How This CFO Says Healthcare Can Evolve

Javier Vallejo, the new CFO for Prism Health North Texas, sees succession planning as one of the biggest challenges in the healthcare industry today.

Earlier this summer, Javier Vallejo was chosen to lead the financial efforts for Prism Health North Texas as its new CFO—a role he was proud to step into to help Prism Health continue its mission to serve people with HIV and AIDS.

Prism Health North Texas is the largest HIV and AIDS service organization in the region. The system serves over 13,000 patients, 5,000 of whom are living with HIV. Prism operates clinics, pharmacies, and a clinical research department. The organization also focuses on behavioral health, healthcare access, and education. Prism Health North Texas recently expanded its telehealth services and STI testing services to address what it describes as an "alarming rise" in STI infections in Dallas County and North Texas.

Vallejo recently connected with HealthLeaders to discuss his plans to help Prism Health grow over the next decade and the way the healthcare CFO role has been evolving over the last few years.

HealthLeaders: What drew you to the CFO role for Prism Health North Texas?

Javier Vallejo: Prism has grown out from primarily a grant organization to getting into more general healthcare services. And through that growth, I've noticed a lot of opportunities to come in and fine-tune some of my strengths and weaknesses, but also to help build Prism up into the next 10 years. I tend to have a systems perspective in how I approached operations and healthcare. My core competencies are in accounting, and my background is in finance. But [what really stood out to Prism] was my vision and knowing how processes should be, being able to work with people, being able to manage and lead and direct change. Those are strengths that typically not a lot of people who have a finance and accounting background tend to have.

HL: What is the mission at Prism Health North Texas?

Vallejo: When HIV and AIDS initially became a huge pandemic in the 80s to today, that science has changed a lot. We're hopeful there will be a long-term cure for HIV and AIDS that's not so invasive and rely on allowing more people to live a full and healthy life based not on their health and income level. But with that, we also have to be open to keeping true to that mission of finding new ways to reach our target demographics and provide new ways to treat them from every front.

HL: Where do you hope to make the biggest difference?

Vallejo: I want to have a real impact on facing the social determinants of health. I want to be an advocate of change. I want to be a leader of change. I want to help shift and navigate the traditional transactional-based healthcare towards more value-based care and help lead that shift. That's going on in the macroeconomic world as it pertains to healthcare.

HL: What is your specific strategy coming into the role of CFO for Prism?

Vallejo: My 100-day plan is I want to make sure that I understand operations, understand the people, and then do some organizational restructuring to put aces in their places and find out where the value truly is. I want to find out what processes aren't bringing any value and try to build an equitable experience. I expect only two things from people that work under me or work with me. I am looking for people who want to do a good job and people who want to be here. To err is human, people make mistakes. But if you want to come to work every day and you want to learn you're going to make those mistakes, but you're going to learn from them and you're going to improve. I'm trying to build a culture of high performance and success and that helps bring about that change I was thinking about.

HL: Someone might hear 'organizational restructuring' and think their job is in trouble. What are your thoughts regarding balancing the organization's overall financial health with maintaining its workforce?

Vallejo: It's not ever someone's intent to lose jobs or to outsource jobs, that's not my focus. Because of the operational growth and because of the business lifecycle, Prism has lost a lot of legacy and institutional knowledge. When CEO John Carlo hired me, he was looking for someone with innovative ideas. COVID-19 has brought about a lot of opportunities to see that the traditional means of doing things—the age of the five-day workweeks or having to commute every day—isn't necessary for every single job function. It's being able to figure out a strategy that works best for everyone. An organization can say I want a standardized process, but a standardized process doesn't necessarily mean everything's identical for everyone. It is about setting proper expectations and making sure you communicate those expectations. And, quite frankly, for me, it's making sure you're not setting anybody up for failure.

HL: What are some of the innovative ideas you are bringing to the table?

Vallejo: I'm focusing on quality and value and trying to align the financial aspects of healthcare with the delivery of care. Healthcare, in general, is known as a loss leader—you can't make any money at healthcare. Time and time again, if you look at the business cycles, the facilities that are doing something right, the facilities that are working towards the future, they are finding ways to bridge that gap and bring those two concepts together.

HL: What are some of the biggest challenges facing healthcare CFOs today, and what solutions to these problems exist?

Vallejo: The pipeline is short. You read about the great resignation and a lot of it's been in the healthcare space. There's been a lot of good leaders who have retired probably a little earlier than planned. I think it's about the next generation having all the skills and having the want to know how to pull those pieces together. It's about being able to give avenues so that the healthcare system does not have a breach, and good financial management, good doctors, and good nurses. I think that one of the main struggles right now in the entire healthcare system space is just a lack of bench strength, a lack of succession planning. We need to be grooming the next generation of leaders.