Christopher Dunleavy's career has taken him across the gamut of healthcare settings including Boston-based Brigham Health, Dallas-based Baylor Health and USMD Holdings. Now he's at a unique stage as CFO of New York City-based Hospital for Special Surgery.
He was appointed to the role in December and began Jan. 2. Mr. Dunleavy discussed his priorities in the role and how other healthcare CFOs should be thinking ahead in 2025.
Note: Responses were lightly edited for clarity.
Question: What are some key growth opportunities for HSS in the next 12-24 months?
Christopher Dunleavy: As we navigate a rapidly changing healthcare landscape, we are monitoring several key trends. These include the emergence of new market entrants, the shift from inpatient to outpatient surgery, and technological advancements that have the potential to transform the way we operate. We see this as an opportunity to further commit to our mission of delivering exceptional quality of care and patient experience, but doing so in new, innovative ways. As we grow across our core New YorkTri-State and Florida markets, we’ll do so thoughtfully and deliberately ensuring we are navigating environmental challenges while evolving our business model to be agile and adaptable along the way. We will continue to bolster and modernize our infrastructure, technology and organizational foundation to ensure we are positioned to navigate any major challenges intensified by these accelerated trends.
Q: You have operated through several significant shifts in healthcare in your career. What do you see as the next big thing that healthcare CFOs need to be paying attention to?
CD: The payers are of particular focus given the increasing difficulty to mitigate avoidable denials. The application of AI technology is a key accelerant to workflow automation and timely physician documentation with appropriate checks and balances. It is important to engage with all clinical and non-clinical stakeholders along the RCM workflows to ensure that the delivery of excellent patient care is reimbursed appropriately.
Q: What are key metrics that you plan to measure to balance HSS financial performance and patient care?
CD: The enterprisewide financial health of each institution and the business segments should be shared with key decision makers to allow for timely and well-informed decisions. Effective communication with your audience is the key for balancing financial performance with the delivery of excellent patient care. The goal is to understand the audience and deliver an accurate and timely message that is understood by key leadership managers who may not have financial backgrounds.
Q: Though hospital margins seem to be recovering, 2024 results have been a mixed bag. What advice do you have for CFOs who may be struggling to get their organization's margins back to a healthy place?
CD: While margins may be showing signs of recovery, the financial pressures on all hospitals remain significant. For CFOs working to get their organizations back to a healthy margin, my advice is to simultaneously focus on operational efficiency and strategic revenue growth.
From an operational efficiency perspective, CFOs should prioritize driving efficiency in both clinical and administrative operations. By taking a closer look at our day-to-day processes, we’ll find opportunities for us to not only adapt historic processes to a modernized strategy, but also identify ways we can further bolster our infrastructure to support efficient, lean processes down the line. Doing so can support healthy margins, as it ensures the sustainability of an organization’s business model.
Equally important is strategic revenue growth. Organizations must think about how they can meet patients where they are — whether by adapting to changing patient preferences or optimizing the overall patient experience. Investing in the right tools and strategic growth initiatives can help build near-term financial resilience, while also positioning for long-term sustainability and success.
Q: How does the role of a CFO at specialty hospitals like HSS differ from that at acute care hospitals? What are the unique financial priorities and operational challenges they face?
CD: The role of a CFO at a specialty hospital, like HSS, differs significantly from that of an acute care hospital. Specialty providers operate as focused care centers concentrating on specific service lines, serving unique patient populations and navigating distinct reimbursement structures.
Q: What are two things you advise other orthopedic CFOs to do to thrive in 2025?
CD: Although there is no singular solution to thriving in such a rapidly changing healthcare environment, my overarching advice to other CFOs is to adopt a proactive approach to managing financial risk and ensure his or her respective organization maintains a strategic mindset toward innovation.
To thoughtfully and proactively manage financial risk, it is critical to leverage real-time data wherever possible. Having detailed visibility into the most granular level, such as case-level profitability, will further an understanding of expenses, surgical outcomes, and implications of reimbursements.
The holistic integration of clinical, financial and operational data will enable CFOs to not only drive efficiency improvements, but also optimize the environment needed to maintain or improve margins without ever compromising superior patient care outcomes.
Promoting strategic innovation is critical for CFOs particularly in a rapidly evolving healthcare landscape. In 2025, the shift toward outpatient care delivery will continue to gain momentum. To meet the growing demand for high-quality outpatient services, CFOs must focus on establishing strategic partnerships, aligning with physicians, and implementing robust structures to support this transition. Diversifying revenue streams through ambulatory surgery centers, innovative collaborations and unique partnerships will be more critical than ever — especially in orthopedics.