Loading summary
Transcript19 lines
- [00:00]
A
This is Madeline Ashley with the Becker CFO and Revenue Cycle Podcast. And I'm thrilled to be joined today by Stephanie Schnitger, CFO of UVA Health. Stephanie, thanks so much for joining me.
- [00:11]
B
Thanks, Madeline. It's great to be here. Thanks for the invitation.
- [00:14]
A
Of course. So, before we kick things off, do you mind sharing with our listeners just a little bit about your background and about UVA Health?
- [00:22]
B
Sure. Well, I'm coming up on my fourth week after joining the organization, so I'm very, very new to UVA Health, not new to Virginia. I've been working in Virginia, Virginia Healthcare for the better part of the last 25 years. Prior to joining UVA Health as the CFO, I actually spent a little bit of time just over a year in Maryland, which was an interesting model at Luminous Health. Prior to that, I spent around five years with Sentara Healthcare in Norfolk, Virginia, and then more than 20 years with Inova Health in Northern Virginia. So, again, Virginia Healthcare is very familiar to me, even though the job here at UVA Health is somewhat new.
- [01:05]
A
Yeah. I've got to ask, before we kick things off, how are your first four weeks going? How are you feeling so far in the new role?
- [01:13]
B
It's been intense. It's been invigorating. We have a lot of things going on here across the university and across the enterprise. Lots of challenges, but also major opportunities. And I'm just extremely excited about the work ahead. I think there's a lot of opportunity to add value, which is really where I get the greatest support sort of satisfaction out of my work. So it's been very exciting so far.
- [01:37]
A
Well, that's great to hear, and I'm excited to dive into our discussion today. So to kick us off, Stephanie, you know, you just shared with us that you've, you know, been in the industry for. For a while. So I would love to hear maybe two to three trends that you're closely following right now as you enter your new role and. And why these trends are so important to you in the world of healthcare that is ever changing.
- [01:58]
B
Sure, absolutely. And I will say healthcare at the end of the day is very local, market by market, but these trends kind of transcend different markets. And the different organizations that I've been through over the years were at different points of their maturity curve when it comes to some of these various trends. But I will say, I think first and foremost, what's top of mind is really the federal regulatory environment right now. Now, this isn't anything new to health care in general. We've had changes, balanced budget amendments. We had the Affordable Care act back in 2014 that went into effect. But recently with the enactment of the one big beautiful bill that is obviously creating a lot of challenges in terms of federal regulatory changes in the Medicaid program in particular, but also Medicare and other areas where it affects how we get paid. And so that's something that I'm following very closely and how that impacts how we are able to get reimbursed here for some of our more underserved populations, particularly the Medicaid population. So that's, that's one major trend that's certainly top of mind. Secondarily, I think this is a theme that, that comes up from time to time. And depending on the market, there are different, you know, different organizations are in different places on the maturity curve. But we are really challenged here in the Charlottesville market with developing lower cost of care settings to help open up access. What we're finding is that a lot of lower acuity patients are presenting in our ED because we don't have a strong, robust primary care and ambulatory platform around the region. Parking can be challenging and expensive to set up those sites of care. But we are going to be investing in that sort of heavily in the years to come. So to open up access to our communities and the patients that we serve, and also to move and shift some of those lower acuity patients out of the higher cost of care setting. And overall, that should bring down the cost of care overall for not just UVA health, but for sort of society overall. So that's, that's a trend and a challenge that we are keeping an eye on as well. And then I think third, and maybe not most important, but really the ongoing competition in challenges with the clinical workforce. So, so we have faced shortages in the past and we're going to have shortages in the future in terms of the pipeline for clinical talent, whether it be nurses, clinicians, clin techs, radiologists, advanced practice providers, but also physicians. And so trying to make sure that we are involved with building those pipelines, whether it's through the education, the training programs and so forth, and that we have robust recruiting and retention programs for the clinical workforce, I think is going to be a key trend that will define how successful we're going to be in the future.
- [04:58]
A
And I want to back up to what you just said about the one big beautiful bill, because it is something, it's been a hot topic, of course, across the industry. You know, coming into a new role like, like yourself and monitoring this, this act now, this, this legislation, have you just basically these last few weeks been, you know, kind of going through it, seeing how it will affect your organization, kind of. Can you walk me through kind of just your process with this?
- [05:24]
B
Well, a couple of different things. So one thing that's new to me is the whole academic medical side of, of the House. And so I am learning and getting up to speed. And this is not necessarily tied to the one big beautiful bill, but just in terms of how research gets funded across our academic universities across the country and so forth. And so that is something that I'm trying to get myself up to speed on a federal regulatory change standpoint. But with respect to the one big beautiful bill, I think the most impactful area of that bill that we're watching here in Virginia at UVA Health, but also I think the other hospitals are watching it as well, is how the changes in the Medicaid program will affect how the funding streams come back through the state of, of Virginia. So, you know, you've got 50 different states, they have 50 different Medicaid program configurations. And some of the changes in that legislation is basically going to lead to a more limited ability to draw down federal funds to support Medicaid in the states. And so how we can plan around and strategize how we can ensure that we can still get reimbursed a fair amount for covering the patients that we know we are committed to covering is absolutely critical to planning our financial future.
- [06:42]
A
Right. No, I appreciate you diving a little deeper there. I'd like to switch gears and hear maybe some of the things you're most excited about right now at UVA Health in your new role and things you're looking forward to maybe throughout the rest of the year into 2026.
- [06:56]
B
Absolutely. Well, as I mentioned previously, I'm really excited to broaden my own knowledge on academic medicine that is somewhat new to me. I've been in community health systems heretofore in my career. And so that's exciting and learning more just about the intersection points of higher ed in academic medicine. So that's really exciting in terms of the different lens that should provide me and my career path here at UVA Health. The other thing I think that is really exciting to me after being in sort of not for profit health care in other areas and across the state, is that I think we have a truly very inspirational mission of delivering high quality patient care to the communities we serve here, regardless of a patient's ability to pay. And we, by function of our nature of how we're structured. I mean, we are actually a public, we're a public university and the health system is owned by the university, which is essentially means that we are part of the state. And by virtue of that, we really walk the talk in terms of making sure that we have access points and we treat every patient regardless of the ability to pay. And I find that to be kind of inspirational in terms of our mission. So that's really exciting to me. And we get reimbursed according to that mission as well, which is helpful and it helps us be able to strategize and plan our growth strategies as well.
- [08:21]
A
For other CFOs listening to this, that might be considering a career path move from, as you mentioned, maybe more community health to academic health systems. Could you share maybe some advice just as you're just a few weeks in and getting acclimated?
- [08:37]
B
Well, I would say prepare for a bit more complexity if it wasn't complicated already. It gets even more complicated when you think about the intersection points of faculty and a university and the running of a health system and physician practices and things like that. So prepare for increased complexity. Also prepare that things don't move so fast through all that complexity. But that's, but with the complexity comes interest in learnings and the ability to sort of navigate new ways to be able to deliver the services that we are committed to delivering in a financially viable way. And so I think that is really exciting.
- [09:21]
A
Oh, that's some great advice there. And you know, you kind of touched on it a little bit. But could you share maybe how you are thinking about growth at UVA Health over the next 12 to even 24 months?
- [09:34]
B
Sure. And again, being somewhat new here, I'm still kind of, you know, really unpacking all the, the strategies that we have in play or are considering at this point in time. But I think sometimes, if I have to say, the mistake that, that maybe some organizations might make is, is that they think about growing for growth sake and maybe there's no deal that they don't like type of thing. When I think about growth and I think I think about really aligning with, you know, our mission, vision and values and not really whether we should grow, but how and where we should grow. So for example, you know, in my view, we should do it where it sensed to me, you know, it makes sense to do it. There needs to be alignment with those mission, vision and values and our long range strategic plan. But what does that mean in plain speak? It means that we should grow in areas where we can support the communities in terms of providing or maintaining access to quality health care in a financially sustainable way. In that may be where it currently exists and where we feel like we can add something. So, for example, maybe we can add operational expertise, maybe we can add workforce or clinical talent, maybe we can add our operating model or scalable technology. But we would want to grow in areas where we can add value in order to provide high quality clinical care to those communities. That's where I think it makes sense.
- [10:54]
A
Well, that does definitely make sense. Stephanie, congratulations on your new role. It was such a pleasure getting to chat with you. And I'm so excited to speak with you again down the line about all the exciting things happening at UVA Health.
- [11:06]
B
Wonderful. Thanks, Madeline. It's been great speaking with you as well.
- [11:08]
A
Thank you.