The first question every health care finance leader should ask about a budget problem

When a budget misses the mark, the instinct is to dig into the numbers. But the better move might be to step back and ask a simpler question: what changed?

Melinda Mastel, financial advisor at the Medical College of Wisconsin, says that one question shifts the focus from the spreadsheet to the operational reality behind it, revealing workflow issues, staffing shifts, and data definition changes that the numbers alone won't show.

Physicians Practice: When someone brings you a budget problem, what's the first question you ask that gets you past the numbers and into what's really happening operationally?

Melinda Mastel: The first thing I look at is what's changed in the numbers. That gets you into context. Maybe someone's bringing you the problem, or maybe you're noticing it yourself, but breaking that down and seeing what changed helps reveal possible workflow changes or issues, as well as changes to data definitions that might be driving things. Whether it's operational definitions, workflow, staffing, volume, or documentation, asking what changed gets at all of those different pieces.