Dennis Hesch, Executive Vice President and Chief Finance and Strategy Officer of Carle Health

Summary

Becker’s Healthcare Podcast Summary: Interview with Dennis Hoesch of Carle Health

Release Date: August 13, 2025
Host: Madeline Ashley
Guest: Dennis Hoesch, Executive Vice President and Chief Finance and Strategy Officer of Carle Health

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Introduction

In this insightful episode of the Becker’s Healthcare Podcast, host Madeline Ashley engages in a comprehensive discussion with Dennis Hoesch, the Executive Vice President and Chief Finance and Strategy Officer of Carle Health. With over three decades of experience in the healthcare sector, Dennis provides valuable perspectives on prevailing industry trends, financial strategies, and the evolving role of CFOs in healthcare organizations.

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About Dennis Hoesch and Carle Health

Dennis begins by sharing his extensive background in healthcare finance. “I’ve been in healthcare now for 30 plus years,” he states (00:21). He traces his career from Deloitte’s healthcare sector to his current leadership role at Carle Health, an eight-hospital integrated delivery system in central Illinois with a health plan and approximately $5 billion in total revenue. Dennis emphasizes the organization’s commitment to serving diverse communities and adapting to the dynamic healthcare landscape.

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Key Healthcare Trends Impacting Finance Leaders

Dennis outlines three primary trends currently shaping the healthcare industry from a financial leadership perspective:

1. The One Big Beautiful Bill (Affordable Care Act Amendment)

   Dennis highlights the widespread attention the recently passed bill is garnering within the healthcare sector. “Revenue and reimbursement rates continue to be a challenge,” he explains (01:34). He emphasizes the necessity of understanding the bill’s long-term ramifications over the next decade and its impact on both commercial insurance and state and federal reimbursements. Dennis notes, “We continue to monitor how we get paid... to figure out how will that impact us here at Carle Health” (01:34).

2. Commercial Payer Denial Trends

   An alarming increase in payer denial rates has been observed, almost doubling in recent years. “We’ve really seen a spike in those in the last couple years,” Dennis mentions (02:54). Despite maintaining a high success rate of approximately 97% in overturning denials, the administrative burden remains significant. Carle Health is exploring the integration of AI and enhanced workflows to mitigate this strain without compromising healthcare delivery.

3. Labor Market Challenges

   Labor shortages, particularly in clinical roles such as physicians, nurses, and technicians, continue to pose a significant challenge. Dennis points out, “Our labor pool is somewhat fixed” in central Illinois, necessitating innovative recruitment and retention strategies to ensure sustained healthcare delivery (03:48).

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Navigating the Impact of the One Big Beautiful Bill

Madeline probes deeper into the implications of the newly passed bill. Dennis articulates the organization's proactive approach: “We have started to look at what that means to us as an organization” (04:10). Carle Health is meticulously evaluating federal policies and their specific effects on central Illinois, particularly concerning Medicaid reimbursements and rural healthcare delivery. Dennis underscores the importance of strategic anticipation and planning to adapt to forthcoming financial changes over the next several years.

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Growth and Technological Advancements at Carle Health

Transitioning the conversation, Dennis shares his enthusiasm for Carle Health’s recent and upcoming initiatives:

1. Technology Implementation

   Carle Health successfully implemented a new back-office system, Workday, at the beginning of 2025. Dennis expresses relief and optimism: “I’m excited to at least have that initial implementation behind us” (05:42). The focus now shifts to optimizing this technology to support strategic decision-making.

2. Strategic Growth

   Over the past five years, Carle Health has expanded by adding five hospitals, targeting contiguous and downstate markets. Dennis highlights the importance of optimizing patient throughput and fostering partnerships, especially with for-profit physician practices. “We’re going to look to continue to expand that... to raise the overall pool for the organization,” he explains (07:07). This approach aims to enhance both financial and clinical success without compromising organizational integrity.

3. Care Delivery Model Adaptation

   With rising healthcare costs and the scarcity of providers, Carle Health is reengineering its care delivery model to emphasize outpatient services. Dennis states, “We need to redevelop and reemphasize our care delivery model... to deliver the most effective, efficient and best care possible” (05:42).

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The Evolving Role of the CFO in Healthcare

In response to a forward-looking question about the CFO role's future, Dennis provides a comprehensive analysis:

1. Fiscal Discipline and Clinical Outcomes

   Dennis believes the CFO role will increasingly focus on ensuring fiscal responsibility within clinical settings. “The CFO role... providing that fiscal discipline in the clinical settings to make sure we're not getting out in front of technology to chase something that isn't going to deliver clinical results” (08:40).

2. Strategic Relationship-Building

   Emphasizing collaboration, Dennis highlights the importance of building strong relationships with operational and clinical teams. This ensures that financial decisions are well-informed and aligned with clinical priorities.

3. Exploration of Additional Revenue Streams

   With tight margins, CFOs will seek innovative revenue opportunities beyond traditional healthcare avenues. Dennis mentions, “Looking for additional revenue streams... whether that's investment returns or other investments that are outside your traditional healthcare” (08:40).

Dennis concludes that the CFO’s role will continue to evolve, balancing financial stewardship with strategic investments to support clinical outcomes and overall organizational health.

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Conclusion

Madeline Ashley wraps up the episode by acknowledging Dennis’s forward-thinking insights and expressing enthusiasm for Carle Health’s future endeavors. Dennis reciprocates the appreciation, reinforcing his commitment to fostering financial and clinical excellence at Carle Health.

This episode offers a profound understanding of the financial challenges and strategic initiatives within a leading healthcare organization, providing valuable takeaways for healthcare professionals and financial leaders alike.

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Notable Quotes:

• “Revenue and reimbursement rates continue to be a challenge.” — Dennis Hoesch (01:34)
• “We’ve really seen a spike in those [payer denials] in the last couple years.” — Dennis Hoesch (02:54)
• “Our labor pool is somewhat fixed.” — Dennis Hoesch (03:48)
• “We have started to look at what that means to us as an organization.” — Dennis Hoesch (04:10)
• “We’re going to look to continue to expand that, not at the expense of one or the other.” — Dennis Hoesch (07:07)
• “The CFO role... providing that fiscal discipline in the clinical settings.” — Dennis Hoesch (08:40)

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For those interested in the nuances of healthcare finance and strategic leadership within a dynamic industry, this episode of the Becker’s Healthcare Podcast with Dennis Hoesch is a must-listen.

Transcript

[Madeline Ashley]

This is Madeline Ashley with the Becker CFO and Revenue Cycle podcast. And I'm excited to be joined today by Dennis Hoesch, Executive Vice President and Chief Finance and Strategy Officer of Carle Health. Dennis, thanks for joining me today.

[Dennis Hoesch]

Thanks for having me.

[Madeline Ashley]

So before we kick things off, Dennis, do you mind sharing with our listeners a little bit about yourself and Carl Health?

[Dennis Hoesch]

Sure, I'd be happy to do that. So as you heard, my name is Dennis Ash. I serve as the chief Financial officer of Carle Health here in central Illinois, close to the University of Illinois. I've been in health care now for 30 plus years. I grew up out east and started my career in Deloitte in their health care sector. Been there for about eight years before taking a job out east with one of Deloitte's clients and moving into Champaign in 2006. I've had the pleasure of serving here in different capacities and roles and had a lot of opportunities to see different things. For those that don't know, Carle Health is an eight hospital integrated delivery system currently with a health plan is as well at about 5 billion in total revenue.

[Madeline Ashley]

Awesome. Thank you so much for sharing that. So to kick us off, Dennis, you know I always say the healthcare world is ever changing. So with that in mind and your, I think you said 30 years in the healthcare industry, could you share maybe two to three trends that are, that you're closely following right now as a finance leader and why these trends specifically are so important to you?

[Dennis Hoesch]

I'd be happy to do that. And one thing I'd be remiss, not to mention, and I think probably everybody in the country and especially in health care is paying attention to is the one big beautiful bill. Revenue and reimbursement rates continue to be a challenge and one of the things we continue to monitor is how we get paid both on the commercial insurance business as well as on the state and federal level. With the bill being passed, there are a lot of trickle down ramifications in the healthcare industry that'll take place over the next 10 years. So I think everybody, including us here at Carle Health, are trying to anticipate and review that bill to figure out how will that impact us here at Carle Health and how will it impact our revenue stream. Does we continue to look at supporting the communities and structuring ourselves in a manner that would better support the care delivery model that we put in place here? I would say another trend that we continue to monitor here and we've seen an uptick over the last couple years is really commercial payer denial trends. We've really seen a spike in those in the last couple years where we've had denial rates almost double. If we're able to work all of those, we see about a 97% success rate in overturning those denials. But the administrative burden that puts on our team to try to get paid for the services rendered in an increasingly tight margin business is something we continue to pay attention to. We're trying to introduce additional workflows and AI to help support that, but that's something that we're really trying to make sure that doesn't burden the organization and our ability to deliver health care in the regions we serve. And probably the last thing continues to be a struggle. I think across the industry is just labor trends. Clinical labor trends, both at a physician level and a clinical service level, whether that's a nurse, healthcare tech, radiology tech continues to be those things we need to pay attention to. Not located up in the Chicagoland. Down here in central Illinois, our labor pool is somewhat fixed. And so we continue to find ways to be able to recruit and retain that staff as well. So again, we can continue to deliver the health care we've been delivering for decades.

[Madeline Ashley]

I kind of want to backtrack something you said at the beginning. Just the first trend, the one big beautiful bill, I mean, that was actually another question I was going to ask you is now that it's passed, you know, just in terms of like from a finance perspective, have you guys just been going over the revised version with the fine tooth comb and just kind of doing an if this, then that plan.

[Dennis Hoesch]

That's a great question. Thank you for that. So we have started to look at what that means to us as an organization. First, we're trying to evaluate what the overall federal policy says in the language within the bill. And then we're trying to equate it to the impact here in central Illinois. Because as anybody that's reviewed the bill, the impact at the federal level with Medicare and the Affordable Care act is one piece. Another big piece is the anticipation and reduction of Medicaid reimbursement and what that may mean for the states and the state populations it covers. And that's really what we're spending some time now is trying to equate it to what does the impact mean here in Illinois, especially in central Illinois with a rural market, and how is that going to impact the care we deliver? Because patients will still come to Carle for care. I think we have the second busiest emergency room in Champaign, Urbana in the state of Illinois. I don't see that changing. What we need to determine is how is the financial reimbursement going to be impacted with these changes that are forthcoming and we probably won't see them this month or next month. It's more over the rest of this year into the next several years and we just need to plan and anticipate appropriately.

[Madeline Ashley]

Sort of a hurry up and wait situation where it's passed and now you guys kind of just monitor, you know.

[Dennis Hoesch]

Yes, I think that's well said.

[Madeline Ashley]

Yeah. So I'd like to shift gears a little bit with you now and talk about what you're most excited about at Carl Health. Anything throughout the rest of the year, maybe even into 2026.

[Dennis Hoesch]

Sure, that's a great question. And things we talk about here frequently. I would say from my standpoint, a couple things come to mind. We've been on a technology conversion cycle where we just put in a new back office system workday that completed and went live at the beginning of 2025. So I'm excited to at least have that initial implementation behind us. Looking to optimize the technology and really getting to focus on our overall strategy and what strategic decisions we need to make going forward. And how are we going to structure ourselves in the ever changing health care space to deliver the best care possible. Because hospital beds are expensive, more and more services are being moved to the outpatient settings. Providers are becoming more scarce. So we need to redevelop and re emphasize our care delivery model defined to do things better, more effective, more efficiently. So I'm excited about the opportunity to take our downstate market across all of our regions downstate here in Illinois and really figure out how are we going to deliver the most effective, efficient and best care possible to those communities we serve and do it in a very disciplined manner so we can take care of as many patients as possible.

[Madeline Ashley]

Could you dive maybe a little deeper into how you're looking at growth from a financial standpoint for the system, maybe even over the next two to three years?

[Dennis Hoesch]

Yeah, growth is an interesting, interesting thing. We've grown here at Carle over the last five years quite a bit. We've added five hospitals over the last five years. So we've had growth downstate and contiguous markets. Now we're looking from a growth from both an optimization standpoint, how do we increase the throughput of patients through our system. We're also looking at growth with partnerships, especially with some of the for profit entities, especially the for profit physician practices. I think they are starving for some non for profit health system collaboration. We have some of that collaboration in place today with some for profits and we're going to look to continue to expand that, not at the expense of one or the other, but really on how do we raise the overall pool for the organization so we can both be financially successful as well as clinically successful when we're delivering health care to those in our community. So in a couple ways, I think it's more organic here for us at Carle right now with us having those five hospitals joining us over the last five years. Certainly excited about the opportunity and what's in front of us.

[Madeline Ashley]

That's amazing. So, final question for you here and again, I know we talked about this a little bit at the beginning, but you've been in healthcare for, you said what, 30 years? A little over. Yeah. So you know, you've seen the industry evolve. Could you share maybe where you see the CFO role headed in the, in the next maybe three to five years, how you see it to continue evolving?

[Dennis Hoesch]

Yeah, that's a great question. Thank you for that as well. The CFO rule I think continues to evolve, has evolved over the last 10 years, five years, and I think will over the next five and 10 years going forward. Healthcare is a very intensive market and industry when it comes to technology. Everybody wants the latest and greatest technology, the latest and greatest drugs. Regardless, I believe at times of the clinical outcomes, people are really looking to do what seems to have the most vision or splash in the industry. Without those clinical outcomes, I see the CFO role continuing to evolve and really trying to provide that fiscal discipline in the clinical settings to make sure we're not getting out in front of technology to chase something that isn't going to deliver clinical results because there is only so much money in the system. And with the increase in administrative burdens, with the highly scrutinized business that we're in, we need to be smart. And I think that's where the CFO really comes into place. Building the relationships with the operational and clinical areas to make sure we're putting good fiscal discipline in our clinical decision making and then explaining why it's probably not the best decision for us organizationally to make sure people aren't feeling as though they're just being told, but there's actually rationale so they can understand why those decisions. And I, I see that ever evolving. That's always been in place, but I think that's going to continue to evolve. I also see it at the health system side because margins are so tight. Looking for additional revenue streams in different areas to help support the bottom line of the organization, whether that's investment returns or other investments that are outside your traditional healthcare. I think that's where the CFOs can really come into place and really provide some additional support to the organization to be able to invest in clinical outcomes.

[Madeline Ashley]

Awesome. Great insights here and forward thinking. Thank you so much for sharing. Dennis. Well, you know what, that takes us to our time, but it's truly been a pleasure chatting with you and I. I look forward to connecting again down the line and hearing all the exciting things happening at Carle Health.

[Dennis Hoesch]

Well, thank you. Thank you for giving me the opportunity to speak today and I hope you have a great weekend.

[Madeline Ashley]

Thank you.