Annual Conference Day 1: HFMA’s Ann Jordan announces new tool to quantify the performance of the healthcare industry

HFMA is formally taking the lead in providing the healthcare industry with true measurements of the system’s capacity to meet present and future demand, President and CEO Ann Jordan announced Sunday.

While kicking off HFMA’s 2025 Annual Conference in Denver, Jordan described the launch of the U.S. Healthcare Vitals Tracker, which “creates a common starting point for a context of a national dialogue on rising costs and underwhelming outcomes compared to fellow developed countries.”

By itself, the Tracker does not offer solutions to systemic problems. Rather, it is one component of a new HFMA strategic business initiative called Vitalic Health, which is dedicated to the pursuit of financial sustainability and better healthcare outcomes through solve-based convening.

The Tracker and upcoming Vitalic Health initiatives have never been more needed, Jordan said, given deepening financial strain across the industry and an increasing expectation “to understand the real levers of affordability and outcomes. Not just unit cost, but cost of care. Not just clinical metrics, but community well-being.”

What the Tracker does

The Tracker is a composite index comprised of indicators in two main areas: national health affordability and functional longevity. Each area consists of underlying measures and sub-measures that reflect recognized and validated metrics such as infant mortality, consumer price index, food quality and unemployment rates.

Specific weighted sums were assigned to each category based on expert feedback, and the sums were rolled up into the two main areas for comparative correlation and to create a cumulative annual score.

“The framework illustrates the powerful factors beyond the control of providers or any stakeholder that impact affordability for their patients,” Jordan said. “It likewise highlights the critical interplay of social determinants of health on outcomes, and the complexities of population health.”

A key feature of the Tracker, she added, is its ability to quantify the impact of future policies and developments by inputting assumptions from new variables. And scores can be computed on a regional basis as well as nationally.

What the Tracker shows

In measuring the effectiveness of the healthcare industry, the Tracker generated a score of 35 on a 100-point scale when incorporating 2023 data. That’s the lowest score of any year in HFMA’s calculations, which looked back to 1997.

“The score confirms what you likely experience and feel every day: That the healthcare system is not making progress towards improving affordability and functional longevity,” Jordan said. “And if healthcare stakeholders are unable to grasp true catalysts and reimagine what’s possible to change the current trajectory, the entire system inevitably will slip further into crisis mode.”

Assessing the individual index measures over a 25-year period, Jordan said, “revealed a clear affordability paradox. Despite medical discoveries, technological breakthroughs and polarizing legislative action, functional longevity has been relatively stagnant and [has] not improved. While affordability continues in a downward trajectory, to speak plainly, the data shows that the pace of medical discoveries and technological breakthroughs has accelerated, adding cost to the system that is not proportional to the improvements of health outcomes.”

Next steps

Any such effort to quantify the effectiveness and volatility of a multitrillion-dollar industry is unlikely to be perfect at the outset. HFMA intends to seek public comment this summer from all healthcare stakeholders, with a special solicitation to HFMA members.

“In the spirit of being a credible convener, we understand there is much to learn and be gained from respectfully hearing the perspective and ideas of others,” Jordan said.

Beyond the Tracker, initiatives of Vitalic Health will incubate and test problem-solving mechanisms through new business pillars, swarm studies and a payment model consortium, Jordan said.

“It is our vision that these activities will lead stakeholders toward revolutionary payment models and business practices to reign in healthcare expenditure growth while increasing health and lifespan,” she said.

The rallying call of Vitalic Health is “meaningful action, lower costs, healthier lives, and [knowing that] leading healthcare doesn’t mean having all the answers,” Jordan said. “It means having the fortitude to move forward anyway through ambiguity, complexity and the uncertain pulse of progress. It means that, knowing the future, we reimagine one where healthcare is more equitable, more sustainable and more human, [and creating such an ecosystem] isn’t someone else’s responsibility, but a collective obligation that is ours to design.”

Invoking the theme for the 2025 Annual Conference, she added, “This is where we show our strength — not just by responding to change, but by leading the way.”

---

Leadership panel: Why health systems aren’t going anywhere

Traditional health systems will remain central to the U.S. healthcare system, but they must evolve to meet new demands, industry executives said as part of a panel discussion during Sunday’s general session.

New approaches are needed to overcome daunting challenges posed by high costs, labor shortages. demographic shifts and inadequate government payment rates. Systems must lead integration and coordination, and they must take responsibility for the total cost of care, panelists said during the discussion, which was moderated by HFMA President and CEO Ann Jordan.

“I don’t view the disruption that’s coming as replacing health systems, but they certainly will not look exactly the same,” said Marcus Whitney, founder and managing partner of the healthcare venture capital firm Jumpstart Nova, and Secretary-Treasurer for HFMA’s Board of Directors.

“If we’re going to figure out this cost issue, this access issue, this labor availability issue, this employer cost issue, they can’t look exactly the same. But I have complete trust in the leaders on this stage and in the audience to navigate us to where we need to go five and 10 and 15 years from now.”

Improved access through technology

Dan Liljenquist, senior vice president and chief strategy officer with Intermountain Health, said acute-care needs are too substantial to imagine hospitals and health systems fading away or undergoing radical changes.

“I do think you’re going to see dramatic changes in how we handle end of life,” Liljenquist said. “We have to [have] those conversations.”

In addition, he said, “I do think you’re going to see some really cool advancements with individuals engaging with their health systems longitudinally in different ways.” For example, self-insured employers have expressed interest in giving employees ways to connect via AI tools.

“The marginal cost [of those platforms] almost dropped to zero,” Liljenquist said.

Technology will help health systems overcome fragmentation and improve coordination, said Robin Damschroder, president of value-based enterprise and CFO with Henry Ford Health.

“The tech is there to do it,” she said. “When you talk about where we need to invest our money, we’ve got a lot of beautiful facilities, we’ve got tremendous clinical talent and we have spent a lot on technology. But [it’s a matter of] sewing it all together to really live the experience of the patient and how we would want to have it done. And we know [that], we know it by the way we bank, by the way we shop and by the way that we go to the airport and travel, so we can do it.”

Not a replicable business model

One reason health systems are likely to maintain their positions is the lack of a viable alternative, said Chelsea Glenn, chief growth officer with Northwell Direct, the direct-to-employer business of Northwell Health. Industry disruptors such as VillageMD have struggled financially, she noted.

“The year [before] Amazon took One Medical private — and I love One Medical, it’s a great company — but it lost $400 million,” Glenn said. “That is not a sustainable economic trajectory that I’m seeing as an alternative to the delivery system that we have as health systems. I haven’t seen an ability at scale of a company to really apply technology in a way that overcomes all of the cost structure problems that we face as delivery systems, to supplant what the health system is offering.”

Another advantage of health systems compared with nontraditional entities is the ability to provide holistic care as opposed to point solutions that look only at a specific disease state.

“It’s really hard to replicate that if you’re trying to create something completely outside of us,” Glenn said.

---

Liljenquist receives HFMA’s top honor

Before participating in the panel discussion, Dan Liljenquist, senior vice president and chief strategy officer with Intermountain Health, took the stage Sunday to receive HFMA’s Richard L. Clarke Board of Directors Award. The award annually recognizes an individual who makes significant, positive contributions to the profession of healthcare finance or the financing of healthcare services.

In addition to his leadership role at Intermountain, Liljenquist is lead architect and board chair with Civica, a nonprofit that aims to improve the affordability of hospital-administered (Civica Rx) and prescription (CivicaScript) drugs by making generics more widely available. The Civica Foundation, a 501(c)(3), fosters philanthropic support for Civica’s work to manufacture and distribute affordable medications. Liljenquist also chairs Graphite Health, a collaborative venture to build a digital infrastructure that allows for the secure, seamless and standardized sharing of health data.

“Through every role he has taken on, Dan has reimagined laser-focused possibilities on making healthcare better, more equitable and more sustainable for everyone,” said HFMA President and CEO Ann Jordan.

The genesis of a bold idea

When the concept of Civica occurred to him in 2016, Liljenquist said, it represented “this idea that perhaps we collectively, by organizing the demand side of the equation, could create a new type of market. A market that was focused on ensuring that essential medicines that have been on the market for decades would be available and affordable to everyone.”

Today, he said, Civica has provided 90 million patients with 240 million doses of medication, with participation by one-third of U.S. hospitals.

Three key takeaways from the initiative, Liljenquist said are:

• Health systems can and must take the lead in solving systemic problems.
• Finance leaders, as represented by those who joined the initiative, have the courage and wisdom to spur major changes.
• Fixing healthcare requires collaborative solutions that start among industry stakeholders.

Said Liljenquist, “The thing that I’m proudest of maybe about Civica is that we created an environment where our fiercest competitors could be in the room working together, by saying, Hey, this portion of the healthcare system [the generic drug supply] should be common, should not create a differential advantage.

“And this is just the first of many opportunities: Data interoperability, stabilizing rural health. … My hope is that [Civica represents] this example of disruptive collaboration and this idea that the only way healthcare can move forward into a more stable future will require you to do it. There’s nobody else coming to do it.”