In this episode of Master Your Healthcare Career, we welcome Todd Nelson the Chief Partnership Executive at the Healthcare Financial Management Association (better known as “HFMA”). Todd leads HFMA's partnership strategy across healthcare industry sectors. HFMA is the leading association for healthcare finance professionals, serving 106,000 members in 67 chapters in the US, and has affiliations worldwide.
Before joining HFMA, Todd was the Chief Financial Officer of a rural Midwest hospital for over 15 years. He serves on several boards and academic committees. Notably, Todd is the Board Chair for CAHME for 2023-2024.
In this session Todd provides key success paths for early careerists including:
1) How being certified from an association such as HFMA and graduating from an accredited program from CAHME provides your employer with a higher level of “surety” that you can get the job done.
2) How to establish a network that serves as a “treasure map” to navigate the evolving healthcare landscape.
3) How to work within an association chapter to attain experiences that stretch your skill set.
Listen now!
In this episode of Master Your Healthcare Career, we welcome Todd Nelson the Chief Partnership Executive at the Healthcare Financial Management Association (better known as “HFMA”). Todd leads HFMA's partnership strategy across healthcare industry sectors. HFMA is the leading association for healthcare finance professionals, serving 106,000 members in 67 chapters in the US, and has affiliations worldwide.
Before joining HFMA, Todd was the Chief Financial Officer of a rural Midwest hospital for over 15 years. He serves on several boards and academic committees. Notably, Todd is the Board Chair for CAHME for 2023-2024.
In this session Todd provides key success paths for early careerists including:
1) How being certified from an association such as HFMA and graduating from an accredited program from CAHME provides your employer with a higher level of “surety” that you can get the job done.
2) How to establish a network that serves as a “treasure map” to navigate the evolving healthcare landscape.
3) How to work within an association chapter to attain experiences that stretch your skill set.
Listen now!
Thank you, melissa, for that introduction and want to welcome everyone today to our special guest, todd Nelson. Todd is the current Cami board chair and his full-time job is the chief partnership executive with HFMA. So, todd, welcome to the session today.
Speaker 2:Thank you, anthony and thank you Melissa. It's great to be here and always excited to talk about health care and leadership and finance and talk about Cami, so all of my favorite things.
Speaker 1:Mine as well. So let's kind of start with that, todd, which I think would be helpful for people to understand our listeners to understand a little bit about your career journey and how that led you to your role at HFMA.
Speaker 2:Thanks, yeah, yeah, so it was interesting. My first job was working in a medical supply warehouse and so I started kind of understanding supply chain and the terminology by working in a warehouse and a few years into that my boss said you're going to go to college and we have people that maybe aren't going to go to college, so maybe you want to get more of an office job because, frankly, there's other people that could use this work and we love having you. You're doing great. But I know some people at the University of Iowa in the business office for the hospital. I made an introduction Maybe you'd like to do that and I said well, I don't know if I want to work in a hospital. I kind of like the guys I work with now and this is great. I mean, I'm not getting fired, am I? No, no, no, we're just suggesting your career trajectory might be different than some other folks that work here that'll work here the next 40 years. So I took a leap and while I started at the University of Iowa, I started working in the University of Iowa hospitals and clinics in the business office and learning the business aspects of health care, and did that through undergrad, had a lot of great opportunities and it's usually that someone helped me along that journey, whether that was working on some of the original in vitro fertilization grants and helping look at that when the University of Iowa was innovating in that space. Whether it was doing the what we now call revenue cycle, but we used to call billing back in the day and then worked with the volunteers that helped with the foundation. So for anybody that's familiar with Iowa football and the wave that happens to the Children's Hospital at the end of the first quarter, one of our first projects was working with folks, walking them as student ambassadors through the facilities to try to build that hospital. You know, learning how to meet with individuals that were established and kind of the discussion and the language that you use with that.
Speaker 2:And and from there out of the blue, I got a call from a headhunter when I was graduating, after working at the University for about a year, and said hey, you know, I don't know if you're interested in going anywhere, but we have a position that we think you should apply for. It's in a place called Grinnell, iowa. And do you do? Are you familiar with Grinnell? And I said Well, when I drive from Iowa City to Des Moines, grinnell is about the midway point and they've got an amazing college there, grinnell College. But I've never really spent a lot of time and so I, needless to say, I went, I interviewed for the job, I drove around the town and everybody waved at me and I was like this is kind of like my hometown of Iowa City, like everybody's like hey, and I remember thinking, do they know who I am? Like? Is this like one of those you know old movies, a Hallmark movie, where they've got like everybody there kind of waving at you.
Speaker 2:So I felt very, very much at home and throughout my tenure in Grinnell at Grinnell Regional Medical Center, we got to see a lot of expansion of services. We had to see a lot of you know new buildings and all those kinds of things. Eventually I became the CFO, after taking on more and more responsibility, and a lot of that was done by people that had been in a position, a CFO position, for a period of time and served as mentors for me. I remember my first real big meeting I went to was an HFMA meeting. So my HFMA journey started 1991, so a few years ago. And I sit at the meeting and there is the CFO of the largest heart care multi-specialty clinic in Iowa, the CFO for the largest then hospital in Des Moines, iowa, and the CEO of HFMA, dick Clark, and I'm eating lunch at a table with them and they said you know, you need to be a member of HFMA and you need to be active. And I went wow like.
Speaker 2:These are the giants, these are like my heroes of the industry. And you know, I still was working in Grinnell and then an opportunity came up to work at HFMA. I had done some advocacy and committee work for HFMA, I had done it for AHA and I just felt like Grinnell was such a great opportunity. But I wanted to take the knowledge that I learned and the style of mentorship and leadership that people had taught me and do that on a bigger scale. And so when HFMA had an opening, I applied for it and was lucky enough to get it. And I've been with HFMA now almost 15 years and it has been a great journey from, you know, beginning a very technical director role where I was analyzing IRS rules and trying to make sense of them and interpret them and put them into plain language for people and I still do some of that to leading our education teams, all the different types of education that we have.
Speaker 2:And then, you know, now my role as Chief Partnership Executive is really to work with academic organizations, universities, colleges, workforce development type folks, as well as other associations to think about health care or health. Many times it's from the finance perspective, but usually it's from a broader perspective. If that's population health or value-based care, it's beyond just finance, and so I've been very fortunate throughout my career. As you can tell, I'm a little excited about it. I mean, I really like what I do and I feel very fortunate that people have always been there to help, to guide me, to offer me advice, and I think that's really the responsibility of all of us as leaders, to do that as well.
Speaker 1:Yeah well, and you know, it's interesting because you talked about meeting Dick Clark and kind of that lunch or that event where you were, you, Dick Clark and other CFOs there, and Dick was a former Cami board member many years ago and it's gotta be neat to kind of think about. Hey, I'm kind of following in those footsteps and I'm doing a lot of the same things that my mentors, your mentors, did for you.
Speaker 2:Well, it is great. I mean you know, from Dick Clark to Joe Pfeiffer, was a Cami board member, the next CEO of HFMA. I feel very fortunate to be able to sit on the board of Cami to chair it currently. You know, now we've got another new CEO, anne Jordan, who you know has got a great focus for us on the member, on the industry, on education. So I feel like this opportunity that I have had, that HFMA has had, the Cami has to really set the standards for the industry and ensure that we are all giving back and that we're all living up to those standards, is really just a. It's an exciting time, I think, for all of us.
Speaker 1:HFMA plays a really important, pivotal role in healthcare and you know, I think a lot of people who are not in the finance space don't really understand what HFMA is. And you know, I remember a few years ago HFMA actually did change its name from the Healthcare Financial Management Association to just those four letters HFMA. So what tell me? Tell me what HFMA is. What is their role?
Speaker 2:Yeah. So you know, our thought process is to be, in essence, the indispensable, unbiased source for healthcare finance, and so we, primarily, are an educational association. So we don't lobby as an example, and so, although we certainly advise and we have an opinion, when we talk to the IRS or to CMS or CMMI about rules and regulations, do we have an opinion? Sure, we absolutely have an opinion, but how we share that is through an educational lens, and so we are working with them on proposed and new rules, we're providing guidance, we're interpreting them for them, but also for our members as well, and so a lot of what we do is education through e-learning, through webinars, through live events, through facilitated roundtable discussions, trying to think about the industry as a membership organization. You know we're excited because we've grown. We're, I think, over 106,000 members now. We've got 60 plus chapters across the US.
Speaker 2:We have a sister organization in Australia and the UK, and so we're just really thinking about how do we bring the expertise and the knowledge that we have to the industry to raise the bar, and you know we do it through education. We also do it through many certification programs that we have. We have multiple sets of credentials and certifications. That helps to share with the field, that an individual that has gone through that and earned that credential demonstrates practical knowledge in the field of that specific discipline, whether that's revenue cycle or business intelligence or accounting and finance or as an overall healthcare professional. We have those there so that when you're trying to make a decision to hire someone and you're not sure because maybe they don't have experience but they've got a credential that means they have some of that practical knowledge that they earned. So we spend a lot of time on credentials and then trying to think about new certifications and new credentials that people can learn as the industry changes and expands over time.
Speaker 1:The educational component within HFMA relative to those certifications is really an important part of it. One of the things that I've noticed with HFMA one of the knocks about associations is associations move people to the status quo. What I've seen with HFMA, and with Joe Pfeiffer and Dick Clark before them, is they're actually pushing the bounds and they're working to make their members better, make their members understand the changes in the trends in healthcare and preparing your members to be exceptional financial executives.
Speaker 2:Well, I appreciate that you said that, because I think we talk a lot about the push and the pull in an association. You're right, we're not trying to keep everybody at the same level. We're trying to push them to want to improve, to incent them to learn more. I think about our value project that we did over a decade ago. That was going to talk about this new thing called the transition to value-based care. We still look back at that. We go man. That's still relevant today because we're still not there. It's about thinking through the people process and technologies needed to move to that next level. We like the opportunity to hear from our members, to understand what their pain points are and then help them move along the road on that journey.
Speaker 1:I remember the value-based project and the amount of effort that went into that part, Really how you educated the financial world to be prepared for it. I think the other part for me that was really fascinating to watch at HFMA was Joe Pfeiffer and his push toward price transparency, which to me was so forward-thinking and so important for the industry to hear.
Speaker 2:We have talked about Chargemaster, simplification, patient-friendly Billing decades ago to patient financial communication, price transparency All of these areas that are important not just for finance leaders in the industry but the patients and their families. A lot of people are like why would you, as a health finance that's focused on hospitals and health systems and health plans, why would you talk about working with the consumer? We would talk about it because they're our customer. We know it's complicated. We know the terminology is full of acronyms. Our job, our role, is to help people understand that. Let's try to make it not just transparent so that people see it, but understandable To us. Simplification, understandability of a complex topic is important.
Speaker 1:Understandability and logic. I think, like most of our listeners, it just got a medical, an invoice from a hospital, and it was a $1,200 charge, of which $60 was reimbursed to them. You look at that and go consumer. Does that make sense? I think a lot of what HFMA is doing around that with the Chargemaster and part is really moving the field forward. It's exciting, it really is.
Speaker 2:I think about it like you're at a certain department store I won't name names, but you look at that shirt that you think is pretty cool and it's $84. You're like $84. I can't pay $84 for that shirt. But you're like oh, I really want it. It says there's discounts available or something, but I'm not sure. You go to the checkout and it's $22. And, by the way, you get $10 with the coupons to spend the next time. So it ends up being $12. And you're like I mean, I'm confused. How does this work? How do you make money? But that's probably a simple example of how a much more complicated health care system works.
Speaker 1:You talked about a whole lot of things and I want to unpack some of them and let me go to one. I'm trying to figure out which one do I want to hit on first. Let me go on the certification, because I think the HFMA certifications and the lifelong learning that you're engendering within is so important. But, as you know, cami does accreditation, so why are both important?
Speaker 2:Yeah, so you know we think about the certification programs and the lifelong learning. Whether you're an early careerist, whether you are not even kicking off your career yet but you're somebody that's interested in healthcare. Whether you're a mid-careerist and you're thinking I've been in banking forever but I'd like to move to healthcare, but how am I ever going to get a job in healthcare? I need to demonstrate some competence. Or if you're somebody that is more tenured in your career and you're looking for a promotion or advancement, something like that. The certifications again offer the ability to demonstrate knowledge in a certain area and I think you know we've built them that way. We've built them such that you take the content, you understand the content and then you have an assessment that helps you to determine that you know and you know.
Speaker 2:I think of Cammie's role when I think about how Cammie looks at the field and the competencies and the skills and the knowledge that's required and sets standards related to that to try to ensure that the bar is raised. And it's not that the field isn't already doing an amazing job they are but somebody somewhere needs something, whether it's a program or an individual, to say you know, you're meeting a certain level, that's been set a standard that's been set. So if it's through Cammie and it's a standard that's been set, you know that that program meets those standards. Or if it's as an individual, and I need to demonstrate I'm proficient in revenue cycle and a certification meets that standard, and so it's really.
Speaker 2:You know they're very similar from what we're trying to do from a content learning, teaching perspective, with a certification credential badge that says yep, we got it, and the badge of Cammie that programs earn, and we know that you know the badge is important for programs to earn. So from a Cammie perspective, we also know it's not easy. You know. We know that this isn't just show up and whoop, yep, here's the gold star, congratulations. We know programs put a lot of work into it to meet those standards. They're difficult to meet but appropriately so. To ensure that when I'm a student or an employer that is looking to determine the background and skills and talents and the level of rigor that Cammie accredited demonstrates that there's a level of rigor there for that program and I think that's you know. I think that's really important.
Speaker 1:Yeah, to me what it does is it also provides a level of surety to your employer. If I'm a fellow in HFMA, that means I've gone through the rigor of learning all about different components of finance within healthcare, from supply chain logistics all the way up to revenue cycle, and I've known that I've at least been exposed to that and have been educated and been certified by HFMA.
Speaker 2:Absolutely. And the cool part secondary part of the fellow is you've also been a leader and given back to the industry. So you can give back through a local chapter, you can give back through speaking and presenting, you can give back by being a faculty member. I mean there's a lot of different ways. So it's yeah, I learned the stuff and took an assessment and passed, but then I took that knowledge and I did something with it and to me that's the mark of a fellow is somebody that has gone above and beyond and given back to the industry, whether that's formally through being a faculty member in a program or it's serving as a chapter leader. There's just a lot of different ways that people can give back to become a fellow.
Speaker 1:I love that concept of giving back and that's going to kind of lead into the discussion I want to go to next with you, which is around the chapters. So one of the things that I always, when I talk to students talk about how to be successful, and what I say is don't network, don't network, but help someone. And I think one of the great ways to help other people is through the chapter kind of process and, especially as an early careerist, beginning at the chapters is such a core part of what you want to accomplish as a professional. So talk a little bit about the chapter process.
Speaker 2:Yeah, the chapters are really interesting. They're a great opportunity and incubator for people to get involved, to understand from the experience of others in the industry all aspects of the healthcare industry. So if I'm a student, I get a network with people that maybe will be an employer someday. But I also get a network and just understand what are the important issues that the industry is facing and I get to share what my thoughts are on it. So you have the ability to influence and bring your experience and when I say experience, everybody's got experience personal experience, professional experience and talk with people about it and it's a wonderful way to demonstrate your ability to hold a conversation, your ability to raise your hand and get involved and a lot of the chapter experience as well, because they're formal, they have a formal board of directors, they have committees for people to get involved. It's a great way for a student, but also people in the profession working at whatever stage of their career, to demonstrate leadership ability.
Speaker 2:And the executive committee roles in the chapter the board, member, chapter roles, the committee you get to learn a whole set of leadership skills, frankly, that you don't when you're working per se. Right, you're in your job and you have so if you made it to manager, that's great, but maybe you're not a manager. Maybe I'm a staff accountant playing a very important role, but I don't get an opportunity to lead a meeting. I don't know what putting a budget together is per se, or how do I organize a group of 150 people to come to a hotel and a program. I mean. It really allows you to demonstrate and learn some leadership capabilities. So the chapters are a great source and it also grounds the folks in the chapter in local issues but also helps serve as a feeder for the larger organization to understand what are those local issues and are there commonalities across states and regions so that on a national basis we can learn from them and head in a direction that helps everyone.
Speaker 1:As a former not HFMA chapter leader, but as a former leader. Somehow I became the president of the Healthcare Planning and Marketing Society of New Jersey, which was a really kind of pivotal experience for me earlier in my career. But you learn how to lead with referent power and you don't have direct authority over anyone. That's kind of volunteering in this, but it's how do you get people on board and marching toward a common goal without any direct lines of authority, hiring and firing and salaries and all that stuff. But how do you get people moving along? And I think that's really one of the big for any students kind of listening out there and going. How do I learn the skills? Think about joining a chapter and getting involved.
Speaker 2:Well, and volunteer leadership through HFMA, I think, peaks people's interest in leadership in general and maybe they'll get that opportunity at their employer, wherever that is. But more often than not, people working in healthcare leadership are also leading a bunch of community-based organizations, whether that is your religious organization, whether that is your sports organization, whether that is the soccer, softball, track, football, whatever team of your children, whether that's or a campy.
Speaker 1:Yeah, or a campy, or a campy.
Speaker 2:Right, and so I mean it provides that opportunity and that spark for you to say I kind of like this way of giving back to. I like volunteering and some people want to volunteer at Habitat for Humanity and go build a house. Other people want to volunteer their expertise from a leadership perspective, helping to run a nonprofit organization, and I think it's a great opportunity for both of those and, frankly, it's a great opportunity working with Cammie on the volunteer board and doing that as well. I mean, it's just it's amazing to see what this group of board and committee and structure and how committed they are to the profession and to the industry. And I always think about the phrase we use our powers for good, and I mean with great power comes great responsibility. And I think Cammie as a board and staff and committee really understand how important work that we are doing and we're listening and we want to continuously get better. So I'm just thrilled to have the opportunity to be part of Cammie and to have been part of Cammie for years now.
Speaker 1:No and Todd, I served on the board of Cammie prior to taking this role, in a similar way that you did as a volunteer, and the part that really blew me away about Cammie was watching all of the intensity that people look at when we review a program, and it's an earnestness, it's an honestness, it's making sure that students are well prepared to lead, and you see that from practitioners like yourself who volunteer at Cammie. You see it from the academics that are involved and you see it from the programs that are helping other programs get better. It really is a neat role to kind of see.
Speaker 2:The detailed process that folks go to, that the Cammie staff, the site visitors, the fellows, everyone goes through along hand in hand with the programs to look at the standards and sure people are prepared. That is probably the thing that has most surprised me the level of detail that folks go through and the level of scrutiny and discussion and debate and collegial all those things to ensure that those standards are met. I mean, I am so impressed by the dedication of everyone, whether I'm a program, a dean, a president of a school, whether I'm a student, whether I'm a Cammie staff member, whether I'm a site visitor, just the passion and preparation that people have is really tremendous.
Speaker 1:No, absolutely. Well, before I conclude, I do want to talk to you about one university that you've gotten involved with a lot and HFMA has a partnership with, and that's Boise State. And Boise State was the winner of the Cammie George and Reggie Herzlinger Award for Innovation and Healthcare Management Education in 2023. And Jenny Gutapati is just an amazing leader of that organization. What led HFMA to say, hey, we want to partner with Boise State in here. What was the genesis of that?
Speaker 2:You know, I mentioned the value project that we did over a decade ago and We've been thinking a lot about the desire to truly partner from the beginning with a program, to be partners in a master's level degree. We do a lot of partnerships that are workshop related or conference related. We partner with other academic organizations around content and adjunct faculty and those things. But we really wanted to in essence to use one of those cool buzzwords co-create a master's degree program with another organization. I met Jenny through a colleague and we started talking about it and they thought this would be interesting to work with an association. And so we've got an academic institution and association started day one together building this program. So we built it from the ground up together and for us it wasn't just to say that we could do it, but it was also to ensure that faculty and others had experience in the field so that the students would learn from people currently doing the stuff they're talking about. And so when you're learning the actuarial science, you are talking to an actuary from a health plan that is currently looking at those tables. So I'm like it is really what's happening. When you're talking about business analytics and quality, your faculty member is a business analytics quality person working in the world of association, quality and analytics. I mean, these are the people, and so that's kind of what we wanted to do and create.
Speaker 2:We also were excited because we thought, well, what if we would get, I guess, lectures every week from the field also to continue to? So, yes, there's definitely academic rigor, don't. Don't. Don't kid yourself if anybody thinks, oh well, it's just a bunch of videos and things. No, no, no. I mean this is a master's degree level program, but we added all of these guest lectures. I think we have over 80 throughout the program that come in so you're learning about strategy from one of the key strategic thinkers.
Speaker 2:I mean, it's the way we designed the program and and frankly it was I'm almost speechless thinking about the George and Reggie Hurslinger Education Innovation Award. We are so proud to earn that, not just because we thought it was pretty innovative, but to be validated. That someone else thought it was was pretty amazing, and for it to be part of Cami as well I know Jenny was. She was beside herself when she heard about it and she and I have this energy level that seems endless on days, but we love this opportunity to partner with Boise State and it's it's been a great journey. And the students that we're getting and the outcomes and they are I mean we call it a transformative degree and they are the health care transformers and I'll tell you what they are ready to transform the industry. So we're excited. The first cohort graduates this December actually next week so it's it's been a great journey so far.
Speaker 1:Well, I you know you talk about Jenny's passion. It was one of the coolest calls I've ever made. When I called her up to congratulate her for winning the award and tears just flowed and I think it was. It's certainly a passion project for her and she just was was really happy to kind of hear that this external organization felt that she was really doing something pretty cool.
Speaker 1:Well, let me let me kind of pivot and I know we're coming to the end of our time right here. And, todd, at the very beginning you talked about working in central supply at a hospital and one of the things that I remember very early in my career when I was doing my administrative residency was going into the bowels and it really literally was in the bowels of graduate hospital. I forget the steps we had to go down in the elevators and separate areas and this huge kind of cavernous place with every supply ever within a hospital was in there. It's an interesting part that that's where you began your journey. If you were to talk to a student right now who really wanted to make a difference in health care and you had to give them some advice, what would that be?
Speaker 2:Take every opportunity that's presented to you. So if someone says, hey, would you like to sit in on this meeting, the answer is yes. Even if you don't like meetings, and even if you don't know anything about the subject, the answer is yes. When they ask for a volunteer to do something, don't be afraid to volunteer, because that's how you're going to learn, even if it's out of your comfort zone. I just think those are two really important things, and the third one I would say is be patient, because we all are motivated, excited and ready to change the world.
Speaker 2:But sometimes our desire to change the world doesn't match up with the opportunity to change the world, and it's really hard, when you're motivated and excited, to be patient. In fact, it's really hard to be patient. That is one of the things that is the most difficult for me, because I'm an excitable, ready to do something to change the world person. Patience is difficult, but I just remind them to keep it in the back of their mind because good things do come. It may not come exactly the same way, but I think that's the most important thing. I think that's the most important thing. It may not come exactly when you want it to, but relish the opportunities you have now, learn everything you can volunteer, be patient and eventually I really do believe that it does work out.
Speaker 1:And I've seen it too, so many times across exceptional people in their careers that that does occur. Well, todd, this was a great conversation and just appreciate you coming on and being part of our podcast. Thank you very much for your time. Thank you for your service to Cami as a board chair. I know that's a lot of work on your part and I appreciate your leadership and advice as well.
Speaker 2:Thank you, Anthony. Thank you for having me and was just so pleased to be asked. So thank you so much for everything you do for the industry and certainly leading Cami. Thanks, Todd.