gonna have to,
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  Medicaid patients will have to qualify twice a
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  year.
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  You know, there's a lot there. From from
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  our standpoint, we just feel the obligation
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  to be,
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  I wouldn't say the one stop shop, but
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  certainly the primary source of of information for
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  them to figure out how to navigate this
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  this whole,
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  new world that we're in as far as
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  different,
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  different changes in legislation,
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  because it's just it's it it is,
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  for us unique.
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  I I think that, you know, for for
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  other systems, if you're in larger metro areas,
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  maybe it's a little bit different. But,
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  overall, there are patients, and our patients are
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  critical,
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  to to to understand,
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  because the biggest concern I think we have
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  as a system is to make sure that
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  they're able to receive care.
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  And so,
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  it it requires
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  more, in my opinion, more productivity
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  to be more outreach than it is just
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  kinda waiting to see what happens.
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  Yeah. And, you know, as as a a
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  CFO, as a leader of the finance team,
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  how are you ensuring to keep your team,
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  you know, resilient and engaged right now? Maybe
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  the the secret sauce to success
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  as you guys, you know, kind of prepare
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  and plan.
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  Right. Part of it's education. I think,
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  you know, I have
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  I'm I'm very,
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  blessed, I would think, to have a great
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  team of directors that work for me that,
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  actually have more
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  insight
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  into all the nuance of what's happening, whether
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  it be in,
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  payer negotiate you know, payers and what's happening
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  in Medicare and what's happening with Medicaid and
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  what's happening in coding,
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  what's happening in procurement,
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  so on.
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  So I really encourage that. They they need
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  to be the subject matter experts.
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  I think secondly
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  is just keeping them focused on what is
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  our purpose. Our purpose is to provide
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  high, you know, high quality patient care.
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  It's easy to get kind of trapped in,
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  the numbers
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  and to to kind of of,
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  become sort of siloed into
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  the issues that you're having
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  as a department
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  as it relates to the rest of the
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  ecosystem in health care. But we all have
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  to kinda take a step back and realize
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  why are we doing what we're doing.
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  And,
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  that, I think, provides some motivation for them
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  to say, ultimately, I'm here to make sure
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  that patients receive the best care they can.
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  And as we're looking to the new year,
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  I can't believe we're almost in 2026,
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  but, you know, where's your mind at in
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  terms of planning for next year? Maybe anything
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  that you're keeping an eye on trends wise,
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  that we'll see next year.
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  Well, I think that one of the things
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  for us is that we we are we're
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  under a fairly,
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  expansive,
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  capital
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  expansion right now. We've finished our cancer center
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  this year, and we are opening up,
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  a second,
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  cath lab sometime in late twenty twenty six,
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  early twenty seven,
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  heart center.
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  So we do have some pretty,
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  robust expansion plans. So that's that there's a
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  lot of planning behind that, obviously,
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  obviously. And it does create some short term
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  transitional issues because we have to, for instance,
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  relocate our cardiologist for a period of time,
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  and,
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  we're moving a lot of things around. So
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  so that logistics,
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  those logistics are always challenging.
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  So that's one thing for us.
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  I think what we're probably looking at at
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  a macro level is to make sure that
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  we understand what the landscape is with
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  our our our payer mix and and and
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  just our
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  regional market. Because even though we're a sole
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  community hospital,
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  we do have
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  in the Kansas City market, we have
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  HCA
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  hospital there. We have a big AVID presence
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  there. We have other large large groups there.
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  So we always need to understand,
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  you know, kinda what's going on and making
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  sure that we don't see the kinda,
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  a lot of out migration from this market.
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  So so those are a couple of things
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  that we have the,
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  that we're paying close attention attention to right
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  now.
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  And, you know, with your experience and background
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  in
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  in health care finance,
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  what is or or maybe what are some
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  of the the biggest skills that CFOs need
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  to hone in on right now just amid
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  all these changes?
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  Well,
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  I think to to really understand the the
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  bigger picture, and what I mean by that
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  is that,
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  health care is a very complex ecosystem, and
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  to try to understand
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  all the moving parts is challenging. It takes
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  it takes a village. It really does. It
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  takes all of my colleagues that work with
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  me,
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  in the finance group. It takes our operations
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  directors. It takes our physicians. It's you know,
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  it it is a
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  it is a
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  big a a a big ecosystem to manage.
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  So I think that what you evolve to
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  is you're really realizing that you're
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  well outside of just the financial picture, but
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  just,
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  a lot of things that are happening
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  that affect the financials, but trying to be
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  out in front of it.
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  I think in particular,
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  we're probably more focused right now to make
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  sure how do we manage our our labor.
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  Labor challenges are are fairly large,
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  probably the same issues that a lot of
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  a lot of different systems are experiencing with
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  the shortage of different,
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  different skill sets being either nursing,
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  medical assistants, phlebotomist,
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  all of that. So one of the things
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  we're also involved in is to try to
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  develop some programs, some training programs
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  for some of those positions because
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  I think that, with the shortage of those
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  skills in the market, you have to make
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  up the difference. You're you're gonna have to
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  grow your own.
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  You know, that's a term that we use
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  around here is how do we,
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  give opportunities
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  not only for,
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  colleagues that we have already in our system,
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  but people in our community to really get
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  involved in health care. Because I think if
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  you look at the at the long term,
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  you recognize the fact that there there's going
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  to be less people,
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  and the demand is certainly going to continue
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  to increase. So so we have to find
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  different ways to find the the quality people
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  that work for our, organization.
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  Yeah. And I've even, you know, seen
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  and reported on here at Becker's some, you
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  know, systems. Some hospitals are focusing, you know,
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  on even high school, middle school students, you
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  know, just introducing them to the world of
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  health care saying, hey. You know, come down
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  the line, come work for us.
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  Yeah. We have a we have a a
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  group here in Lawrence,
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  a technical school called Peasley Tech. It's named
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  after
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  a
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  a
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  real,
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  a gentleman that was really involved in the
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  community.
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  But,
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  they probably touch,
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  four or 500,
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  high school students every week. And you're absolutely
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  right that,
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  getting them interested early and maybe some opportunities,
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  because I think the big thing is to
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  to make them see that
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  there are other pathways than just necessarily a
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  college education to be really successful.
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  And,
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  I I think that that we we have
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  to emphasize that because that is the way
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  we're going to have a robust workforce.
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  Right. And it's such a needed and important
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  profession. So Mhmm.
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  Well, Robert, I really appreciate you hopping on
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  this call, and it was so great to
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  to be able to discuss with you, you
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  know, again, some of the industry uncertainties we're
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  seeing and and how LME CHA is going
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  forward tackling it. So thank you so much
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  for for being on again. It's been such
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  a pleasure chatting and excited to connect with
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  you again in in 2026.
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  Okay. Appreciate it.