Todd Conklin, CFO of Care New England

In this episode, Todd Conklin, CFO of Care New England, shares key trends shaping healthcare finance, including policy shifts, the role of AI, and strategic growth priorities. He also discusses how the system is meeting community needs while navigating financial transformation and preparing for the future.

Episode Transcript

(00:00):
This is Madeleine Ashley with the Becker CFO
and Revenue Cycle podcast, and I'm thrilled to
be joined today by Todd Conklin, CFO at
Care New England. Hey, Todd. Thanks for joining
me. Thanks for having me, Madeleine.
Pleasure to chat with you. So I'm really
looking for to diving into our conversation. But
before we begin, would you mind sharing with
our listeners just a little bit about yourself,

(00:20):
and Care New England?
Great. Thank you. So my name is Todd
Conklin. I serve as the, CFO of Care
Care New England health system, which is a
health system
based in Providence,
Rhode Island.
I joined Care New England in 02/2023.
So I'm in my third year,
in my role with Care New England.

(00:41):
Care New England plays a pretty prominent role
in the Rhode Island health care market.
We have a concentration of services in women
and infant services, behavioral health services,
and general community
hospital services.
Oftentimes, hospitals and health systems measure themselves by
the number of hospitals
and annual revenue. We're a three hospital system.

(01:04):
We also have about seven operating units in
total, and our annual net revenue is about,
$1,400,000,000.
On a personal level,
I'm originally from
Chicago. I spent my first forty years or
so of my life in the Chicago,
land area in the Chicago Health Care market.
Traditional finance background,

(01:27):
I'm educated as, my MBA from Kellogg School
of Business at Northwestern
University.
I've always felt pretty fortunate,
to serve in health care. Our industry helps
people, at really some of their most vulnerable
times.
We do a lot of good in the
communities in which we serve, and again,
very happy to be part of it.

(01:48):
Wonderful. Thank you so much for sharing your
background there, Todd, and a little bit more
about Care New England.
So I'd love to dive in here with
this first question. Obviously, the health care industry
is an ever changing one. And so I
would just be so curious to hear maybe
two to three trends that you're closely following
right now and maybe why these trends are
so important to you and your industry?

(02:11):
Yeah. It's a great question. And I think,
you mentioned,
that is an ever changing industry, and we
certainly feel that now.
Probably the first, you know, the most important
two or three trends that,
I'm currently following, and it won't surprise you,
but the executive orders from the new,

(02:31):
executive presidential
administration,
those being
Medicaid reimbursement cuts,
federal research cuts, and and limits on the
indirect cost reimbursement.
As you know, I work in a geographic
area,
health care market with a disproportionately
higher share of the Medicaid population.
In our line of work, we take all

(02:52):
comers and and work to meet their health
care needs. So,
Medicaid reimbursement
is certainly relevant to my health system and
relevant to my community.
I also worked in academic medicine, so research
and grant funding,
is also very pertinent to, my day to
day.
The other trend, which I think is,

(03:14):
exciting and one that I follow is
artificial intelligence,
in our industry.
AI is being used in a wide variety
of ways,
interesting ways these days,
diagnosis and imaging. So we we now have
algorithms that analyze X rays and MRIs and
CT
scans,

(03:34):
predictive analytics,
within electronic health records,
identifying
at risk patients,
you know, that which ultimately supports early
intervention,
personalized medicine, tailored treatments based upon a patient's
genetic makeup,
and then administrative
tasks, medical transcription,

(03:55):
billing documentation,
all pretty exciting developments in our industry, and
I'm trying to follow it closely.
And then lastly, I think, with a lot
of the
within the health care capital markets,
you know, the whole access to capital for
health care systems across the country amid,
challenged or shrinking margins. Those are probably three

(04:17):
trends that I'm watching very closely these days.
Yeah. And I'd like to circle back, you
know, to the first
trend that you said you're following.
I would just be curious to hear, you
know, just in terms of potential Medicaid cuts,
maybe some contingency plans that you have in
the works right now at Care New England
or or just how how you're monitoring during

(04:37):
these, potential policy changes closely and, you know,
coming up with plans of of attack if
needed.
Yeah. Great question.
Part of the trend or that that trend
that relates to,
research,
reimbursement
cuts and,
indirect cost reimbursement
around research grants.

(04:58):
Those are
part of the challenges that I think,
have quantifiable,
easier to quantifiable
impacts to health care organizations.
And,
you know, I believe that although they will
represent challenges of ultimately,
the tentative cuts that are being discussed actually

(05:18):
go into effect.
There are some solutions for them, albeit challenging,
organizations,
can can track to,
potentially provide,
less,
research.
There are more easily identifiable
solutions to those. The Medicaid cuts, as you
indicated, and I think the magnitude of the

(05:40):
cuts,
that were being discussed tentatively,
I think would be so catastrophic,
in the industry,
in particular
to those health systems like Care New England
that has a disproportionately
higher,
share of the Medicaid population.
I think those,

(06:00):
solutions will be very,
difficult
and overwhelming
for health system, not only in my immediate
market of the Northeast or Rhode Island, but
really nationally.
No. Thank you for diving a little deeper
there.
And, yeah, I mean, really, all you can
do right now is just kind of wait
and watch and and just come up with
potential solutions. Right? You know? Yeah. Yes. Definitely.

(06:24):
So I kinda wanna switch gears a little
bit here. I would love to hear maybe
some of the things that you're most excited
about right now at Care New England, maybe
any plans with for partnerships,
collaborations,
just looking down the line in in 2025.
Yeah. Thank you. You know, I'm probably most
excited about our operational,

(06:45):
and financial
transformation.
You know, we have a, as I indicated,
a prominent position within the,
Rhode Island health care market.
And, you know, we've continued to grow most
specifically over the past two years,
growing in discharges,
in neonatal intensive care unit discharges,

(07:06):
our behavioral health
services, emergency department visits, and surgical services.
Oftentimes, people measure themselves by growth.
My particular interest in it is it validates
that we're meeting the needs,
of the communities in which we serve. You
know, there is a great need about
eighty two percent of the babies that are

(07:28):
born,
in Rhode Island are born,
within women and infants hospital, which is one
of our hospitals.
We have a very predominant
offering of behavioral health services in the community.
So it's more about,
being a good corporate citizen,
a good asset within the community, and making
sure that we meet the needs,

(07:49):
of the patients that live,
in the Rhode Island area.
We've also stabilized,
you know, a past period of economic challenges.
You'll be familiar with the challenges that many
health care systems,
experience during COVID,
and the recovery in the post COVID period.

(08:09):
We've had two years of financial success,
as a health system. Our bond rating outlook
improved, which makes us a bit more credit
worthy,
and we're able to invest,
in programs, invest in facilities,
and equipment.
And we've got, you know, you indicated
productive partnerships. We have many productive partnerships,

(08:31):
within the state of Rhode Island,
with,
some of our business partners,
some with other health systems within,
the Rhode Island market. But the one that
I hold out most,
is our productive partnership,
with the state of Rhode Island that we
partner with,
in many, many productive ways to provide services

(08:52):
and making sure that we're meeting the needs,
of the patients that we serve.
Yeah. And it's nice to hear too. I
you know, you touched a little bit on
just labor and delivery birthing, you know, your
your hospital. What did you say? Eighty two
percent? What was that number again?
Eighty two percent of the babies are born
at women and infants hospital. Yeah. That's really
great to hear because I feel like one

(09:12):
of the challenges in health care right now,
something we've covered heavily at Becker's,
is some of the labor and delivery units
closing across The US. So,
you know, definitely an important part of the
the health care puzzle, if you will,
maturity. Indeed. It is. Yes.
You know, you touched on growth, you know,
even throughout the rest of the year. But

(09:32):
how are you kind of spearheading and looking
at growth maybe even over the next
twelve to twenty four months?
You know, it's a great question.
You know, our our best day,
in growing in,
within Care New England health system is when
we align with the needs of the community.
And we're also keeping in mind,

(09:53):
that we're a tax exempt
organization, and we need to keep sustainability
in mind with all the decisions. But I'd
probably call out,
three areas,
of growth that,
we know,
also align with the the needs of the
community. Primary care.

(10:13):
Care New England is investing in primary care
and primary care physicians,
and specifically within our primary care network.
In this broader market,
and also within the Northeast,
primary care and access to primary care has
been a challenge,
for a number of years. It's probably heightened,
at this point, but Care New England's growth,

(10:36):
has certainly been aligned with our ability to
provide greater access,
with primary care services.
I'd also touch on behavioral health services,
that are needed. And
this past year, we
opened a new short stay unit,
within Butler Hospital within
Care New England. And,

(10:58):
really, it was immediately full,
and we partnered with the state, partnered with
the federal agencies for funding,
of that, unit. But we brought it online
this past June, and it's been immediately full,
which is a good sign that the services
that were needed sometimes we make,
assumptions,

(11:19):
in our planning activities, and this one has
been a very good one because it's
been highly utilized and it meets the needs
of the community.
Lastly,
I would say emergency department services
are another area where we sense that there
was demand. So much so that one of
our hospitals, Kent Hospital,
in the last year has implemented a no

(11:41):
diversion policy,
to where we just do not allow,
Kent Hospital to Kent Hospital's emergency department to
go on diversion.
And it creates or requires
increased planning and operational excellence, but,
when patients come to Kent Hospital,
to the emergency department, they will be seen.

(12:03):
And it's been very productive,
and very satisfying for patients,
in the Rhode Island,
marketplace. But those are probably three areas, Madeline,
that I would say were focused on growth.
But, again, we want foundation to foundational to
that, is ensuring that it meets the needs
of the community. Well, that's great to hear,
and I appreciate you,

(12:24):
you know, sharing and diving a little deeper
there just in terms of growth of the
system. My final question before you hear today,
and it's one I do like to often
ask CFOs as we talked about ever changing
industry. And with that c suite roles in
hospitals and health systems also have to acclimate
and change, how do you foresee the CFO
role evolving maybe in the next three to

(12:46):
five years?
That's a great question.
You know, I I think as a a
CFO that's been doing this for
a long time,
I believe focusing or continued focus on,
you know, we're not in the finance business.
We're in the health care business. And

(13:06):
if I can
commit a very large percentage
of my time
supporting our clinical teams, our operational teams,
I can have a high degree
of confidence
that we will achieve success within our organizations.
Paying attention,
to,

(13:26):
the mission of the organization
on serving the community
and finding sustainable ways within health care to
do that. Eaking out a small enough or
an, adequate enough margin to continue to to
reinvest,
and meet the needs,
of the operation, I think are are very

(13:46):
helpful ways for people in my role to
to serve the health care organizations.
Yeah. Some great forward thinking insights there. Todd,
I truly appreciate you hopping on this podcast
with me today.
It was a pleasure chatting with you, and
we'll have to get you back up to
Chicago sometime soon.
Maybe a Cubs game.
Yeah. Amen. Thanks very much, Madeline. It was

(14:08):
my pleasure. Thank you, Todd.