Pictured above: Rebekah Fincher, chief administrative officer, Conway Regional Health System

The complexities of today’s health care market are common knowledge bordering on cliche these days but are precisely what feeds Rebekah Fincher’s furnace as the chief administrative officer of Conway Regional Health System.


Fincher, whose areas of direct responsibility include physician enterprise, marketing, communications and public relations, physician relations, medical staff administration, and graduate medical education, has served in this role or its equivalent for nearly a decade. Focusing on strategy, growth and business development, she has been at the forefront of the hospital’s sustained success, which, considering the state of independent community hospitals as nothing short of a dying breed, is saying something.


“I think [Conway Regional] is an awesome case study,” she said. “Every single day, we live out this purpose of being a stand-alone community health system where all across the country you see consolidation happening among health systems, not just hospitals. Conway the city has an incredible amount of pride, as does Conway Regional. When you think about the communities we serve in central Arkansas and the River Valley, you think about the people that work here and the physicians who choose to take care of their patients here, there is a lot of pride in what we do every single day.


“I think the advantage to that is when you have pride in your work and you can make decisions about how to care for your patients and how to take care of your community, people are generally happier. Giving folks the ability and autonomy to be able to make decisions as part of a coordinated team effort creates a really special place to be. For me, that’s the part that is really, really special about being here in Conway.”


Based on recent statistics, consolidation is not just a factor in the health care market; it has become a fact of life in many communities as hospitals bow to enormous economic pressures and join vertically integrated health systems. As last summer’s Agency for Healthcare Research and Quality Compendium of U.S. Health Systems pointed out, this has resulted in a health care market that is more concentrated than ever before. The compendium showed 76 percent of hospitals, 93 percent of hospital beds and more than half of physicians in general and primary care physicals in specific belonging to a vertically integrated health system. Numbers in each of these categories are several percentage points higher in 2021 than in 2018.


Equally telling is the fact that health systems themselves are changing hands at a rapid clip. The report noted 63 health systems listed in 2018’s compendium were absent from the 2021 report, most either by merging with or being acquired by other health systems. The overall number of systems remained level, which is another direct reflection of what is growing out of all the consolidation activity, as entities continue to merge and form new health systems.


Conway Regional, by contrast, has always been an independent entity, dating to its establishment as Faulkner County Hospital in 1925. The road has not always been smooth for the entity — the city of Conway purchased the hospital out of foreclosure in 1937, and Baptist Health opened a hospital on its doorstep in 2016, ramping up direct competition — but Conway Regional has weathered these challenges and continues going strong today. The organization’s 2022 annual report noted the system, anchored by its 180-bed hospital, employs 1,900, including 225 physicians, and serves a seven-county footprint.


Fincher said rather than being a limitation, Conway Regional’s size and independent status is actually a catalyst for the kind of strategic decisions and innovative thinking that is so critical to keeping the health system moving in the right direction.


“Being able to make your own decisions operationally, having an independent governing board, being able to make capital decisions locally has been key,” she said. “That goes for what equipment we’re going to invest in, what growth really looks like from a facility and equipment standpoint, what service lines are needed. Being able to do all that locally helps us to be nimble, and I think is what has really translated to the growth and success that you’ve seen over the last eight years.”


Conway Regional enjoys a partnership with CHI St. Vincent in Little Rock, which gives the Conway health care system buying power and allows it to centralize certain back-office functions. The relationship has been successful and provides a ready blueprint for other partnerships, Fincher said.


“The St. Vincent partnership is the best of both worlds; it gives us access to a national health system because CHI St. Vincent is part of CommonSpirit and allows us to have some purchasing power as a small independent hospital. I don’t know of any other arrangement that’s like it in Arkansas,” she said. “We are pretty resolved as an organization that there are things that we do really, really well and that need to happen here, but there are some things that we just need an external partner for. Let me use the example of hematology/oncology; I think these are things we might need an external partner for, and there are other things that fall into that category, as well. I think [partnering] has created space for those conversations to happen.”


At the same time, the health system has demonstrated an innovative mindset in addressing organizational and consumer needs internally. For instance, Fincher spearheaded the effort to create a graduate medical education program at Conway Regional whereby medical students can serve their residency in one of three specialties — internal medicine, family practice and rural training.


“With the emergence of medical schools in Arkansas, our part in that was to create more residency slots to train medical students that want to be physicians,” she said. “We’ve created a training ground, and when all our programs are in full complement in 2024, we’ll be training 33 residents. We’ll matriculate and graduate a class each year. That will be our contribution to addressing the physician shortage and access-to-health-care shortage here in Arkansas.”


In addition to the homegrown talent Conway Regional hopes to educate and retain through its graduate program, the organization has been extraordinarily successful in attracting other medical talent to central Arkansas. Fincher estimated more than 30 physicians have been successfully recruited over the past few years. While her area of operations does not directly recruit and hire — nor does it deliver patient-facing medical services — she noted the overarching strategy for Conway Regional’s success lies with every department working together.


“Health care is a team sport — everything from your physicians to nursing to your environmental services to your marketing and your administration team,” she said. “How well marketing gets a message out there starts with the team that’s doing patient care, which gives [marketing] something authentic to talk about.”


Fincher was born and raised in rural Arkansas, and the Shirley native, who earned her undergrad at the University of Central Arkansas in Conway and her graduate degree from the University of Arkansas at Little Rock, said this has inspired her to drive easier access to medical care for those living outside the metro areas of the health system’s footprint.


“Access to health care, for me, is something that I have been passionate about from growing up in a small town,” she said. “Getting to influence what access to health care in Arkansas looks like every single day is something that I consider a privilege.”


Fincher applies the same passion and skill to employees’ careers, especially women in health care, by improving means of advancement and mentoring wherever it is needed.


“I started in a very different role in the organization, a very frontline business-development role that offered, very frankly, no pathway to growth in the organization,” she said. “I will forever and always be incredibly grateful to Matt Troup, [president and CEO], for deciding to invest in me. Because of that investment and by some hard work, some grit, and a lot of luck, I think I have somewhat met his expectations and hopefully continue to.


“As a result, I feel a real commitment to doing the same thing for women who want to be in health care. At Conway Regional, 70 percent of our workforce is women, but that doesn’t always mean that women find their pathway on the administrative or business side. If you’re privileged enough to be in a position of leadership and there is someone that you can take the time to invest in and grow, I think we each have an obligation to do that, male or female. As women especially, we must recognize that we need to do that for one another. I think the opportunity to do that is really special, and I’m very grateful that I get to be a part of that conversation.”


Fincher said the human component is, ultimately, what sets Conway Regional apart from the competition because employees and staff serve a constituency that are not only patients, but friends, family members and neighbors. Such commitment to serve is a vital piece to not just meet today’s challenges, but to advance and sustain Conway Regional Health System well into the future. Creating an environment that caters to employee satisfaction, delivers next-level care and does it in a way that is fiscally responsible is a challenging journey, but one Fincher considers well worth taking.


“I am drawn to health care because of the complex nature of it,” she said. “Every single day, when I come to work, the challenges that are put in front of us are complex, and they require creative and innovative solutions. They take into account people and processes and everything else. That is what has really drawn me to health care. Very frankly, it’s one of those things you could look at like exercising: Once you get into it, you kind of become addicted to it.