Steven Blake, CPA, CGMA

CFO and managing director for Paladin Healthcare Management and Avanti Hospitals

Steven Blake, CPA, CGMA
Steven Blake, CPA, CGMA, is the CFO and managing director for Paladin Healthcare Management and Avanti Hospitals, which owns and operates four community hospitals in east and south Los Angeles. Paladin also manages a university hospital in Washington. (Photo by Matt Harbicht/AP Images)

'We can do our part'

Delivering health care services in underserved areas is critical: To those of us that practice in underserved areas, the need is evident. We can do our part to ensure that services are organized efficiently, that we are oriented to participate effectively in funding opportunities, that quality outcomes are measured, and that related goals are met. There is also a role to play in public policy to meet this need and improve access. Access to primary care physicians leads to more timely treatment and reduces costly treatment in the ER.

Using Big Data to improve wellness and care: We are investing time and resources poring over public databases to identify opportunities to participate in managing "wellness" of the populations we serve. Our industry sector and the government refer to this effort as "population health management," a collaborative effort to improve affordability and quality of life. Here's an example of analytics that work for us. Safety net hospitals typically receive a larger percentage of admissions through the emergency room. This is often the result of real or perceived lack of access to primary care in clinic settings. Whatever the socio-economic cause, it is a factor that drives our analytics and tracking. We track throughput in the ER, including minutes to be seen by a physician and time spent in the ER before release or transfer to a room. Understanding the factors that measure quality outcomes, efficiency, and revenue capture and having the analytics to monitor these are important.

Succeeding on a limited budget: We take pride in the fact that we can run hospitals with governmental reimbursement in low-income areas and still be a success. For years, as long as I can remember, it's always been the practice of hospitals to buy new equipment. But there is a secondary market out there that's much less expensive. We can buy refurbished units that are a year old, get a warranty with them, and pay anywhere from 60% to 70% of the new cost. So we save a lot of money.

Eliminating reliance on high-cost services: We're working on developing our own insurance product for low-income populations that would offer patients access to physician services outside the four walls of our hospital, less costly post-acute access and psychiatric care where warranted, plus transportation. Sometimes patients come to our emergency room because they don't have a way to get to a doctor's office, or they postpone treatment until the illness is acute enough that they require an ambulance to get to a hospital. And that's not the most efficient way to manage somebody's health; it's certainly not good for them in terms of outcomes and interventions that they didn't get earlier.

—As told to Ken Tysiac (, a JofA editorial director.


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