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The most important health care decisions don't happen

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in isolation.

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They happen when leaders come together.

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Becker's sixteenth annual meeting brings together more than

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3,500

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hospital and health system executives this April in

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Chicago.

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With 800 speakers from Ascension, Cleveland Clinic, CommonSpirit

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and more, the conversations get real. Leaders will

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share how their scenario planning for policy shifts,

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breaking through value based care barriers, and building

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clinical teams that translate new ideas into real

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world care.

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Join top decision makers in the room April

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13 through the sixteenth.

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For the agenda and event details, visit beckers

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hospital review dot com and click on the

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events tab in the upper right.

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This is Madeleine Ashley with the Becker CFO

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and revenue cycle podcast, and I'm excited to

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be joined today by Jim Malloy, executive vice

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president, CFO, and treasurer of Ochsner Health. Jim,

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thank you for being on with me today.

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Thanks, Madeline. It's a pleasure to be here

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and looking forward to the conversation.

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Me too. But before we begin, Jim, if

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you don't mind just sharing a little bit

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about yourself, your background in health care, and

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more on Ochsner Health with our listeners, that'd

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be great.

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Sure. I guess since,

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the context here is this part of my

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career, which is only,

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about three years in in the making,

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a little bit of background on because I

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have an unusual

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way of arriving to my current position

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is worthwhile. I spent the vast majority of

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my

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career has been in health care, but much

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of it was in consulting and banking.

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The and the vast majority of that was

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on the banking side. So a little bit

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unusual for a CFO, and I will admit

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that,

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I've been drinking from the fire hose for

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three years, but getting pretty pretty comfortable with,

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the new role here. And I'd say,

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from my perspective, it's it's a bit mixed

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in drinking from the fire hose for three

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years straight on information is a little bit

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of a disadvantage, but I think,

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it's been offset by coming in with a

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pretty fresh perspective,

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and not a lot of past really to,

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burden my thinking. So it's been a great

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experience for me,

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and this is always planned to have a

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meaningful portion of my career, and and it

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is turning out to be just that.

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Oh, thank you so much for sharing that

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background.

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And, you know, to your point, coming from

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a a a different background than just historically

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health care CFO,

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could you maybe share some of the things

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that you've that have really stuck with you?

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I mean, the industry is ever changing. We're

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always seeing something new popping up. So how

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are you able to quickly get on board

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with that?

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You know, I think taking a fresh look,

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as I said, has been pretty helpful. And

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a couple of the early things, you know,

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noticing, especially,

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you know, coming into this year and some

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of the trends that are here.

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I've always known that there was a big

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dependence on governmental programs, but you sort of

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don't realize how much those shifts are important

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with the population and everything else. So there's,

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you know, both a higher percentage of the

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population with the aging population going into Medicare,

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and other items that have regulatory risks such

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as the Medicaid program,

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three forty b, etcetera,

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and and different things that are the result

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of legislation.

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You realize how important those things are from

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a different perspective.

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And that's probably been the most intriguing of

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the things

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to me or the most different from

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when you're looking at it from this perspective,

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the importance of it becomes

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much more elevated.

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Yeah. No. For sure.

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And so let's let's dive a little into

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that. Now that we're here in 2026,

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maybe could you share,

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the specific financial trends or shifts that you're

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keeping a a super close eye on right

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now and why these trends are so important

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to you?

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Sure. You know? And I think what I

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talked about with the the realization

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on this dependence on the governmental programs,

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it it points to what's become and

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probably elevated in 2026,

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sort of a fundamental imbalance in the industry

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between payment versus expense. And what I mean

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by that is

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the governmental payers are not keeping up with

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inflation,

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generally in any of the categories. So if

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you look at because of provider

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shortages and different things that we are experiencing

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in the industry,

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our expenses are going up in in a

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bunch of areas along with

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even more so than regular inflation throughout the

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economy.

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So we have to deal with that on

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that side when the increases that we're seeing

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on the revenue side aren't there. And, you

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know, fundamentally, that's okay. It just causes a

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focus for a need on change.

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And we need to get more,

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efficient without any question, and it's really forcing

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us to do that. The the most recent

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difference, I think, though, is that

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the commercial payments haven't been keeping up either

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with that,

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expense inflation that we're having. So that's really

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causing a new importance on change for us

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and really make it an an imperative.

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You know, and the simple things you think

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about, you hear often all over the place,

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you know, bringing the right care in the

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right place,

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getting people,

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out of the hospital when they're ready. And

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as you all know, no one likes to

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be in a hospital. So a lot of

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the things that we have to do, fortunately,

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are good for our patient population as well.

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But I think the

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the level of change that's required is definitely

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accelerating as we head into '26.

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Yeah.

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And could you maybe share you know, a

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lot of CFOs that I've talked to lately,

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have also placed some emphasis on some of

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the rural health

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information fund that we're seeing kind of slowly

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starting to trickle out.

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Have you kept an eye on that at

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all? Any any other policies that you're you're

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watching closely?

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Yeah. We're definitely looking at those things and,

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you know, hopefully, getting involved in the conversations

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that that go on and and weighing in

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like I think a lot of others are.

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But,

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there's nothing out there, as you say,

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that that that can be from the positive

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perspective. There is nothing out there that's gonna

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offset a lot of the other trends that

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have not been that,

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positive on the legislative side. So,

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although we're keeping up to date on all

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those things and looking at them on a

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a a daily and monthly basis, there's nothing

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out there that we're really counting on to

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have an an impact that's gonna offset some

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of the general trends that we have to

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deal with.

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Yeah. No. To your point, lots out there

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going on. And and when you say that,

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nothing that's going to have that that large

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impact, does that mean that you have to

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then turn inward, look at yourself and your

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team? How can we tackle all of this

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together? What's what's your solution?

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Yeah. There's no question about that, and and

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that's, you know, one of the things from

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my perspective

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that's gonna be different about 2026.

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And

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I think one of one thing you'll

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everything goes back to fundamentals, right, at the

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end of the day. And the big thing

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for us are patients and people in health

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care.

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So the two words we've had in our

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organization

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pretty consistently this year are access and experience.

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The access side that relates directly to the

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patients.

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You know, there's too many people that don't

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have and can't have timely access to the

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services they need.

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One thing we're doing is patient journey mapping.

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And we're doing that in a couple select

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areas and really

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following it from a a patient's perspective, every

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aspect of when they enter that area to

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when they get out the end. And although

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we have a couple select areas picked out,

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we're eventually gonna go across the entire patient

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experience from the beginning of when they reach

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out to the organization in any way,

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to the end of their experience when they

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drop the bill, but then,

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even going beyond that to the ongoing relationship

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that they have and making sure we see

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that from that perspective.

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And, you know, that ties into the experience.

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I that really we're talking about our people,

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and what their experience is coming into work

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every day and how critical that is because

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at the end of the day,

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they are the ones that are delivering the

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care.

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Our frontline

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people are the most important thing we have

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in the organization.

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And when you have

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significant cost pressures,

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worry about things like AI that the general

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population has,

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and these access issues, quite frankly,

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with the patients being,

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upset about those. Those are the people that

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are gonna have to deal with that right

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up right up front when they come in.

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So it puts a lot of pressure on

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our people, and we're making sure that we

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are,

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taking care of our people and,

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easing that burden as much as we can,

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especially this year. Yeah.

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No. So important.

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Now, Jim, I wanna shift gears just a

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tiny bit and ask you where you're seeing

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the biggest opportunities for smart growth at Ochsner,

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you know, in the year ahead. I I

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know in 2024,

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you and I actually connected and, you know,

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we talked about how, the system has placed

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such a hefty emphasis on acquisitions in the

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past. Now it's kind of looking to mold,

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that creation. So that's still kind of the

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case. What what does growth look like to

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you now?

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Yeah. And I'll I guess I'll go off

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the word used in front of it because

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there's a lot of different ways you can

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grow.

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But when you say smart growth,

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I think the smartest growth of all is

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really through increasing your efficiency.

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And in in health care, the best ways

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to do that, you know, as a provider

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are things like length of stay reduction. You

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know, I mentioned before, no one likes to

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be in a hospital.

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So that's another win win on both sides

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for that is when people are ready to

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get out and they've received the appropriate care,

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getting them through quicker is gonna get someone

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else in the bed. That helps us on

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the access side. Right? So we have someone

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else that's actually getting care when they wouldn't

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if that bed was filled.

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And it's better for us from an efficiency

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perspective because the resources there, you don't wanna

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have any wasted time. So it's really about

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throughput when I think about smart growth.

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And you have that in the hospital side,

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and you have that same thing on the

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clinic side,

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which is really making sure that,

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you're getting

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that old standard again, right care, the right

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place at the right time.

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And a lot of that is

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somewhat

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a

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exercise of patient triage,

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but it's also making sure that you're scheduling

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properly and making it easy to schedule. And

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when things go wrong with the schedule,

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making sure that you're able to fill those

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things in, when people don't show up, etcetera,

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and utilize all of our time and the

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time of our people

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as effectively as we can,

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in serving the patients. So

300
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that to me is the definition really of

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of of smart growth,

302
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and that that again solves access. And

303
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I I guess the other side, when you

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look at it, you can actually grow by

305
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leveraging scale, and that's standardizing processes,

306
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different preference I items and things of that

307
00:11:34,115 --> 00:11:36,514
sort. You know, you'll hear that among use

308
00:11:36,514 --> 00:11:38,835
probably the most expensive are with joints where

309
00:11:38,835 --> 00:11:41,175
there's a lot of different things out there.

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And the more you can get your people

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trained on using,

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you know, one item versus having a choice

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of five when you find the best one

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and getting everyone to use it, things of

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that nature,

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also allow us to save money and then

317
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reinvest those savings in other areas.

318
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Definitely. So, I mean, gotta ask. For this

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this year, any anything on the books in

320
00:12:03,414 --> 00:12:05,975
in terms of acquisition? Anything you're personally eyeing

321
00:12:05,975 --> 00:12:06,794
as the CFO?

322
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From an acquisition perspective, we really had, and

323
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and I wouldn't say it's complete, but we've

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had somewhat of a a time out on

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that front going on because we went through

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period of extreme growth,

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where we'd,

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increased our size, you know, doubled in a

329
00:12:24,429 --> 00:12:26,289
relatively short period of time.

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And what we needed to do was integrate

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a lot of the things and the parts

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of the organization

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00:12:32,475 --> 00:12:34,634
that we'd acquired. And we've been spending a

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ton of time doing that, getting our efficiency

335
00:12:37,595 --> 00:12:38,415
up, and,

336
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getting a lot of the processes that we'll

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00:12:40,875 --> 00:12:43,070
need when we turn back to that more

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00:12:43,070 --> 00:12:45,710
external growth. So most of the growth we've

339
00:12:45,710 --> 00:12:48,289
had in this interim period has been organic.

340
00:12:48,909 --> 00:12:51,330
I think I'd expect unless something,

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00:12:52,190 --> 00:12:55,725
unusual or phenomenal opportunity comes up, we'll probably

342
00:12:55,725 --> 00:12:58,125
be in that mode the rest of 2026.

343
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But after that,

344
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I think we'll probably

345
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return to a normal mode of just looking,

346
00:13:05,245 --> 00:13:07,884
for whatever great opportunities there may be out

347
00:13:07,884 --> 00:13:08,384
there.

348
00:13:09,559 --> 00:13:11,659
Yeah. And you can always find great opportunities.

349
00:13:11,720 --> 00:13:13,959
So, yeah, definitely worth keeping your eyes peeled,

350
00:13:13,959 --> 00:13:14,620
I'm sure.

351
00:13:15,799 --> 00:13:18,279
So, Jim, with everything we've discussed today, you

352
00:13:18,279 --> 00:13:20,059
know, just in terms of growth,

353
00:13:20,440 --> 00:13:23,144
policy shifts, everything happening in health care, what

354
00:13:23,225 --> 00:13:25,304
do you think is the most important mindset

355
00:13:25,304 --> 00:13:27,384
that CFOs need to keep right now just

356
00:13:27,384 --> 00:13:28,524
to navigate everything?

357
00:13:29,304 --> 00:13:31,705
You know, two words, and and our our

358
00:13:31,705 --> 00:13:34,264
CEO has used this a lot, Pete Pete

359
00:13:34,264 --> 00:13:34,764
November,

360
00:13:35,225 --> 00:13:37,279
that I really think are important from a

361
00:13:37,279 --> 00:13:39,940
CFO perspective, especially, is optimism

362
00:13:40,399 --> 00:13:41,459
is number one.

363
00:13:42,159 --> 00:13:44,080
You know, entering this year, I think, with

364
00:13:44,080 --> 00:13:46,639
all the legislation and everything else that's been

365
00:13:46,639 --> 00:13:48,799
going on in the world, it's easy to

366
00:13:48,799 --> 00:13:49,459
be negative.

367
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But I think when we sit there and

368
00:13:52,195 --> 00:13:54,434
look at it from our perspective, there is

369
00:13:54,434 --> 00:13:57,575
so much opportunity out there, almost unlimited.

370
00:13:58,835 --> 00:14:01,174
There are tremendous and not necessarily

371
00:14:01,634 --> 00:14:01,715
the

372
00:14:02,679 --> 00:14:04,600
it's more a nature of how things have

373
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evolved versus,

374
00:14:05,960 --> 00:14:08,679
the people that are involved in things. But

375
00:14:08,679 --> 00:14:10,059
there are tremendous inefficiencies

376
00:14:10,360 --> 00:14:11,259
in the industry.

377
00:14:11,639 --> 00:14:13,639
We have a lot of opportunity to get

378
00:14:13,639 --> 00:14:14,460
after those,

379
00:14:15,095 --> 00:14:17,595
you know, both from our own internal perspective

380
00:14:17,735 --> 00:14:19,514
and from an advocacy perspective

381
00:14:20,054 --> 00:14:23,095
when looking external with our government relations people

382
00:14:23,095 --> 00:14:25,514
and and and everyone else to point out,

383
00:14:25,894 --> 00:14:28,534
some of these issues. But, optimism and the

384
00:14:28,534 --> 00:14:29,514
only other word

385
00:14:29,829 --> 00:14:32,809
I'd say, that's critical, I think, is urgency.

386
00:14:33,429 --> 00:14:34,870
We do have to have a sense of

387
00:14:34,870 --> 00:14:35,370
urgency.

388
00:14:35,990 --> 00:14:37,209
You know, making

389
00:14:37,589 --> 00:14:39,289
changing things takes time.

390
00:14:39,990 --> 00:14:41,909
So you have to start well in advance

391
00:14:41,909 --> 00:14:43,589
of new things, and there's been a lot

392
00:14:43,589 --> 00:14:45,684
of, things that we have to deal with

393
00:14:45,684 --> 00:14:47,785
already on the plate and more coming.

394
00:14:48,485 --> 00:14:51,045
You know, even even AI, despite the fact

395
00:14:51,045 --> 00:14:51,545
that,

396
00:14:52,004 --> 00:14:53,764
if you read, it's gonna solve all the

397
00:14:53,764 --> 00:14:55,465
world's problems in six months.

398
00:14:56,660 --> 00:14:58,420
You know, a lot of things that you

399
00:14:58,420 --> 00:15:01,299
take advantage of there require process change. They're

400
00:15:01,299 --> 00:15:03,540
gonna take time, so you can't wait. You

401
00:15:03,540 --> 00:15:05,000
have to have a sense of urgency,

402
00:15:05,940 --> 00:15:07,620
right now in order to get to where

403
00:15:07,620 --> 00:15:08,519
we need to go.

404
00:15:08,980 --> 00:15:11,115
Yeah. Yeah. AI, nice to have, but not

405
00:15:11,115 --> 00:15:12,735
always a quick fix. You know?

406
00:15:13,514 --> 00:15:16,315
That's for sure. Wonderful. Well, Jim, thank you

407
00:15:16,315 --> 00:15:18,394
so much for hopping on this podcast with

408
00:15:18,394 --> 00:15:20,347
me. It's truly been so fun getting to

409
00:15:20,347 --> 00:15:23,227
chat with you, and, I'm excited to to

410
00:15:23,227 --> 00:15:25,647
chat again down the line. So appreciate it.

411
00:15:25,787 --> 00:15:27,807
Thank you so much. It's been a pleasure.