Nick Barcellona, CFO, WVU Health System

In an interview with Invest:, Nick Barcellona, CFO of WVU Health System, detailed the system’s strategic response to unprecedented industry pressures. He emphasized that the dual challenge of a constrained talent pipeline and rising employee benefit costs is the dominant issue shaping the health system’s current initiatives. “At WVU Medicine, as a payer provider with an insurance and provider arm, we aim to collaborate between teams to bend the cost curve and improve the health and wellness of our employees, our patients, and all covered lives on the insurance side,” Barcellona said.

Reflecting on the past year, which specific policy, operational, or technological changes had the most significant impact on the health system, and in what ways?

It’s a challenging time in healthcare with unprecedented pressure, though it seems like we say that every year. We are still facing workforce challenges, worsened by the pandemic. Many health systems addressed agency costs and premium pay, but our talent pipeline remains too small for the demand in our sector. We are focused on recruiting and retaining top talent. One of the best ways to win in recruitment is to effectively retain our current employees. We prioritize culture to energize and retain our employees, but the future pipeline is a daunting challenge that will persist across the clinical enterprise — physicians, where the pipeline is acutely strained, nursing, allied health professionals, and administrators. At the same time, employee benefit costs are also rising across all sectors. 

At WVU Medicine, as a payer provider we aim to collaborate between the payor and provider teams to ensure our financial incentives are always aligned. This is a key focus and the future for addressing ever-increasing healthcare benefit costs across sectors.

Workforce development remains a key challenge in healthcare. What strategies are you focusing on to develop both clinical and non-clinical talent?

The answer depends on what area you are focused on. You have to be tactical in responding. For example, we created our own diploma nursing school at our Innovation Corporation, a beautiful reuse of historical space vacated by another company. It’s a win for the community and us, especially since we do not charge anything to  attendees. We also created an internal nursing agency pool, which has scaled successfully across our system. We work closely with our human resources team to ensure fair compensation, staying ahead of the market as best we can. Those are a few tactical answers, but the real secret to success is our culture. We are very conscious of our structure. In healthcare, many organizations are hierarchical, with decision-making at the corporate level. We run a lean corporate infrastructure, giving autonomy to local business unit leaders, empowering them to make decisions. This allows us to recruit top talent for those positions, fostering a sense of ownership and community among team members. That’s a core part of our strategy to recruit and retain the best leaders across our enterprise.

WVU Health System is a major regional economic driver. How do you see your role as a cross-border anchor institution?

We have 35,000 employees and 25 hospitals across West Virginia, Pennsylvania, Ohio, and Maryland. The local community is key in healthcare. When moving into new regions, we sit down with local leaders, legislators, board members, and industry to understand community needs and have transparent conversations about what healthcare looks like and how partnering with WVU Medicine will play out. We focus on access, serving many rural populations aiming to bring care closer to home. Our mission is to improve the healthcare trajectory of West Virginia and beyond through excellent patient care while supporting the teaching mission of WVU. We balance what’s right for each community, ensuring the best access to improve health outcomes. Our insurance plan, Peak Health, started in 2023, enhances population health and wellness, aiming to lower healthcare costs for these communities, addressing the challenge of rising costs.

This year, WVU announced $460 million in system-wide projects. Where is the impact most evident and how is that shaping your strategic direction?

A key part of our strategy is bringing care closer to home by investing in the breadth and depth of our health system in local communities. Morgantown remains our central hub, with a significant academic presence, but we continue to expand beyond it. The $460 million in strategic capital investments this year are all outside Morgantown, including a new tower at Berkeley Medical Center in Martinsburg, a significant expansion at Jefferson Hospital in the Eastern Panhandle, a new regional cancer center and children’s facility in Wheeling, and the acquisition of Weirton Medical Center near Pittsburgh. We’re also investing in a cancer center in Summersville, a new ambulatory clinic in Elkins, and facilities in Charleston and Princeton in West Virginia, Uniontown in Pennsylvania, and in Ohio. 

These investments strengthen regional hubs so patients do not always have to travel to Morgantown for care. This year marks our first year with no investments in Morgantown, which is a powerful statement of our expansion into communities like Southwestern Pennsylvania and the Northern and Eastern Panhandles of West Virginia.

WVU has also moved into Southpointe. How does this expansion strengthen your presence specifically in Pittsburgh?

We love the Southpointe space. It’s a beautiful four-story, 90,000-square-foot building off a main thoroughfare. We’re actively building out the first and second floors for clinical services, with shell space on the third and fourth floors likely to be developed sooner than expected. It will be a multispecialty ambulatory location with imaging, labs, significant primary care, and subspecialty care. Located in Pittsburgh’s South Hills suburbs, it complements the great health systems in downtown Pittsburgh, which we respect. We bring a different experience, emphasizing our culture. Our facilities avoid bridges, tunnels, and complicated parking garages, offering free parking right out front. This distinct experience is what we focus on for our patients and covered lives in the region. Southpointe is an exciting milestone for us.

What other challenges and trends are influencing your financial and operational strategies, and which trends are shaping the healthcare landscape most prominently?

We’ve discussed workforce challenges and concerning employee benefit cost trends, which aren’t new. There’s uncertainty around federal and state funding for government programs like Medicare and Medicaid, which we take seriously, advocating with other health systems regionally and nationally as a nonprofit. Our strategy to address this uncertainty includes investments in regionalization, expanding the breadth and depth of our system, and growing Peak, our insurance provider, with a focus on population health. We’re cautiously optimistic about our position to thrive and grow. Navigating competitive dynamics and external pressures is always challenging, but our core strength lies in financially aligned incentives between our payer and provider, supported by a workforce and culture that attracts top leaders. The people are our best resource, and aligned leadership is our secret sauce for future success.

Looking ahead three to five years, what are your key goals and priorities?

We must be cautious about forward-looking statements, but I think we’ll continue to grow. Healthcare will face significant pressure, likely leading to further sector consolidation. Being well-positioned to respond to opportunities and staying nimble is a core part of our strategy. Continuing to invest in our insurance arm, Peak, is central to our diversification strategy for future success. It’s about being nimble, navigating opportunities, seizing the right ones, and knowing when to walk away.