With healthcare pressures arriving faster than many health systems can respond, a strong CEO and CFO partnership has never been more important.
At York, Pa.-based WellSpan Health, Roxanna Gapstur, PhD, RN, president and CEO, and Laura Buczkowski, executive vice president and CFO, have spent nearly six years building that kind of partnership, forging a relationship rooted in trust, complementary expertise and a shared commitment to collaboration, even if the path forward isn’t always clear.
WellSpan Health became a 10-hospital system March 10 with the opening of WellSpan Newberry Hospital in Newberry Township, Pa., the first of three neighborhood hospitals the system plans to open this year. The other two facilities, which will bring the system’s total to 12, will open in late March and April.
While Dr. Gapstur brings years of both clinical and operational depth to the CEO role, Ms. Buczkowski’s 35 years of healthcare finance experience is a tool that has helped shape WellSpan’s growth and future.
Becker’s connected with both Dr. Gapstur and Ms. Buczkowski to discuss their strong working relationship, WellSpan’s continued growth and how they’re navigating an increasingly complex healthcare landscape together.
Question: What’s the most important thing a CEO with a clinical background brings to a partnership with a CFO?
Dr. Roxanna Gapstur: I think critically important is the knowledge of healthcare operations that I had from being an operational leader for so many years. I really worked my way up through the health system, so that I’ve played almost every operational role you can think of. Everything from a nurse manager to a director to a senior director, and then across hospital and clinic operations.
I think that that really brings a strong business sense and business planning, as well as in nursing. Being a systems thinker is really important, and it helps with strategy. Being able to connect finance and strategy together, and then drive execution is where some of my strengths are. It’s been a really good partnership with Laura, who is very deep in financial acumen.
Q: What’s the most important thing a CFO brings to a partnership with a clinician CEO?
Laura Buczkowski: I’m a finance leader, but you have to understand operations in order to be a strong finance leader. What I love about working with Roxanna is that we can brainstorm on ideas. She knows clinical and we can bounce ideas back and forth. We’ve spent countless hours together doing that and we came up with a good solution. I think it speaks to the trust we do have with one another, but also blending all of the operational, the clinical experience, the financial and being able to pull together strategies that work for the organization has been a lot of fun over the last five years, into our sixth year now. The challenges have not diminished.
Q: How has your leadership approach evolved, given the financial realities facing health systems today?
LB: [During] the pandemic, there were a lot of unknowns. We spent so many weekends together virtually trying to come up with, “What is the playbook?” We’ve been kind of used to this.
We started our partnership in that pandemic, where we really were facing a lot of challenges from the unknown, financially, operationally and clinically. From that perspective, I see that as how we formed our strong partnership. Now it’s not much different with all of the issues we’re seeing, whether it’s coming out of Washington, the payers, the continual pressures on reimbursement. We’re using the same thing between scenario planning and working together to say, “How do we help the organization, from a strategic perspective, understand these challenges?” They do, but it’s a little bit more intense now. It’s coming faster and more furious, so we have to be at the top of our game.
RG: Well, No. 1, I think trust is really critical in respecting what each of us brings to the table. I have a deep respect for Laura and her knowledge. She is, in turn, respectful of what I’m bringing. In addition to that, I would say this is our whole team, but certainly Laura and I feel a deep sense of humility as well.
We have faced challenges in healthcare the last six or seven years that have never been faced before, and admitting that we don’t always understand exactly the right path, but then working together, bringing that collaboration and teamwork together to get all of the ideas out on the table and identifying a way forward is where we’ve really been able to align our thinking.
Two things have led to our success. We’ve both stayed very close to the operations and the financial performance of the organization, along with the board. The second thing is just going back to the basics. That basic blocking and tackling in healthcare, what I call, “financial hygiene,” of “let’s do the basics really well and then let’s build from there.” Our team has really come together around that. Getting clear messages from the CEO and the CFO that we are both aligned, and this is the work that we think needs to be done, I think has helped the team execute.
Q: What’s one area where you think health system CEOs need to be pushing their organizations harder?
RG: I think the basic blocking and tackling will always be important. Where I think we should be pushing harder is around transformation, innovation and how we use people process and technology. Laura has been a terrific partner in that way. Not all of our new technologies are seamless yet, and not all of them are integrated into our care system. Making sure that we are being aggressive enough and testing new ideas and new functions is important while balancing the need for [return on investment] in most of what we do. We have good hygiene around where we need ROI, but we’re also willing to try some things that we think could bring value in the future. As CEOs, we need to be pushing there.
Q: What’s one area where you think health system CFOs need to be pushing their organizations harder?
LB: CFOs, when I look over my 35-year career, we’ve evolved quite a bit. You have to be very heavily engaged in strategy. You can’t be the person that’s saying no to everything.
I think exactly what Roxanna has said, we take risks. We are intentional when we’re looking at AI transformation within the organization, because we’re always looking at that five- to 10-year view. “What can we be? Where should we be focused?” It’s exciting as a CFO to be involved in that, partnering with the CEO and the other leaders on our team, because we have a phenomenal team. It’s how we can be transformative in that long term, not just the basic blocking and tackling.
Q: What are you most excited to work on together the rest of 2026, leading into 2027?
LB: We never have a shortage of things that we’re doing. Both of us get a lot of energy from one another. We get very excited when we have projects. When we talk about innovation, I’m excited to see what we can do. We have a lot of ideas right now. Everything to me is an opportunity. How do we look at it and then really [turn it] into something that we can take on, engage and roll out.
RG: I love investing in innovation, learning and identifying new ways of doing things that can help our care teams or our patients. We’re also growing. We’ve been a growing organization for the last five or six years, and it is exciting to see the growth plans coming to fruition now, and to be developing new growth plans for where we’re going to grow next.
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