More on Operations

Letting go of the balance sheet

Tips for CFOs to survive the transition to value

The likelihood that healthcare organizations are going to take a financial hit as they transform from fee-for-service to value-based businesses is sure to cause CFOs anxiety and panic. Here are some tips for letting go of the balance sheet.

Get real. 

  • Give up clinging to the illusion of certainty, said executive coach Tony Mayo. Accounting is a black and white world and as such attracts people who like certainty. However, once you move from being a bookkeeper to being a CFO, you are dealing with the future rather than keeping track of the past. "We think we can control the outcomes, but we can't, so trade certainty for confidence," Mayo said. "Confidence that you can handle what is coming next. Rather than trying to control and constrain, let's learn how to respond and create."
  • Understand your purpose. "If you identify yourself with a particular number occurring on a particular day, you can't win," said Mayo, so get clear about your purpose as a human, as an executive and as an organization. All the inspirational materials gracing the walls of your facility? You should be living up to those every day, he said.
  • Manage expectations, said executive coach Samuel Dergel. CFOs are realists, said Dergel, and once they recognize and accept the reality of the situation, they get busy.
    • Firstly, they must get buy-in from the CEO and the board. "If the pressure from the CEO and the board is reduced or not there, or they're on the same page, then it's just a reality that they're facing and everybody has to move up to it," said Dergel. "CFOs face pressure based on things they can't control, but if the people they report to and have to work with understand that, respect that, and give them what they need to be able to deal with that kind of uncertainty, the stress is certainly less and that's, I think, the key to dealing with any turbulent times."
    • Get strategies that deal with the financials and the "politics." Once reality is faced, have conversations with your CEO and board to make clear what sort of resources and support you will need from them and how you will keep them in the loop as the organization makes the transition. "If they're not comfortable with how to manage the political or the relationship aspects, they should try to get help and not be afraid of it," he said.

Get help.

  • Don't go it alone. CFO can be a lonely role, said Dergel, and managing the "politics" strategy may be more of a stretch for CFOs. "They're technical, they're technical, they're technical, then all of a sudden they have to be real leaders and not every person has had the training or experience that allows them to step up to the plate and be a real leader within the business," Dergel said. 
  • Find someone to talk to. That could mean paying for the services of an executive coach, like Dergel or Mayo, or it could mean talking to your peers, said Dergel.
  • Get in touch with your values and live consistently by them. "Get out of the office and get away from the numbers and keep walking until you can find someone you can help. Then go back and do your job," Mayo said. "Then you'll be reminded why you do your job. It's not just numbers any more."
  • Try meditation. Mindfulness meditation may help you reduce anxiety and fear, which may help you to view problems from a different emotional state, said Andrew Hafenbrack, the lead author of a study on de-biasing decision-making through mindfulness meditation. "I think it's definitely still painful to incur losses," he said, "however, meditation quickly helps people feel less bad, and we have some preliminary data suggesting it may also increase patience." Meditation may help CFOs distance themselves from the grip of the compulsion of making short-term gains so they can accept the long view that needs to be taken in the transition to sustainable value. For free guided meditation recordings: