Episode Summary: Kelly Johnston, Interim CFO of St. Vincent Hospital

Podcast: Becker’s Healthcare Podcast
Date: September 1, 2025
Guest: Kelly Johnston, Interim CFO, St. Vincent Hospital
Host: Laura Dearda

Main Theme

This episode centers on the financial transformation of St. Vincent Hospital, rural healthcare challenges, and strategies for sustainable hospital growth. Kelly Johnston, serving as interim CFO, shares actionable insights into revenue cycle optimization, cost management, community-oriented service line growth, and leadership in today’s rapidly shifting healthcare landscape.

Key Discussion Points & Insights

1. Introduction and Background of St. Vincent Hospital

[00:11 – 02:04]

• Kelly Johnston gives an overview of her role and the organization’s recent history.
• She attributes the hospital's significant financial turnaround—from deficits and minimal cash reserves to financial stability—to strong leadership, strategic recruitment, realignment of service offerings, and a deep focus on matching services to community needs.
• Notable collaboration mentioned with Andy Driessen and Cypress Health Support.
• Quote:

  “We’ve taken the organization from a pretty large loss with really little to no days cash on hand to having positive days cash on hand and a really strong, healthy bottom line.”
  — Kelly Johnston [01:01]

2. Critical Success Factors in the Financial Turnaround

[02:04 – 04:53]

• Focused efforts on revenue cycle optimization due to shifting reimbursement rules and payer complexities.
• Meticulous front-end processes and provider education to ensure complete and accurate patient care documentation.
• Leveraging cost-based reimbursement models and department-level efficiency to ensure a good return on investment for expenses.
• Quote:

  “It is really, really imperative for us to make sure we're getting paid for the work that we're doing and correctly.”
  — Kelly Johnston [02:44]

• Emphasis on physician recruitment and retention as vital to ongoing stability.
• Looking ahead, maintaining efficient reimbursement practices and ROI strategies remains central to future plans.

3. Revenue Cycle Optimization Tactics

[04:53 – 07:14]

• Revenue cycle is dissected as a comprehensive process, starting from patient registration to claim completion.
• Kelly recommends a “gamma walk”—a step-by-step analysis of every part of the revenue cycle to pinpoint efficiencies.
• Encourages the creation of operating procedures (SOPs) for consistency and streamlined practice.
• Staying ahead of regulations is stressed as essential for successful operations and forecasting.
• Quote:

  “Revenue cycle starts the minute that patient presents in the emergency room or books an appointment and doesn’t end until you write off the claim or get paid.”
  — Kelly Johnston [05:24]

• Proactive multi-year financial forecasting used to drive decisions instead of reactive management.

4. Growth Opportunities and Community Engagement

[07:14 – 09:10]

• Top growth area is advancing community and patient education—keeping patients informed about stable access regardless of external changes.
• Strategic evaluation of services to ensure offerings are tailored to community needs, including adding targeted specialties trimmed during leaner times.
• Hesitation to “offer everything” common in rural hospitals: focus remains on matching real community needs and doing those well.
• Quote:

  “Our goal is to serve the community to what its true needs are and what we’re really good at and stay focused on that.”
  — Kelly Johnston [08:28]

5. Leading a Thriving Rural Healthcare Organization

[09:10 – 11:37]

• Agility is seen as a rural advantage—quicker pivots in service and administration than larger systems can manage.
• Leadership must “roll up our sleeves” to stay in touch with frontline needs.
• Sourcing alternative funding and developing strategic partnerships (for services not offered on-site) are critical.
• Continuous community communication assures patients of accessible care in shifting environments.
• Acknowledgement of the essential role of the clinical team and the necessity for ongoing patient outreach.
• Quote:

  “Over the next five years, it’s going to be a lot of continued block and tackling...really making sure we have strategic partnerships to offer those services we might not offer internally, but our patients could get elsewhere.”
  — Kelly Johnston [10:14]

Notable Quotes & Memorable Moments

• “We’ve taken the organization from a pretty large loss with really little to no days cash on hand to having positive days cash on hand and a really strong, healthy bottom line.”
  — Kelly Johnston [01:01]

• “It is really, really imperative for us to make sure we're getting paid for the work that we're doing and correctly.”
  — Kelly Johnston [02:44]

• “Revenue cycle starts the minute that patient presents in the emergency room or books an appointment and doesn’t end until you write off the claim or get paid.”
  — Kelly Johnston [05:24]

• “Our goal is to serve the community to what its true needs are and what we’re really good at and stay focused on that.”
  — Kelly Johnston [08:28]

• “Over the next five years, it’s going to be a lot of continued block and tackling...really making sure we have strategic partnerships to offer those services we might not offer internally, but our patients could get elsewhere.”
  — Kelly Johnston [10:14]

Timestamps for Key Segments

• [00:11] – Introduction and background of St. Vincent; success in financial turnaround
• [02:31] – Keys to success: revenue cycle optimization, cost control, physician recruitment/retention
• [05:19] – Deep dive on revenue cycle best practices, process streamlining, and forecasting
• [07:39] – Growth opportunities: community outreach and right-sizing service lines
• [09:38] – Future outlook: leading through change, agile leadership, partnerships
• [11:37] – Host wraps up; reflection on key learnings

Episode Tone

Kelly Johnston’s delivery is candid, practical, and forward-thinking, reflecting the spirit and agility often found in rural healthcare leadership. She constantly emphasizes teamwork, adaptability, and a deeply community-centered mission, making this episode both informative and inspiring for industry peers.