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New Mission Health CFO Targets Growth, Costs, Value, Efficiency

By Christopher Cheney  
   February 13, 2018

Top finance executive wants growth in complex-care cases, control of supplies and drug utilization, an ongoing shift to value-based care, and investment in technology to optimize revenue cycle.

After serving in a transitional role as deputy CFO at Mission Health, Paul McDowell, MBA, is now CFO and senior vice president of finance at the Asheville, North Carolina–based health system.

McDowell's deputy CFO role was created about two years ago in anticipation of the retirement of CFO Charles Ayscue, who stepped down in early January. The deputy CFO role was created to hand over responsibilities to McDowell over time.

Before coming to Mission Health in January 2013 as vice president of finance, McDowell was senior vice president and CFO of King's Daughters Health System in Ashland, Kentucky.

HealthLeaders Media recently spoke with McDowell, and the following is a lightly edited transcript of that conversation.

HLM: What are the primary growth opportunities at Mission Health this year?

McDowell: Complex-care cases. We want to grow at the top end of the acuity scale.  Over the years, we have developed programs in advanced cardiac care, for example, to alleviate the need for patients to travel outside of western North Carolina. We have also added pediatric specialties so that children and their parents can receive excellent care closer to home and avoid having to travel to Charlotte or Raleigh.

In addition to growth at our tertiary hospital here in Asheville, we are surrounded by five much smaller hospitals that are part of our system. We are focused on making sure they take on the lower acuity cases that can be safely and effectively treated in those more rural communities and closer to the patient's home. It's more convenient for patients.

We want to make sure we have our patients in the right setting. It is not only good for the patients but also frees up capacity at our tertiary hospital for more acute patients.

HLM: What are Mission Health's primary financial challenges in the coming year?

McDowell: Mission Health has a difficult payer mix. Almost 75% of our payer mix is Medicare, Medicaid and self-pay. Medicare, Medicaid and certainly self-pay have not increased their rates very much in the past few years; and with a small commercial component in our mix, it is hard make up revenue.

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


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