After nearly three decades in the Le Bonheur Methodist health care system, Chris McLean is the Chief Financial Officer of Shelby County.
After a long career in healthcare, Methodist Le Bonheur Healthcare’s executive director, Chris McLean, intended to retire at the end of 2018. His plan was to move to Florida and “relax” . However, in the midst of a nearly two-year retirement transition process, McLean was approached by recently-elected Shelby County, Tennessee mayor Lee Harris to join his administration as chief financial officer.
McLean says one of his retirement goals was to continue giving back to the community, so he accepted Harris’ offer and took over as county financial director this year.
McLean discussed his tenure at Methodist Le Bonheur Healthcare with Health leaders, highlighting the ever-changing nature of healthcare and what he has learned over nearly 30 years in the healthcare industry.
The following transcript has been slightly edited.
HL: What has been the biggest or most notable change at Methodist Le Bonheur from your arrival until your departure?
McLean: When I look back I was at [Methodist Le Bonheur] for over 28 years, but I spent six years in another market during that time. In the ’80s and early’ 90s, we were a regional health system with as many as 18 hospitals spread across Arkansas, Mississippi, and Tennessee, dutifully starting with the sale of our Mississippi hospitals, then the sale. from our rural hospitals in western Tennessee to focus on Memphis. [That decision] was one of the main changes in strategic direction [with] the belief that we would be better off focusing on our main market than being in a rural setting. I think it turned out to be a good decision.
[Also,] leveraging and expanding our academic relationship with the University of Tennessee has been a critical component. When I was gone, Methodists merged with Le Bonheur, the children’s hospital, and it got us a lot more into academics and related to UT. Then Baptist left the medical center area in early 2000, and we formed many adult educational relationships. Staying in all parts of the community and expanding our academic presence and adding Le Bonheur has been of huge benefit to us.
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Finally, focusing on meeting the needs of all sectors of the Memphis community, both the affluent and the affluent, [is what] we believe that we have been successful in increasing our market share, especially our commercial market share.
It is not a thing; I think it’s a series of steps that have helped us grow and be successful. We have grown in size. Coming back to Memphis, we went from a $ 1.2 billion health care system to a $ 2 billion health care system. We have focused on growing in Memphis and growing regional and national referrals, particularly at Le Bonheur Children’s Hospital.
HL: How do you see the current state of healthcare compared to when you first entered it?
McLean: I think we have a great health care system in our country, but we have one that is unaffordable. The biggest challenge in the future will be how to prevent health care from continuing to grow as a percentage of GDP and eliminate other investments and opportunities?
When I got into the healthcare industry in the early 1980s, we were at 12% of GDP. I never thought we would get to 15% or 16%, and we are quickly heading towards 20% of GDP.
I think the biggest challenge in the future is how to curb growth? I don’t think anyone is trying to bring it down to 12% of GDP, but it can’t keep growing at that rate. How we deliver in a more cost effective way that is affordable for businesses, affordable for individuals and affordable for governments is going to be the real challenge. [and], at the same time, improving our quality and surface results.
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It’s going to get a lot more difficult because I firmly believe that the cost-shifting capacity is gone, which means we need to do business differently from how we have done in the past. We’ve been saying this for four or five years now and haven’t really pushed the ball forward, but it’s going to happen, and that’s where the next generation needs to take us.
HL: What advice would you give to a young CFO of healthcare that could help them make the transition into this new world of healthcare?
McLean: Learn from other industries, be flexible and be good communicators. i tell everyone [that] paid mixes are everything today: those with high commercial mixes are going to do well financially, those with low commercial mixes are going to have more problems. That could change and probably will change in the future.
Understand what your financial engine is and what is the risk of it being disrupted. Work with the leadership team to develop new strategies, as what worked in the past is unlikely to work in the future, what will succeed in the future is yet to be determined.
It will be an interesting and stimulating time. Looking back on my career, we thought every year was going to be terrible. The DRGs were going to kill us, the Balanced Budget Act was going to kill us, but it was a fair lucrative time given the growth in healthcare spending and how we increased it through shifting costs and to some unique government payment opportunities, such as the drug 340B for savings.
In my career, we took advantage of these opportunities when they arose, but we did not anticipate them. You know it when you see it, and that’s what the new generation is going to have to do is seek out those opportunities and react quickly when they seem to be working.
HL: Is there one achievement that you are most proud of since your time with Methodist?
McLean: The accomplishment comes from the entire Methodist team. The one thing I’m most proud of is the fact that we have remained in all parts of the community, rich and poor alike, and our mission has never wavered.
We were going to serve the whole community, regardless of their ability to pay. To do this, we had to have a very large commercial market share. I’ve always said it was sort of a “Robin Hood” strategy. We have taken advantage of trade margins to take care of the poor. It’s what kept me in health care — it’s a sense of purpose — and something I’m proud of and a part of.
Gary Shorb was the CEO most of the time I was here, and the only comment he made that always drove me crazy but turned out to be true, was “We will do good by doing good” .
Jack O’Brien is the Content Team Leader and Financial Editor at HealthLeaders, an HCPro brand.