Coins to cheesecake: forces of influence in healthcare finance

Healthcare Financial Management, Dec, 2005

Every HFMA member has his or her unique reasons for choosing a career path in healthcare finance. And every member has an individual story to tell about his or her career journey, lessons learned along the way, and secrets of success. Rose Dunn, FHFMA, CPA, RHIA, FACHE, a member of HFMA's Greater St. Louis Chapter, is a prime example.

Coins: Early Influences

For Dunn, who today is COO of St. Louis-based First Class Solutions, Inc., the career journey began with a regular childhood exercise involving coins and the encouragement of a parent. "Before I started elementary school, my father would have me count the change in his pocket each evening when he returned home from work," recounts Dunn. "This evening event sparked my interest in mathematics and finance at a very young age."

But counting coins was only the first of several influences that pushed Dunn in the direction of healthcare finance. "My favorite uncle was a physician," she continues. "So it was natural that I pursue a career in health care. I wanted to enter the field of medical research. My high school guidance counselor suggested a medical records degree:'

Upon graduating summa cum laude with that degree from St. Louis University, Dunn was appointed director of medical records at an organization that has been ranked among the top 10 healthcare institutions in the United States-Barnes Hospital, a 1,200-bed teaching hospital and the current flagship of St. Louis-based BJC Healthcare System.

"My interest in finance continued, so I enrolled in an MBA program," says Dunn. "My coursework allowed me to develop an elementary P&L on several of the key admitters for the hospital after the DRG system was implemented in the '70s and a predictive algorithm of admissions by clinical condition:'

Dunn's career at Barnes progressed, and she was promoted to vice president. By the early 1980s, she was responsible for the majority of nonnursing patient care services and the home health agency, a position overseeing 1,400 employees, 600 interns and residents, and a $79 million revenue budget. "Given this scope of responsibility, I thought some day I'd like to pursue a CFO position," she recalls. With this goal in mind, and after a "Becker" review course, she passed the CPA exam.

After Barnes, Dunn joined MetLife Healthcare, a subsidiary of Metropolitan Life Insurance Company, where she held nationwide responsibility for utilization/case management, provider relations, and customer service for the 24 MetLife HMOs.

HFMA and Cheesecake: Secrets of Success Eventually, Dunn was offered an opportunity in a unique, community, Catholic hospital in Illinois, where she finally achieved her goal of being CFO. "It was then that I joined HFMA and found the value of the local and national Associations' resources, especially the education programs," she recalls. "Although I had a broad understanding of health care from both the provider and payer's aspect, I had little hands-on experience with day-to-day accounting functions. My HFMA colleagues did not hesitate to share practices, policies, procedures, and just plain good advice."

Dunn moved on to establish First Class Solutions, a healthcare consulting firm with a team of HIM management, coding, and UR/CM professionals that specialize in working with and improving troubled health information departments. "Knowing the tie between HIM and receivables, we focus our efforts on both improving HIM processes and the rapport between HIM, medical staffs, and patient financial services," she explains. Dunn often serves as an interim director for HIM and occasionally for PFS. "In this and my consulting role, I help build a greater understanding of the issues both PFS and HIM encounter on a daily basis for other departments and for CFOs and other administrators," she says.

Today, Dunn is a recognized leader of the American Health Information Management Association, having served as both the president and the chairman of the board for the 50,000-member national association. She is a recipient of AHIMA's Distinguished Member Award. She also is an active member of The American Institute of Certified Public Accountants and the American College of Healthcare Executives. She is a Fellow of ACHE, AHIMA, and HFMA.

Amid all of these activities, in addition to obtaining her HFMA certification, Dunn has continued to be actively involved in HFMA, climbing the ladder of chapter positions to eventually become president of the Greater St. Louis Chapter. Since joining HFMA, she also has served as an hfm reviewer, spoken at the Association's Annual National Institute, and contributed to other HFMA activities.

For fun, Dunn says she enjoys writing. She has published more than 200 articles and written several books, including Haimann's Healthcare Management (published by Health Administration Press), More with Less (published by HcPro), and Finance Principles for the Health Information Manager (published by First Class Solutions), Dunn also enjoys speaking at various state and national healthcare industry meetings--an activity that allows her dry sense of humor to surface,