Monday, May 1, 2017

Richard W. Silveria, SVP of Finance and CFO of Boston Medical Center

Today's guest is Richard W. Silveria, the Senior Vice President of Finance and CFO of Boston Medical Center. Rich is the Senior Vice President for Finance and the Chief Financial Officer for Boston Medical Center. Boston Medical Center is a safety net hospital, with roughly 80% of its $1.2 billion revenues coming from Medicare and Medicaid. In addition to being a safety net hospital, it is an academic teaching hospital associated with Boston University’s medical school.

Rich has been the Chief Financial Officer since 2010. During his tenure he helped engineer a financial turnaround of the organization, and continues to strive to be a leader focused on driving change.

In this podcast we trace Rich’s career from a start in biology and education, through computer programming and financial systems through to today where he is a senior leader in the third largest health system in Massachusetts.

This is also our 50th interview on the Health Leader Forge! I'm very pleased to have such a distinguished guest to celebrate this milestone.

Links to the Podcast

Podcast Outline

Time       Topic
0:01:43 University of Massachusetts at Lowell
0:03:22 Choate Symmes Hospitals
0:04:35 transitioning to IT/financial systems
0:06:08 building home-grown computer-based financial systems
0:07:08 learning financial systems at the transaction level
0:08:09 financial systems manager
0:11:07 "Why don't you get an A in your job"
0:13:24 Lawrence General - financial crisis - building credibility
0:19:09 going from two to fifty employees - lessons in management
0:24:53 why MBA vs. MHA? Commitment to healthcare?
0:27:47 the difference between finance and accounting
0:29:45 moving up from Director of Patient Financial Services to VP of Managed Care
0:34:21 setting up the Lawrence General Physician Hospital Organization
0:35:34 challenges of taking on insurance risk without the tools
0:38:00 moving to Partners Healthcare - what is Partners?
0:41:11 Corporate Director of Revenue Finance
0:45:04 what was it like moving from a $125M organization to a $4B organization?
0:46:58 getting the Partner's job through networking
0:47:55 PT boat vs. a couple of battleships - an influence model, situational hierarchy
0:50:07 learning to listen better, becoming self-aware
0:51:31 Executive Director of the Compass Program - revenue cycle process integration
0:57:57 transition to Boston Medical Center (BMC)
1:02:47 Boston Healthnet affiliaiton
1:06:20 BMC Healthnet Plan/Wellsense - a Medicaid MCO
1:07:52 reporting structure for the CFO of BMC
1:08:40 relationship between the CFO and COO
1:11:50 CFO's staff
1:12:48 financial turn-around in 2010
1:13:23 supplemental dollars and cost shifting (cross-subsidization)
1:19:57 "You would never build this place based on net return on assets"
1:20:27 A day in the life of the CFO
1:23:33 what keeps him up at night - "in a word, uncertainty"
1:26:17 what do most people outside of finance misunderstand about finance?
1:27:12 healthcare finance has evolved to be a strategic asset
1:29:07 what do most people outside of finance misunderstand about finance?
1:31:04 leadership philosophy
1:35:25 what does he look for when hiring leaders?
1:37:14 a difficult leadership lesson learned the hard way
1:39:06 what advice we he give his early careerist self?
1:41:19 the importance of professional organizations
1:42:56 what do early careerists need to learn about finance?
1:44:07 why should young people pursue a career in healthcare finance?

Topics Discussed:

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