ORLANDO — One would think that a gathering of health care CFOs would be a glum affair, given the pressure they’ve under been under due to health care reform and the shift to new payment models.

In reporting on the future of hospital financial management a bit ago, the outlook for the role of CFO sounded grim. But I didn’t get that impression on my first day at the Healthcare Financial Management Association’s 2015 Annual National Institute. In sessions and on the exhibit floor, financial managers at hospitals and health systems and vendor executives alike seemed to be fairly upbeat about the prospects for the transition to value-based care that is taking place.

Cecelia Moore, CFO at Vanderbilt University Medical Center, was able to kick off her portion of a session on implementing bundled payments with a bit of a joke. "I have to admit that, as a CFO, sometimes it's hard to think about why we'd want to do this," she said.

Nevertheless, from a CFO's perspective, testing bundled payments offered the potential for increased revenue, improved cost control or could have been at the least a good learning experience, she said.

Moore and her colleagues at Vanderbilt laid out how Vanderbilt decided to test bundled payments in describing the medical center's approach in cardiac valve care, an area that is a big driver of post-acute and readmission costs, though not a particular problem area for Vanderbilt. Centers for Medicare & Medicaid data indicate that one-quarter of valve patients accounted for 68 percent of the related post-acute care costs, noted Tom Ervin, Vanderbilt’s assistant director of finance.

Valve replacement was just the start for Vanderbilt and hospitals in the state. Medicaid providers in Tennessee also are going to be increasingly subject to bundled payment reimbursement. The state has set a goal of creating 75 bundled episodes of care coming in 11 waves over five years, and began the process in January with implementation of the three first episodes.

State employers with commercial carriers also will have to participate, noted Brittany Cunningham, senior quality and patient advisor at the Vanderbilt Heart and Vascular Institute.

"So, it is here in the state of Tennessee, and we are living it in the moment," Cunningham said with a smile.