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Balancing the Future Ep. 35 - The Business of Care: Healthcare Accounting in a Changing Market with Melvin Alexander
153 Plays3 days ago
Veteran CPA and former healthcare CFO Melvin Alexander joins host Chris Mitchell to unpack what makes healthcare finance uniquely challenging—and surprisingly mission-driven. They dive into how reimbursement really works, why consolidation keeps reshaping hospitals, and how labor, inflation, and technology pressures are squeezing margins. Melvin also explains what “complex accounting events” look like in healthcare and shares practical career advice for students and accountants considering the field. If you want a clear, real-world look at the financial engine behind patient care, this episode delivers.
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Transcript
Introduction to the Podcast and Guest
00:00:02
Speaker
Music
00:00:09
Speaker
Welcome to another episode of Balancing the Future. My name is Christopher Mitchell and today i am here with Melvin Alexander. Melvin is a dear friend and he's also a very, very successful individual when it comes to being a CPA, having his own practice and just being an all around good guy. So Melvin, I don't want to take all the thunder and and the glory away from you. So I'll let you introduce yourself and then We'll do some discussion as it relates to health care and kind of what to expect and what it means as relates to accounting, so forth and so on. So please share.
Melvin's Background and Career Path
00:00:43
Speaker
Well, Chris, it's an honor to be here and to share my background. out My name is Melvin Alexander and I'm a CPA based in Texas. I have an accounting practice and as well as oversee a healthcare consultant firm.
00:01:03
Speaker
ah Been in ah the industry for right at 30 years now and former healthcare CFO, health system CFO. and went into public accounting after a number of years and um actually in terms of firm ownership.
00:01:22
Speaker
And so the last 10 years been service and health care organizations as well as general public accounting in the needs of customers so but through public accounting services.
00:01:34
Speaker
You know, one thing I know about your background that the audience doesn't and that's that you're a veteran. So thank you for your service. I know you serve well, so we really do appreciate that. Well, thank you. it was an honor and a privilege to serve our great nation. Awesome. Awesome. You know, when I think about health care, it's just changing a lot. And you got started in health care 30 plus years ago. OK, I'm giving you a plus on that.
00:01:59
Speaker
Why did you pick
What Makes Healthcare Accounting Unique?
00:02:00
Speaker
health care? Why did you go down that path? Yeah. So ah you mentioned my my service and I was actually a um I was in the medical service field and a health care administrator.
00:02:15
Speaker
And, um you know, coming out of high school, I had my my plan set. I was going to decided to major an accountant to join the FBI. Mm But as fate added, I ended up in ah the military, serving first as an enlisted member and going back and finishing my degree and then rejoining as a commission officer and just landed in health care. And it's it's been a fit since.
00:02:44
Speaker
And after a military service was up, I went into a CFO development program. And from there, you know, the rest is history. ah So it's it was it was the pathway that was was paid for me, I believe. You know, when I think about accounting, but when I think about health care, accounting in health care, it's it sounds even more strange to me.
00:03:08
Speaker
ah How does it work? It works like it works in any organization. Am I correct? Or are there anything anything you could point out that would be different as relates to health care versus what we would see in a normal organization?
00:03:22
Speaker
Yes. ah You know, health care is very unique. it yeah First of all, it's ah it's a very small industry from the standpoint of yeah know less than 5000 hospitals, but it extends beyond just hospitals, physician offices and specialty care.
00:03:42
Speaker
And what I see that's really unique and important for an accountant decided to specialize in health care is that um the specialty is going to be with the clinical operations, being able to work hand in hand with clinicians.
00:04:01
Speaker
ah The reimbursement systems are completely different in terms of the private sector, non health care. and then the the numerous regulatory requirements.
Current Challenges and Changes in Healthcare
00:04:12
Speaker
And so for someone who likes to, who enjoys accounting, but also enjoys being a financial mentor to non-financial professionals, ah the challenges of being able to maintain regulatory requirements,
00:04:28
Speaker
ah Some of the specialty areas. So it's it's a very broad field that you find finance, accounting and finance professionals specializing within health care.
00:04:39
Speaker
ah There are different pathways, operations, finance, as well as re revenue cycle. reimbursement. So i can I can go on and on about the the the different subspecialties.
00:04:51
Speaker
And then there are those who who who go the CFO route, ah which would mean that you would you would have the competence level in order to to know what you need to ask. But in terms of just the specialists and being a specialist different areas.
00:05:10
Speaker
Very unique, very unique challenge. And it's it's ah it's a great career path in terms of, I'll say, um there will always be a need for solid accounting professionals and within healthcare.
00:05:24
Speaker
You know, one thing I know about healthcare that it seems like it's changed a lot in the last 10 years. and especially in the last three. And I won't state why I believe it has changed that much, but I know that it has. So what's your take on that? Where is it going? What's the direction that it's headed in?
00:05:41
Speaker
Yes. Well, it's it's um there has been a lot of change in health care. um You know, three years ago, god still fresh off the pandemic. And, um you know, in terms of reimbursement, which I'll use the term reimbursement, which is the equivalent of revenue.
00:06:00
Speaker
ah And I'll use that term from the standpoint that that health care organizations are paid from a third party, not necessarily the customer who's receiving the care, but from health insurers, ah you know state programs, Medicaid, federal programs, Medicare.
00:06:20
Speaker
So. Reimbursement has been a has been a source of constant change, not just within the last three years, but it's it's a field that um healthcare organizations constantly finding themselves adapting to. And that's where, when I think about an accounting professional, um not only are you you know coming into the field, but you understand ah be a a FASB, depending on the organization formation, because there are governmental hospitals and as well as ah non-governmental.
00:06:58
Speaker
And so with that, um ah the accountant professional is already astute when it comes to you know recording the credits and debits. But also, there's a big need to help understand real-time decisions uh being able to analyze and on a real-time basis what's the most effectiveness route what's the most cost-sufficient uh and then also from the standpoint of there's been a lot of consolidation in healthcare care over the last 10 plus years.
00:07:30
Speaker
ah But it's it's a field, and that's one of the and one of the most enjoyable aspects of healthcare is there's constant change. And usually there's constant change for the for the betterment of patients.
Impact of Healthcare Consolidation on Accounting
00:07:43
Speaker
But one unique thing aspect of healthcare of healthcare care and and ah and an accounting professional is that even though you're not a clinician, but you do feel part of the team in terms of providing solutions, um you know, be it, um you know, from from my past, I can recall days when I've discussed refinance and $200 million dollars in debt to discuss and price it on different services and just across the board. But you never lose that sight that you're there to help others and improve the health of patients served.
00:08:22
Speaker
You know, one thing that you mentioned was consolidation. And I noted that as a major change that's happened within the last 10 years. And why has that happened? And does that change the accounting component? And how significantly does it change it if it does change it?
00:08:38
Speaker
Yes, um there has been tremendous, a lot of consolidations, M&A. And a and um The biggest driver over the last 10 years, last 10, 15 years ago, is just the change in reimbursement, ah the projected change, and um then also taking a transactional approach to certain processes that perhaps that efficiencies were gained by consolidating, such as I'll say billing and collections.
00:09:11
Speaker
And also in terms of just the uncertainty about reimbursement. And one one thing that we've we've seen is that over the last 15 years, and and it's just the the consolidation of physician and hospital services.
00:09:31
Speaker
Although you still have large independent practices, but again, a lot of that was looking at the most efficient way to deliver healthcare services. And, you know, politically today, we we we still, you know, we we hear, you know, constantly that health care in the news, ah the cost of insurance.
00:09:49
Speaker
and And so it's just all the different components laden to what's the the um the most efficient way to deliver health care services.
00:10:00
Speaker
Then also our country, you know, for the longest, you know, health care in terms of GDP is one of the highest in in the world. And that's just been a constant, you know,
00:10:13
Speaker
uh objective to bring down the the cost of health care so talk to the uh the cost of health care and why the shift and the change in the escalation uh because i know it's it's changed a lot in the last year because of political reasons yes um but what else is going on because i know it's on the move and it's shifting day in day out so what are your thoughts yeah it's uh and Excellent question and dependent on ah on if you were a payer, meaning an insurance company or from the hospital side, the physician side, yeah the the biggest say in the top three that that are fairly consistent would be reimbursement.
00:10:55
Speaker
And um Also, we're in an inflationary environment and then the labor costs. ah Labor costs continues to climb and um the reimbursement pressures um and which goes hand in hand with inflation. But even before, you know, the current inflationary environment we've had the last four or five years,
00:11:19
Speaker
ah It's always a challenge. And as insurance premiums rise to for the for the, you know, for the population who has insurance, it's a it's a challenge.
00:11:32
Speaker
ah But in terms of those are the the biggest drivers, ah the labor costs, too. And even with the consolidation of services, we still see that as as a big as ah as a huge driver.
00:11:50
Speaker
So Melvin, another question I have is related to ah consolidation and the team. And I know there's been a lot of effort to pull together these hospitals, but what does that do to the structure of an accounting team and how you guys still account for revenues that are flowing in? i mean, has it changed considerably as a result of that?
00:12:11
Speaker
Yeah, there
Complexities and Financial Pressures in Healthcare
00:12:12
Speaker
has been some change. And one of my... um Just from experience back um when I was involved with consolidating ah three health systems and three different accounting teams, ah different systems, financial systems.
00:12:31
Speaker
And um the key is... When, ah at least from my experience and what I've seen in the current industry, there are still those opportunities there for the profession, but in terms of the service delivered to patients and clinicians, the goal is always for to you know the outcome to be seamless and and the same level of service is still provided.
00:12:54
Speaker
But for the financial professionals, it may mean move into a different organization, ah location at a different organization. But overall, it's consolidation, the same level of work, and but just deliver it for a larger larger customer base.
00:13:15
Speaker
So when I think about that structure, we know we've got the CFO at the top. How does that trickle down into those that are supporting you? What does that structure look like? but Well, the structure may lead to a consolidation of services for other regions and for depending on, and and that's a great question because, you know, there there there are numerous responses there.
00:13:39
Speaker
So if it's a CFO who previously had a a revenue cycle team that supported his or her organization, and all of a sudden there's a consolidation,
00:13:52
Speaker
and now the services are moved to one central location um you know the um the expectations in terms of being able to understand revenue flow where the opportunities are remain the same but from a skill set standpoint that you know additional um additional requirements to work outside you know when you when there was once the ability to go to a different location, see your team, all of a sudden you you're part of a bigger team. And so from that standpoint, it creates challenges, but also, ah you know, for the betterment of the organization long term, it pays off.
00:14:33
Speaker
Now for the individual who takes on the massive responsibility where once, you know, it was just a defined number of organizations that were being supported and know, a consolidation and now go from three hospitals, three clinics to 10 20, whatever the number is, you know, it creates a different set of challenges. And overall, I think in terms of the fundamental skill sets learned along the way in terms of understanding revenue cycle and payment and what the drivers are, you know, from that standpoint, it's all about the outcomes and
00:15:14
Speaker
and how the the bottom line is is impacted so when i think about traditional accounting and i think about subsidiaries and i think about primaries and i think about reporting out on that activity is it similar because i would think that you've got subs out there and you've got a primary and you've got consolidated financials is that the way it looks or is it different well that's uh it depends on uh
00:15:42
Speaker
it Because of doing a consolidation and and there there are certain types of affiliations, ah but let's say that organizations are combined and um there's outstanding debt or bonds.
00:16:01
Speaker
And so from a reporting standpoint, that that unit may continue to report you know as an individual, but is also rolled up into a consolidated organization.
00:16:13
Speaker
And so there are unique challenges and and not one size fit all. But let's say that all the hospitals that are consolidated are are purchased and and rolled up to one organization, then the traditional model that we You learn and school and and and college still applies.
00:16:32
Speaker
ah But there's ah there's a great deal of and at at times that you you have different reporting requirements and, you know, debt that was issued that remains outstanding under an organization.
00:16:46
Speaker
So when I think about pressure, just pressure in general, getting given all the transformation in the in the market these days and kind of the state of where things are politically, you know, what are some of those pressures, those financial pressures that a lot of health care organizations are feeling right now?
00:17:05
Speaker
Yes, ah you know, one is technology. um and and And I say one is technology and not listed in the sequence of importance, but but but, you know, it comes down to, you know,
00:17:22
Speaker
reimbursement technology drivers um in terms of having the right skill mix or the right services for an organization. there There are certain states that have what's called a certificate of need.
00:17:38
Speaker
And with that, it it provides... a level of protection that if if hospital aid goes out and and and purchase the latest technology and um you that, you know, there there's a there's some assurance that the hospital will be in the same area. You can't do that if there's not a ah provided need. But that doesn't that doesn't always exist. And that that requirement doesn't exist in every state.
00:18:07
Speaker
And so with that, um you know, technology, the the medical staff, the um um then the demand, um you know, service quality, ah you can go down the list. But in terms of of competing for capital dollars and lightest technology, access to capital and believe it or not, you know, a lot of small businesses Uh, that that's ah a big issue, but the the larger the organizations, you know, it's still a concern, especially when you're in a, uh, in a industry such as healthcare.
00:18:44
Speaker
So within the healthcare care industry, how, how do you compete? I mean, i know there's competition out there. How does that work? Because are you going for pricing? Are you going for comfort? Are you going for convenience? I mean, how do you compete in in the market and what does that look like?
00:19:04
Speaker
Yeah, kind of competition um quality is and in terms of um being ranked the best, ah which ah you there are several um there's so several organizations that will we' come out and and assess the quality. There are minimal quality standards that a hospital healthcare system has to meet in order to ah to receive full reimbursement.
00:19:34
Speaker
ah But separators, you know, what distinguish one hospital ah from the other? i There are many variables. um One, reputation, physician staff, and could be the service itself, the service that the the patient is is seeking out.
00:19:55
Speaker
So, and I know you've, and I'm going to backtrack bit and I'm going to and i ah I want you to kind of share this question or an answer for this question. And all that you've been exposed to within healthcare care and You know, it's hard to stick around a profession for 30 years.
00:20:11
Speaker
Okay. What do you attribute your success? Because I know you've been a CFO. I know you've graduated up and through the ranks. I know you've had small teams, large teams. I know you've been through consolidations. I know you've been through ah transformational exercises, using IT t as an instrument and and marketing and and so forth
Career Motivation and Professional Advice
00:20:29
Speaker
and so on. People don't know how much a CFO actually does in making a contribution all of that.
00:20:34
Speaker
So what do you attribute your success your success to and your desire to just stick around the profession for that long? Yeah, health care. And this may be one of the the the the the largest it understatement that you've that you've probably heard.
00:20:54
Speaker
um But what's unique about health care is that, you know, although you may not, and most accountants don't, i go into a procedural room, at the end of the day, there's the connection of helping others.
00:21:11
Speaker
And, um you know, in other industries, um I'm sure there's a connection point. But early on in my career, that was the one that really stood out is that being part of a larger team that delivers great care or needed care.
00:21:28
Speaker
ah You have these organ, there are hospitals, critical access hospitals, um they're called. And now there's a rural hospital designation ah that's about 15 hospitals nationwide has implemented.
00:21:45
Speaker
But there are very small communities where there may not be a hospital for hundreds of miles. And you have an organization that's there to to help and thus the the term critical access.
00:21:58
Speaker
ah But nonetheless, just being a part of that team. And i think that's one of the, um not just for me, but for other professionals that that keeps them into the specialty area of health care.
00:22:14
Speaker
And, uh, but it's, it's, it's a, it's a huge team environment. It's it, it, and, you know, be it the accountant professional, the clinician, the physician, and i've been a part of an organizations where every employee, you know, where we had incentives and, and every employee from, know, from dietary workers, uh,
00:22:39
Speaker
housekeeping all ah all levels participated in and you know just really it reinforces that you're part of a bigger team you have one you have a role or multiple roles on the team but nonetheless it takes all to to produce high standards and you know provide quality care healthcare So if I am a CFO and I need support with a project and I don't have the resources in house, where do I go? Do I go to a traditional consulting firm? I mean, how do I get the support that I need? Because I know you have a consulting practice as well. I mean, how does that work?
00:23:18
Speaker
Yes. And so if if there's a health care, there are so many specialty areas. And um and I mentioned earlier about reimbursement, um which goes into cost reports and other areas that that the health care organization ah are required to complete.
00:23:43
Speaker
And, you know, just with any industry, ah there's no one person who knows it all. And you have different subspecialists. And so the same with health care. But but typically, um you know, for our firm, we we offer advisory services.
00:24:00
Speaker
And it's just a matter of making a connection. we have professional organizations like the Health Care Financial Management Association. ah which offers certifications um in in different areas, such as revenue cycle, cost report, to name two.
00:24:18
Speaker
And then also there's the American College of Healthcare care Executives, which is more for individuals. individuals in an operational role and and I belong to both organizations. I'm a fellow in and both of those organizations.
00:24:34
Speaker
ah But and then there's the annual audits and and um but with that within those organizations, there are sources for different areas that a ah CFO may need the services of.
00:24:48
Speaker
And so that's typically how a provider of those services are identified. And Melvin, another question that I was thinking about, and you can probably add a lot of value, and I know the audience is probably interested in this as well.
00:25:02
Speaker
When I say complex accounting event, What does that mean to you and health care? Because there are always things that are surfacing in corporate. But I'm trying to figure out how you as a CFO view a complex accounting event. And you may have your definition of what that is. So share whatever you'd like.
00:25:22
Speaker
But, you know, that's my curiosity. Yeah, so ah it's a great question, and I'm going to answer that from ah from different angles because healthcare accounting is very complex in its own right.
00:25:38
Speaker
um From the standpoint, I'll start with the monthly close um when it comes to revenue and determining what revenue to recognize from the standpoint that one hospital may have ah 20 payers that pay them all differently, although your charges are the same.
00:25:58
Speaker
But in terms of when you make the contractual adjustments, you come up with different numbers. So, of course, there are accounting systems that help with that process, but it's a very important issue.
00:26:10
Speaker
Another issue may be a real-time analysis in terms of what's the cost of performing a certain service or you you have someone who who who wants an estimate.
00:26:24
Speaker
And um so it's it's complex from the standpoint that At one at some point, are there was a transition from the historical or accountant records, you know, transactions that happen to now to been very involved in the and the decision making in terms of providing feedback.
00:26:47
Speaker
And then, you know, beyond that, ah beyond those two examples ah would be a consolidation. if If you brought on a new, um yeah you consolidate it through an acquisition, or let's say that there was a discontinuation of services and needing to make sure that transaction was recorded correctly, which be would be consistent with other with other industries.
00:27:17
Speaker
And then with accounting, have the accounting pronouncements that are somewhat unique. So it's a very complex operation. So there's no one single answer, but in terms of ah it just depends on, you know, the scope and any and at times when there's an event that's not um that's not, um that doesn't occur frequently, it can become very complex until you get the the right answer. ah But again, it's a, um and that's what's so unique and special about the the industry in terms of professional challenges, growth, and just once you're you're trained in that area, that is it's a skill set that's
00:28:09
Speaker
That's why we need it. And, you know, there are a lot of hospitals that are struggling and need the financial ah team member later to to help navigate those waters in terms of just reimbursement losses and operating losses.
00:28:28
Speaker
ah You know, concerns that if the organization can continue on. So it's, it's ah you know, it it just depends on the organization and the location.
Future Risks in Healthcare Accounting
00:28:40
Speaker
ah But it's ah it's a a very challenging but yet rewarding ah area of specialization. You know, when I think about challenges and I think about risk come to mind right away, and I think about the landscape that we we have right now and what's coming in the future, because I can't predict the future.
00:29:01
Speaker
I wish I could. I'd be a very rich man. um But when I think about the next 24 months and I think about health care and I and I think about the risk. um I can see a lot of movement from a political perspective. I can see a lot of change as it relates to cost.
00:29:16
Speaker
I can see the rise in inflation. I mean, what are the risks? What risk do you see when I say 24 months, health care and what to be on the lookout for? Yeah, there's there's a lot of uncertainty in terms of, you know government reimbursement. um You know, this year, you know, hospitals are losing money operationally.
00:29:39
Speaker
and um And that percentage seems to to to be increasing, least through the first quarter. And, you know, reimbursement is always, there's always a great deal of uncertainty there. ah You know, the political landscape right now,
00:29:58
Speaker
you know, the Affordable Care Act and and how that will change. And in terms of the subsidy and and will it go away? So, you know those, it's, I look back over, i think back over the years now and, you know, I can't remember a period when we didn't have uncertainty. So, you know, the biggest challenge is, you and And I don't know if I can define one biggest challenge, but but the challenges combined will be reimbursement, technology, and labor.
00:30:31
Speaker
um We're in a high inflation how environment right now, and those pressures will remain. You know, I know human capital always comes into the equation in trying to find qualified people.
00:30:44
Speaker
Do you have any concern just given the lens that's on public accounting now and the shift in the change in the mindset for certification and so forth and so on? are Is there concern that there may not be ample resources available to fulfill, you know, whatever the needs are for the business on a daily?
00:31:03
Speaker
I think that's I think that's a valid concern. And. and um ah Definitely, it's a valid concern. you You look at the number of openings around the country and um and in the skill set that's needed.
00:31:18
Speaker
So, at ats you know, not just from a finance standpoint, but from an operational standpoint. And, you know, the certifications, I think, are are crucial in terms of just... so distinguished in one in terms of being proficient and in ah and a given area. and And back to our topic in terms of health care, there's the fellow of Health Care Financial Management Association, which is and before that, there's a set of certified health care professional, financial professional. And those are important credentials um in terms of just showing that you understand this uniform body ah of testing towards health care finance.
00:32:02
Speaker
um But the more a profession understands the total industry, how the operations work and and how it all flows in through from a financial standpoint, the more effective they are to an organization.
00:32:16
Speaker
And, you know, it's one thing to hold a position in the title, but in terms of being proficient and helping the organization ah along in terms of, you know, a very turbulent time that we are in right now, ah that's a key. and And, you know, but...
00:32:34
Speaker
I, you know, we both would be kidding ourselves if we we think we could predict the next 24 months. But it's been a concern of late. and And I think that concern is, you know, will stay in place.
00:32:47
Speaker
You know, I
Advice for Aspiring Healthcare Accountants
00:32:48
Speaker
think about, you know, your success that you've had within health care. And I think about your rise to CFO. And I think about um all the other things that you built as an entrepreneur and having your own public accounting firm, as well as your own consulting practice.
00:33:02
Speaker
So if there's someone graduating today because they could be listening today trying to figure out, so what path do I want to take? Am going to go and I'm going to work for a Tesla or am I going to go and I'm going to work for a hospital?
00:33:14
Speaker
OK, from an accounting perspective. And I'm not trying to measure the two and compare to the two against. What would you share with them? If they say I've got an interest in health care, how would you tee them up for success down that path?
00:33:28
Speaker
Yeah, I would, I'm a little biased, but I would definitely suggest healthcare. ah and you know, from from just the the comments made earlier in terms of the team approach, being a part of the a bigger team, but also just the opportunities to, they may not want to go the the CFO route. They may want to ah go the rest revenue cycle route.
00:33:56
Speaker
ah They may want to do something, you know, they they may want to specialize. They may want to specialize in position enterprises. ah But there's just a number of opportunities that are rewarding and just, you know, the sky's the limit.
00:34:13
Speaker
And then also they may want to go into the advisory role. And um and I think if you look at sheer numbers, um there are likely more advisory professionals with the healthcare care background than those individuals who are working in the day-to-day jobs.
00:34:30
Speaker
ah But in terms of, like like I said, I warn you I'm biased. I would definitely, and I've never worked with Tesla either, but in terms of, you know, hands-on, you have accounting systems, but then again, in terms of Understanding the accounting systems and and and helping someone project the future and what it means in terms of giving back to a community right away. ah And that's ah that's a pathway that's it's kind of hard to match with another industry.
00:35:04
Speaker
You
Conclusion and Reflections
00:35:05
Speaker
know, another question that comes to mind, and I think this is in alignment with skill set and trying to prepare someone for success. I think I need some clarity as it relates to at the very high level when we say aspirations and we are pointing folks in a direction of health care and I see a CFO, you know, from an accounting perspective, you've mentioned revenue.
00:35:25
Speaker
And I'm trying to figure out how how all these roles complement one another because I know there's one delivery. There's nothing. There's not understanding as relates to financials and how are we going to be successful and for the organization as a team?
00:35:38
Speaker
What does that team look like at a very high level? And how do are you working together to deliver the optimum um numbers, information to executive leadership? Yes, and depending on the structure of the the system, the healthcare organization, you'll you'll have different roles. But leading the financial operations is the chief financial officer.
00:36:03
Speaker
ah the revenue cycle manager, or I say manager, but usually it's the revenue cycle executive, which could be a VP our or could hold the title as chief revenue officer.
00:36:17
Speaker
and ah That individual was in charge of of billing and collections, you know, the the lifeline in terms of cash flow of an organization. And and usually...
00:36:32
Speaker
The revenue a new cycle, depending on the size of the organization, could have hundreds of people underneath the the revenue cycle ah later. ah And then typically you would have a vice president of managed care services, and that's the individual who's in charge of negotiating payer contracts and it with the the large insurance companies.
00:36:56
Speaker
And then there's the traditional financial controller roles where you would have a controller with you know the financial records accounts payable and such so a very complex organization and again depending on the size there are different levels uh that you would have additional roles wow wow you know this conversation that we've had has been very interesting i mean you are a very complex individual you've got your businesses, you've been in health care for over 30 years. It's been an absolute pleasure chatting with you about just the infrastructure and how it works and what it looks like as an accountant and how you're graduating up and through the system and not keeping in mind, you know, we're all influenced by the market and politics and everything else. So
00:37:45
Speaker
For me, it's very interesting. you know Before, maybe I was a little more biased towards technology because that's where I grew up. It looks like you have got your ducks in a row and and sticking with health care. So thank you for joining us, Melvin. I know you're a busy man. i can tell.
00:38:00
Speaker
i know when you're busy, I can see it in your eyes, but I really do appreciate you you making the time to to have a chat with us today. Well, appreciate the the invitation and it's it's always a joy talking about healthcare care and accounting and finance.
00:38:15
Speaker
Fantastic. I'll say these words, you know, as we continue to ah graduate on and and and up to other episodes. i appreciate everyone and and your time and tuning in.
00:38:27
Speaker
The conversation that we've had today has been across the board. I mean, we want to know what it takes in order to be successful in the healthcare care profession. And as an accountant, it takes a unique skill set. It takes patience. It takes understanding. It takes wanting to give back and plug into the industry in a different way. We know the accounting is different. We know that the challenges are different. And you know it has and it flows, but it is very necessary. So don't turn away from healthcare.
00:38:55
Speaker
Don't think that it's not something that you should seek because I think there will be plenty of opportunity in the future. My name is Chris Mitchell, and I'd like to thank you for just being a part of another episode of Balancing the Future, and I look forward to future conversations.