Thanks to hands-on experience in managed care and finance, Blaine Petersen has landed on his feet again.
In 1995, the accountant was forced out of a job as chief financial officer and vice president for managed care at Holy Cross Health Services of Utah, Salt Lake City, when its parent, South Bend, Ind.-based Holy Cross Health Services, sold its Utah operations.
Next, Petersen, who has a master's in business administration, tapped his managed-care contracting know-how and previous experience conducting Medicare audits at Blue Cross and Blue Shield of Indiana to land a position as vice president for managed-care contracting and strategy at Rocky Mountain Health Care Corp., Denver. But a year and a half later, the company's reorganization left him unemployed.
Today, Petersen works for himself. As a consultant based in Denver, he has carved out a business helping physician-hospital organizations get rolling and assisting HMOs with capitation agreements. Despite plenty of competition for jobs, "there's probably more opportunity now," he says.
These days more CFOs and healthcare finance professionals are finding themselves squeezed out of jobs as hospitals and health systems merge and restructure. Sensitive to the trend, the Healthcare Financial Management Association announced at its annual meeting earlier this month that it had begun developing a task force to help members find work and succeed in nonhospital settings.
Measuring healthcare finance job losses is difficult because in some cases after a reorganization a CFO will remain with the system but under a new title.
In a survey two years ago, the HFMA found that 15% to 20% of finance executives had been in their jobs for less than a year, a sign of job turnover. But the Westchester, Ill.-based association has no current figures on the number of jobs shed from hospitals and healthcare systems.
"It's a tough market," sums up Richard Proctor, a partner with the Morristown, N.J.-based search firm of Foley Proctor Yoskowitz. Healthcare administrators are competing with finance executives for the same jobs, he says. Students coming out of graduate programs have a leg up in the job market, in some respects, because they've picked a specialty, whether it's practice management, long-term-care administration or managed care, he says.
That's not to say CFOs can't find work in hospitals and health systems, but the available jobs may require a move. "These CFOs who get outsized or downsized wind up not so much in an alternative delivery provider . . . . but usually . . . . they go to a smaller market," says Vickers Chambless, president of Chambless Managed Search in Atlanta. "That's where the jobs are."
Petersen can vouch for that. "I got a lot of job offers in places of the country that I didn't want to go to," he says.
And while titles may be comparable, the pay may not. "My sense of it is they are losing compensation relative to the cost of living," Chambless says.
But having a finance or managed-care background clearly is a plus. Proctor says his firm is considering finance people for a variety of positions, such as practice administrators. Physicians, he explains, are looking for administrators with either finance or managed-care contracting experience.
The HFMA expects to fill its task force with healthcare finance professionals who have held jobs at hospitals and health systems and then moved to other settings, such as HMOs or physician group practices. The goal of the project is to identify products and services that will help finance executives make the transition to new jobs outside of the hospital.
CFOs who have made the switch stress the importance of possessing a variety of skills.
Suzanne Petru had been senior vice president of finance and treasurer at SSM Health Care System in St. Louis when she learned of an opening at Group Health Plan, a St. Louis-based unit of Coventry Corp. Although she had a steady job, Petru initiated the move, realizing managed care is where growth and opportunities lie. "I had been wanting to move from the hospital side into the managed-care side for two years," she says.
Petru joined Group Health as vice president and CFO last October with some managed-care experience under her belt. From 1982 to 1985, she audited HMOs for the accounting firm Touche Ross (now Deloitte & Touche). She also had been involved in SSM's managed-care activities.
"The skills are certainly adaptable," Petru says. "I had done managed-care contracting from the hospital side." But as she quickly learned, "it's not the same as being in an HMO."
For one thing, the types of reports produced are different. But the biggest area of learning, Petru says, has been medical underwriting. If you're accepting global capitation premiums, you have to understand the underwriting risks, she says.
"My advice to people who are looking for what they can do to be at the top level . . . . is to expand their knowledge base," she says. "Take advantage of educational opportunities to learn the insurance side of the business."
Tony Speranzo, another successful job-switcher, advises healthcare CFOs to rely on their strengths. After 11 years at St. Joseph Health System in Orange, Calif., where he served as senior vice president and CFO, Speranzo was ready to make the switch into investment banking and already had honed the skills he would need.
In the past three or four years at St. Joseph, he spent more than half his time developing the system's strategic growth initiative. Instead of letting bankers run the system's hospital and physician mergers and acquisitions, Speranzo put those deals together. He now serves as vice president and manager of corporate finance in John Nuveen & Co.'s Irvine, Calif., office.
"I think having a wide net of responsibilities in your current organization is extremely important," he says. "Just because you're a CFO doesn't mean you cannot be involved in other aspects of that hospital or healthcare organization," such as strategic development.