Introducing the 2025 Finance and Budgeting Survey
Methodology in Brief
In Summer 2025, THMA conducted a double-blind quantitative survey of senior finance leaders at large U.S. health systems regarding the budget and investment strategies at their organizations. The research captures insights on investment priorities, evolving care models, and long-term sustainability from 40 CFOs and VPFs across systems with over $750M in total annual revenue.
Here’s a preview of what we’re hearing from CFOs:
Margins are razor-thin—and cash flow is king. Most are operating at less than 5% margin, with delayed reimbursements and rising expenses creating a persistent squeeze.
Denials, delays, and high deductibles are draining the system. Revenue friction is a top concern as CFOs battle tightening payer behavior and patient affordability issues.
Cost containment isn’t optional—it’s survival. 90% are cutting costs, and 87% are focused on revenue cycle improvements to stay afloat.
Medicaid reform looms large. More than 75% say changes to eligibility or work requirements would have the most significant financial impact on their organization.