A Strategic Look at What’s Driving CFO Decision-Making
Gain exclusive insight into the priorities and concerns shaping the minds of leading Health System CFOs. This session distills the key themes from our closed-door Spring 2025 gatherings, offering strategic takeaways for industry partners looking to better align with today’s financial decision-makers.
Session Takeaways
Policy uncertainty is dominating much of the CFO's mindshare. Finance leaders continue to discuss the potential of four major reforms:
Medicaid Cuts:
Proposed federal Medicaid cuts could lead to a $32B loss in hospital reimbursements across expansion states by 2026. With Medicaid accounting for 15-30% of health system revenue, state-by-state implications will be critical to track.
Elimination of NFP Status:
Policy discussions around ending not-for-profit tax exemptions are gaining traction. While only 16% of finance leaders cited this as a top concern, its potential impact varies widely by state - and could reshape financial strategy for NFP systems.
Site-Neutral Payments:
Full site-neutrality is the number one concern among CFOs, and finance leaders are preparing for a future where reimbursement no longer favors hospital-based settings, including the continued expansion of ASCs and other non-HOPD sites of care.
340B Reform Threatens Drug Discounts for Safety-Net Providers:
340B discounts totaled $66B in 2023, but growing resistance from pharma and PBMs is putting the program under pressure. While only 5% of finance leaders ranked it as a top concern, changes could limit access to affordable medications and erode margins for safety-net providers.
Reimbursement challenges continue with frustration around AI-driven payer denials and rising patient obligations.
CFOs are looking for solutions to preauthorization and denial issues, whether via legislation or AI tools.
Employer costs for health care continue to rise, and we’ve seen an increase in ICHRA volumes. CFOs aren’t sure what the repercussions are yet, but are tracking closely and voicing some skepticism with these arrangements.
Continued rising workforce costs and physician engagement issues are top of mind
Growth in hospital employee compensation continues to outpace inflation and is driving margin compression
At the same time, more health systems are reporting on physician unionization efforts—interestingly, demands are more around practice autonomy than compensation.
Finally, ambient listening and automation tools are an investment priority as CFOs see the need to offload “burnout tasks” from their clinicians.