How CFOs Can Rewrite the Hospital Narrative

As federal reimbursement pressures mount and public perception leans negative, hospital CFOs are uniquely positioned to lead.

The CFO role is expanding, now encompassing far more than financial stewardship. And with unstable federal reimbursement threatening hospital revenues, they're increasingly on the front lines, navigating both internal operations and external perceptions.

To maintain financial sustainability, today's CFOs must step beyond traditional boundaries.

As discussed at the recent HealthLeaders CFO Exchange, this is especially crucial for rural health systems, which are often more isolated from external support and visibility.

Reframing the 'Bad Guy' Narrative

CFOs are all too familiar with the misconception that hospitals are part of the problem. When patients, policymakers, and community members don't fully understand how the revenue cycle works, or the complexities of payer relationships, hospitals can suffer.

CFOs are in a position to shift that narrative. By engaging with their communities, building relationships with state legislators, and fostering internal cultures of trust and transparency, finance leaders can offer a more honest picture of the challenges that health systems face.

Consistent Community Advocates

Hospitals, especially in rural areas, serve as major economic drivers. At the CFO Exchange, leaders emphasized the growing importance of storytelling and philanthropy in demonstrating that value.

Whether it's offering high school internships, providing housing stipends to staff, or actively recruiting residents into healthcare careers, CFOs can lead initiatives that strengthen workforce pipelines and economic impact.

By aligning these initiatives with financial data, CFOs possess a kind of "superpower"—leveraging numbers and narrative to build community trust and philanthropic support.

Speaking the Language of Lawmakers

Few executives are better positioned than CFOs to advocate for hospitals at the policy level. Combining financial expertise with strategic storytelling enables them to clearly articulate how legislation affects health systems and their communities.

Kurt Barwis, CEO of Bristol Health, said CFOs can provide legislators with the data-driven insights needed to understand the downstream effects of healthcare policy. He encouraged finance leaders to build relationships not only with lawmakers, but also with peers in nearby systems to strengthen collective advocacy efforts.

With mounting financial pressure on hospitals, Barwis reminded CFOs: "We just have to keep fighting."

Internal Influence

Strong internal leadership is equally critical. CFOs must foster clear, frequent communication with both executive and clinical staff to maintain alignment and trust. Without that foundation, even well-intentioned strategies can fall flat.

Barwis noted strategic acumen isn't enough.

"You can't put [a CFO] at the top of your organization if they have no people skills, no interpersonal skills, and, most importantly, no self-awareness,." he said.

Stephanie Schnittger, CFO of UVA Health, echoed the importance of transparency. In complex systems where unintended consequences are inevitable, she says, downplaying financial risks only damages credibility.

"The CFO has to be among the most trusted leaders in an organization for it to be financially viable and sustainable over time," she said.