Jeff Francis, Vice President of Finance and CFO of Nebraska Methodist Health System

Summary

---

Podcast Summary

Podcast: Becker’s Healthcare Podcast
Episode: Jeff Francis, Vice President of Finance and CFO of Nebraska Methodist Health System
Date: August 25, 2025
Host: Madeline Ashley

---

Episode Overview

This episode features Jeff Francis, Vice President of Finance and CFO of Nebraska Methodist Health System. The conversation covers Jeff’s career background, the scope and recent achievements of Nebraska Methodist, as well as key healthcare finance trends he is monitoring. Jeff shares strategic insights on cost management, workforce optimization, the role of AI in revenue cycle, and growth plans—including new behavioral health initiatives. The episode offers leadership guidance for emerging healthcare finance professionals.

---

Key Discussion Points & Insights

1. Jeff Francis’ Background & Nebraska Methodist Overview

• CFO Experience: Jeff recounts his extensive finance career, including leadership roles at Allegiant Health, Parkview Health, and Ministry Healthcare, culminating in his current nine-year tenure at Nebraska Methodist.
• Nebraska Methodist Highlights:
  • Four hospitals in Omaha area
  • 30 multi-specialty clinics
  • Nursing and allied health college
  • Linen/distribution service across four states
  • 8,000+ employees, $1.4B annual revenue
    (02:07)

2. Top Healthcare Finance Trends to Watch

• Artificial Intelligence (AI):
  • Transforming business and clinical operations.
  • AI is used to automate data entry, shifting staff focus to auditing and decision-making:
    “It keeps the quote, human in the loop, unquote, in the process, as well as allowing that staff to work at a higher level, working at the top of their license and being a little more challenged than just doing that data entry.” — Jeff Francis (03:33)
• Denials Management:
  • Upstream accuracy (registration, pre-authorization, scheduling) prevents costly rework and improves billing efficiency.
• Cost Management:
  • Rising costs outpace revenue; focus must be on controlling spend despite growth aspirations.
    “Would be a lot more fun to focus on the growth, but really having to focus on that cost management.” — Jeff Francis (04:50)

3. Cost Management Strategies at Nebraska Methodist

• Workforce Optimization:
  • Seizing opportunities when staff retire/leave to redesign roles instead of simply rehiring.
  • Leveraging Nebraska Methodist College to supply nursing and clinical staff, reducing reliance on expensive contract labor:
    “We've gotten to the point where our contract labor is below pre-pandemic levels and now focusing on the recruitment, retaining and keeping that great staff at Methodist.” — Jeff Francis (05:42)
• Supply Chain Management:
  • Reevaluating contracts, renegotiating prices, and exploring substitute products to reduce supply expenses without impacting patient care.(06:21)

4. Evaluating New Technologies

• Problem-Driven Approach:
  • Only pursue tools and technologies that address concrete organizational challenges.
• Long-term AI/RPA Use:
  • Seven years using AI and RPA for claim statusing, coding, and denials. Result: staff can focus on complex problems, improving yields on difficult cases.
    “...that's allowed us to see improved yield because they are working those more difficult cases.” — Jeff Francis (07:36)

5. Growth & Exciting Initiatives

• Strong Post-Pandemic Leadership:
  • Emphasis on teamwork and executing strategic plans, with a focus on expanding the primary care network to support specialty services and gain hospital market share.
• Behavioral Health Expansion:
  • New hospital in partnership with Cadia Healthcare, opening early 2026 in Council Bluffs, Iowa:
    • Expanding from 24 to 96 beds, serving geriatric to adolescent populations.
    • Partnership enables broader, higher-level behavioral health services.
      “An opportunity that's needed in the area and excited that we can do that with a joint venture partnership that focuses and brings an extra level that we just weren't able to do with that small of a unit.” — Jeff Francis (08:42)

6. Five-Year Vision & Strategic Anchors

• Smart Growth Model:
  • Focused expansion of service lines: oncology, primary care, women's services (including NICU), and orthopedics.
• Continuity & Leadership:
  • Confidence in the leadership team to sustain and build on past decade’s gains.
    “Look to be able to do it with this leadership team going forward for the next decade.” — Jeff Francis (10:11)

7. Advice for Aspiring Healthcare Finance Leaders

• Be a Teacher:
  • Importance of explaining the financial perspective to clinical colleagues, cultivating understanding and collaboration: “Being able to be that teacher helping the clinical side, understanding the why from the business aspect...provides the why, you know, allows all of us to work so that we can have the sufficient funds so that we can acquire the capital, we can reinvest, we can go into innovation.” — Jeff Francis (10:48)

---

Notable Quotes & Memorable Moments

• On AI and Retaining the Human Element:
  “It keeps the quote, human in the loop, unquote, in the process, as well as allowing that staff to work at a higher level, working at the top of their license...”
  (03:33 — Jeff Francis)
• On Growth vs. Efficiency:
  “Would be a lot more fun to focus on the growth, but really having to focus on that cost management.”
  (04:50 — Jeff Francis)
• On Clinical Partnership:
  “Being able to be that teacher helping the clinical side, understanding the why from the business aspect...”
  (10:48 — Jeff Francis)
• On Behavioral Health Expansion:
  “Excited that we can do that with a joint venture partnership that focuses and brings an extra level...”
  (08:42 — Jeff Francis)

---

Timestamps for Key Segments

• Jeff Francis' Background & Health System Overview: 00:45–02:48
• Top Industry Trends: 03:08–04:59
• Cost Management Strategies: 05:12–06:41
• Evaluating New Tech/AI: 07:00–07:51
• Growth Initiatives, Partnerships, Behavioral Health: 08:10–09:38
• Strategic Growth Vision: 09:51–10:28
• Leadership Advice: 10:46–11:29

---

This summary captures the practical leadership themes, strategic focus areas, and operational insights discussed by Jeff Francis, providing an actionable snapshot for healthcare leaders, finance professionals, and anyone interested in industry innovation and transformation.

Transcript

[A]

Introducing Altera Digital Health, a new name in digital healthcare solutions. We see the summit of what healthcare can be and we're focused on helping you take the steps to get there. It's time to look at healthcare solutions differently. Altera the alternative you need for the outcomes you want. To learn more about us, visit altera.

[B]

Health.Com this is Madeline Ashley with the Becker CFO and Revenue Cycle podcast. And I'm thrilled to be joined today by Jeff Francis, Vice President of Finance and CFO of Nebraska Methodist Health System. Jeff, thank you so much for being on today.

[A]

Thank you for having me.

[B]

So, before we kick things off, do you mind sharing with our listeners just a little bit about yourself, your background in healthcare, and more about Nebraska Methodist? Yeah.

[A]

Thank you. Yeah, I started in healthcare at Allegiant Health, which was a system that's now part of Common Spirit back in the late 90s. I got that job after getting an MBA from Creighton University and then had an opportunity a little bit later to move to Fort Wayne, Indiana, went to Parkview Health and then became the CFO of Parkview Health the Thursday before the Lehman Brothers collapsed there in September of 2008. So learned quite a bit the following weeks after that. Later I took a position with Ministry Healthcare in Milwaukee as the chief administrative and financial officer. So I had the traditional CFO items, but also responsibility for IT and HR. And I was there from 2010 until 2015 and I've now been with Nebraska Methodist Health System for a little over nine years.

[B]

Wonderful. Thank you so much for sharing your background. Could you dive a little more into Nebraska Methodist itself?

[A]

Yeah, Methodist Health System, based in OMaha, we have four hospitals in the area. We also have a multi specialty physician group with about 30 clinic locations. Additionally, we have a nursing and allied health college and a distribution and linen service that services the four area states in Iowa, Missouri, Kansas and Nebraska. And overall, we're a little over 8,000 employees and about 1.4 billion in annual revenue.

[B]

Amazing. Thank you so much for sharing that background there. So, Jeff, I want to dive in. You know, as you mentioned, you've been in the industry for a while on the finance side. So I would love to hear maybe two to three trends that you're closely monitoring right now in healthcare and why these trends are so important for you to keep your financial eye on.

[A]

I would be remiss if I didn't start off with AI. Obviously that's critical, both from a clinical but also from a business finance revenue side cycle perspective. You know, our. My focus is more around the finance and revenue cycle. And we just really see AI having the ability to take out that, processing that keying effort that's done by much of the staff and really turning that staff into auditors and reviewers. It keeps the quote, human in the loop, unquote, in the process, as well as allowing that staff to work at a, you know, a higher level, working at the top of their license and being a little more challenged than just doing that data entry. Another item that I'm focusing on is denials management, focusing on the accuracy upstream. How can we have a more accurate, a better registration, better pre authorization, better scheduling to avoid that rework that happens in the coding or the billing office that adds costs, delays, cash and is really not a value add. And then lastly, of the top three trends, it would be cost management. Our costs are increasing at rates greater than revenue. Whether you take into account just population growth or the rates that the third party payers are giving us, would be a lot more fun to focus on the growth, but really having to focus on that cost management.

[B]

Sure. And with that, with cost management, could you share some strategies, maybe diving a little deeper into kind of how you guys are looking at this and some plans of attack? Essentially.

[A]

As any good leader, you should look at opportunities when people leave or people are retiring. So that's been an effort that we've been looking at this year. How can we stop doing items? How can we reassign so that we don't necessarily have to fill that position again? We've been able to focus on hiring nurses and some of the clinical areas because of our Nebraska Methodist College and the ancillary students that graduate so that we've been able to reduce our incentive pays that went up due to the pandemic. We've also been able to focus on reducing contract labor. We've gotten to the point where our contract labor is below pre pandemic levels and now focusing on the recruitment and retaining and keeping that great staff at Methodist. So, you know, and that's obviously the largest of our costs are on the personnel side. But looking at supplies, trying to renegotiate, looking at substitute products, constantly trying to, you know, do those areas because it's not impacting that direct patient care that we want to focus on.

[B]

No, I appreciate you diving deeper there. I also have one final question for you. Just on these trends, you know, you started with, you know, discussing AI. How do you decide, you know, with all the new tools and technologies coming out right now, you know, what's the process look like for deciding what best fits your organization?

[A]

We definitely want to look at solutions that help our problems. Others may have other problems that tools can help solve, but that's not where we're going to focus. We've also worked from a revenue cycle with a company that we're now going on seven years utilizing some of the AI and robotic process automation RPA to help us with claim statusing, with coding, with denials so that we can again have those staff work on that higher level functionality which has allowed us to see improved yield because they are working those more difficult cases.

[B]

And I appreciate you sharing that. I want to dive into a different topic now and kind of discuss maybe some of the things most excited about right now at Nebraska Methodist and and maybe any plans or partnerships that you're looking at through the rest of 2025.

[A]

Mostly what we're or what I'm excited about is the strong leadership team that we have coming out of the pandemic. Definitely work well together. We're able to then continue and focus on our strategic plan which is around growing the primary care network. With that stronger primary care network able to support our specialty physicians as well as then gaining market share at our four hospitals. So but that's really internally we're also looking forward to opening a behavioral health hospital with Cadia Healthcare in early part of 26, able to expand our behavioral health footprint over in Council Bluffs, Iowa, southwest Iowa, from a 24 bed unit up to the new hospital which will start off with 96 beds that will include everything from geriatric back to adolescent and again an opportunity that's needed in the area and excited that we can do that with a joint venture partnership that focuses and brings an extra level that we just weren't able to do with that small of a unit.

[B]

And when you think about growth at the system over the next maybe even three to five years, what does that look like in your mind, in your head and, and you know, are you excited about it?

[A]

We are excited about the growth and with our strategic plan it is around smart growth so that we're emphasizing those anchor service lines and that is really what we've been doing for the last decade. What are we doing around oncology, primary care, women's services and our NICU area along with orthopedics, being able to keep focusing on those areas as we have this past decade, look to be able to do it with this leadership team going forward for the next decade.

[B]

And when we, you know, at the beginning of the podcast we talked just about, you know, some, some industry changes that we're seeing. And I would be so curious to hear maybe a piece of advice you might have for incoming health care finance leaders. You know, what would you tell yourself right back when you were starting?

[A]

When I'm looking back what I've picked up on over the last 10 or 15 years, it's really being able to be that teacher helping the clinical side, understanding the why from the business aspect the two have to work well together and being able to provide the why, you know, allows all of us to work so that we can have the sufficient funds so that we can acquire the capital, we can reinvest, we can go into innovation that will benefit our clinicians, benefit our patients in the years to come.

[B]

That is some truly great advice, Jeff. I appreciate you taking the time to connect with me today and to learn more more about all the exciting things happening at Nebraska Methodist Health System and I look forward to chatting again soon.

[A]

Would enjoy that and thank you.

[B]

Thank you.