When Boston Medical Center needed a reimbursement specialist to rev up its collections four years ago, it turned to Mark Goldstein, who had a go-getter reputation from his work at three Massachusetts hospitals.
But Goldstein flatly rejected a job offer there. Boston Medical Center had been formed just a year earlier by the merger of public Boston City Hospital with an academic organization, Boston University Medical Center, and it was losing money.
"It didn't have a strong balance sheet and didn't have good financial direction," Goldstein recalls. "Their (chief financial officers) were turning over left and right. I didn't think I could be successful in the organization without knowing who the CFO was going to be."
Boston Medical's president and chief executive officer, Ellen Ullian, didn't give up. In 1998, she finally persuaded Goldstein to leave his post as director of financial planning at Winchester (Mass.) Hospital, after hiring one of his former bosses to be her CFO.
Goldstein, 38, is now the medical center's director of payment systems, a position that reports directly to the CFO.
As it marks its fifth anniversary this year, Boston Medical expects to have its first operating gain. Goldstein, who posts the hospital's managed-care settlement letters and financial news coverage on his wall, couldn't be prouder. He calls the turnaround "very exciting."
Under Goldstein's revenue-capture initiatives, the hospital has reduced the average time it takes to collect payments to 54 days, well under the average days in accounts receivable for Massachusetts hospitals-64, according to the state hospital association. Ullian also credits Goldstein with getting 90% of the hospital's claims paid within 90 days. "These are huge achievements," she says.
Goldstein stalks uncollected dollars with the intensity of a bloodhound. His strategy is simple: Arm yourself with good data and persist. "I've learned a long time ago it's much easier to create revenue than to cut expenses," he says.
Colleagues say Goldstein is a supreme tactician with tremendous drive and a passion for solving problems. He's also a really nice guy. "A lot of times we see people in finance that kind of go through the motions, and they become negative. Mark didn't get negative," says Stephen Laverty, president and CEO of Northeast Health Systems in Beverly, Mass. Laverty was CEO at Winchester during Goldstein's tenure there.
Months after his arrival at Boston Medical, Goldstein's role was expanded to include negotiating managed-care contracts and overseeing the hospital's relationships with government payers, which account for half of the facility's revenue. Though Goldstein is a natural candidate to be a CFO, one thing had stood in his way: his lack of an advanced degree.
The son of a warehouse foreman and a nurse's assistant, Goldstein says he was the first member of his family to graduate from college. He earned a bachelor's degree in health administration and accounting at Worcester State College in 1985. The hardest thing he's ever done, he says, was returning to school in his mid-30s to earn a master's degree in business administration while continuing to work full time and be a father to two school-age girls. He completed his degree from Boston University last year. He says an MBA has made him a better manager and helped him to become more involved in hospital operations.
Colleagues expect Goldstein soon will achieve his goal of joining the ranks of the state's hospital CFOs.