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January 1, 2023

Yale New Haven Health CFO Kosyla signs on as hospital challenges ramp up


Gail Kosyla brings a range of experience at academic and Catholic hospitals to her new job as chief financial officer at Yale New Haven Health (YNHH), the New Haven-based system with plans to grow soon into an eight-hospital network that spans the state.

Most recently executive vice president of system financial operations at New Jersey’s RWJBarnabas Health, Kosyla has also held top strategy posts at Hunterdon Healthcare System and a major New Jersey Catholic health system.

She was drawn to New Haven in part due to YNHH’s reputation, she said.

“Business people — we look at the financial statements, but you also look at the quality of the business,” Kosyla said. “That’s really the name of the game, especially in health care. Yale New Haven Health has a great brand associated with it. … The connotations of quality are there.”

YNHH CEO Chris O’Connor highlighted Kosyla’s background in announcing her appointment in September.

“Her extensive experience in health care, and in an academic health system specifically, will help us shape the future of our health system in the years ahead,” he said. “We are fortunate to have recruited someone with Gail’s incredible talents.”

Kosyla will need all of her talents to navigate the headwinds facing health care coming into 2023, as ongoing impact from the COVID-19 pandemic and an industry shift away from hospital care is weighing on hospital bottom lines.

Yale New Haven Health hasn’t been immune to those challenges.

Quarter after quarter of dire results prompted the system to announce its first staff cuts in recent memory in September, with 72 people laid off and 83 vacant jobs eliminated. At the time, the system was projected to lose $250 million for the fiscal year.

“Unfortunately, this is the difficult residue of the pandemic that’s impacting hospitals,” YNHH Senior Vice President Vin Petrini said in announcing the cuts.

Hospitals are struggling across the country: The American Hospital Association reported in September that an analysis found that more than half of U.S. hospitals were projected to operate in the red through 2022.

Hospitals in Connecticut saw substantial gains in revenue during 2021, but many were expected to operate at a deficit during fiscal 2022, which closed Sept. 30, as pandemic relief diminished, patient volumes remained sluggish and costs continued to rise.

“It’s an ugly year in health care, there’s no two ways about it,” Dr. Eric Dickson, CEO of UMass Memorial Health, told the Boston Globe in a December article. According to the Globe, Boston system Mass General Brigham reported a $432 million operating loss for 2022, the largest in its 28-year history.

The gravity of challenges facing Connecticut hospitals was on view Dec. 2, at a hearing hosted by the state Insurance Department, along with the Office of The Healthcare Advocate and Office of Health Strategy.

Labor and supply costs have risen even as hospitals admit more patients who are sicker and stay longer, pushing down the bottom line, said James Iacobellis, senior vice president of government and regulatory affairs at the Connecticut Hospital Association.

“The pandemic has disrupted long-term trends in health care. Its effects continue to play out and only time will tell what that impact will mean,” Iacobellis said. “Hospitals and health systems have confronted many challenges, including historic volumes, revenue losses as well as skyrocketing expenses.”

Griffin Hospital President and CEO Patrick Charmel spoke with urgency of the tightening noose around the Derby health center’s finances, exacerbated by the growing gap between rising costs and lagging reimbursements. Hospitals serving poorer communities are especially hard-hit, he said.

“The reality is hospitals are not going to be able to continue to operate unless we fix this system,” Charmel said.

‘Renewed sense of partnership’

A native of the Philadelphia area, Kosyla started her career in public accounting and worked in the field for five years before taking her first job in the healthcare industry at Franciscan Health System, a Catholic group of hospitals in New Jersey that is now part of Trinity Health.

Working in health care appealed to her compassionate side, Koslya said.

“There’s just such a feel-good aspect of serving the community and trying to provide services, quality services, to the community,” she said. “Being the finance person who is helping the leadership team to be sustainable really connects you to the mission of health care, and it’s something that has always kept me coming back.”

Kosyla spent 20 years at Franciscan, rising to the post of CFO for affiliate hospitals in Trenton, N.J., and Langhorne, Pa. She then took a post at Hunterton, where she spent six years before joining RWJBarnabas Health, which is affiliated with Rutgers University.

With $6 billion in revenue and 12 affiliated hospitals, RWJBarnabas Health is comparable in size to Yale New Haven Health and has a similar academic mission, Kosyla said. For fiscal 2021, YNHH reported net revenue of $5.6 billion.

YNHH’s strong ties with Yale Medical School and the research side of health care was part of what attracted her to the CFO job, Kosyla said.

“To join an organization where that's really, truly ingrained in the culture is exciting,” she said. “We have this renewed sense of partnership with the school and I think that’s going to do so many great things for the health system — cutting-edge research and applying it to how we care for patients.”

Reinforcing the system’s ties to the medical school has been a top priority for O’Connor, who took over as CEO early last year from Marna Borgstrom.

O’Connor has also been intent on growing the system.

YNHH currently consists of five hospitals: Bridgeport, Greenwich, Lawrence + Memorial, Yale New Haven and Westerly, along with its Northeast Medical Group network of practitioners. The system is set to expand in the next year or so with the acquisition of three more hospitals, Waterbury, Manchester Memorial and Rockville General hospitals.

The deal to acquire the three hospitals from Prospect Medical Holdings, announced in October, is currently in the regulatory review process. YNHH filed initial Certificate of Need forms with the state’s Office of Health Strategy on Nov. 28, and is awaiting a decision.

Adding the three hospitals, Kosyla said, will help patients across the state access quality care and provide economies of scale.

Consolidation in the state’s healthcare industry has raised concerns about the impact on the cost of care, and studies have shown that it can lead to higher prices for patients.

In order to prevent future layoffs, Kosyla said the system will be looking to redeploy workers as it shifts its services and managers. It will also be scrutinizing open positions.

‘Exodus in the labor force’

Growth potential for the system includes the Prospect hospitals, Kosyla said, along with the major new neuroscience institute announced this year for the St. Raphael’s campus and an ongoing expansion of services at Smilow Cancer Hospital and of cancer care at all the system’s outposts.

“When you think about the long term you want to build for the future,” Kosyla said. “You don't want to build for what’s happening right now.”

YNHH is also facing labor force issues as more healthcare workers retire and leave the industry.

“Our healthcare workers went through so much,” Kosyla said. “There's just been an exodus in the labor force.”

“That's really a huge challenge — really looking at the way we do business,” Kosyla said of the issues facing hospital systems. “Building more efficiencies into the way that we operate is going to be really important.”

Kosyla said she has confidence that YNHH’s leadership can lead the system through the current financial turmoil due to their commitment to the mission of providing quality health care.

“That connection to mission — I felt that all through my interview process,” Kosyla said. “So far it’s been a great move, and I'm looking forward to a great future.”

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