With more than two decades of leadership experience—including dual CFO/CEO roles—Rice is focused on aligning revenue cycle, capital strategy and clinical performance to strengthen margins and sustainability.
When Amy Rice joined Saline Health System as CFO in December 2025, she brought more than 20 years of healthcare finance leadership experience—including time as both a CFO and hospital CEO.
Most recently, she served as CFO for Northwest Medical Center–Bentonville and Siloam Springs Regional Hospital, where she led initiatives that generated $7.4 million in expense savings and $2.8 million in additional net revenue through billing improvements.
That blend of financial discipline and operational leadership now shapes her priorities as she steps into the role at Saline.
Establishing a financial baseline
In her first 30 days, Rice focused on understanding the organization holistically, resisting the urge to move too quickly into execution. That diagnostic phase is increasingly critical as health systems navigate margin pressure and rising costs.
Her early work centered on evaluating revenue cycle performance, expense structures, and service line viability, alongside a deeper look at workforce needs and capital assets.
“Sometimes you don't realize, especially from a capital standpoint, what the age of equipment is,” Rice said.
This emphasis on capital visibility reflects a broader challenge for finance leaders: aging infrastructure can quietly erode efficiency and require significant near-term investment if not proactively managed.
Overall, her approach was about establishing a baseline—“assessing the lay of the land” to inform future strategic decisions.
Reframing financial performance
Rice’s philosophy reflects a shift many CFOs are grappling with: financial outcomes cannot be separated from clinical performance.
“It’s not all about the finances,” she said. “If you have good patient experience, good quality outcomes, everything else just kind of falls in line.”
For CFOs, this mindset underscores the growing importance of integrating quality metrics into financial strategy. Poor outcomes can drive up costs and suppress volume.
Rice’s background reinforces that perspective. Having operated in both CFO and CEO roles, she brings what she describes as a “COO/CFO” mindset—one that connects workforce engagement and physician alignment directly to financial results.
Finance as a strategic partner
A key theme in Rice’s approach is positioning finance as an enabler of clinical priorities, not a constraint.
“Patient safety has to be first…regardless of what the finances are,” she said.
That principle carries through to capital allocation and technology investment decisions, which she emphasizes must be clinically driven and collaborative.
“It takes the whole team approach and if it doesn't work from a clinical standpoint, it's not going to work for the rest of us,” she noted.
While telehealth remains an important access tool following its expansion during COVID-19, Rice is taking a measured approach to newer technologies like artificial intelligence, monitoring developments while evaluating their real financial and operational impact.
Driving alignment across leadership
Operationally, Rice is focused on tightening alignment between finance and clinical leadership. Informal, real-time communication plays a central role in that effort.
“With other C-suite leaders right next door, we rely on impromptu conversations all the time to quickly align on decisions and share insights,” she said.
For CFOs, this approach highlights the value of reducing decision-making friction. Faster alignment can help ensure financial decisions support, not inadvertently undermine, quality, safety and patient experience.
Navigating rural healthcare realities
Rice also points to the unique financial dynamics of rural health systems, where balancing community needs with long-term sustainability is particularly challenging.
“It is a fine line to walk between what actually meets the community needs, but also is something that's viable long-term for the hospital,” she said.
High Medicaid populations and fluctuating demand can complicate service line decisions. Starting and then discontinuing services risks damaging community trust, adding another layer of financial and reputational risk.
Her approach emphasizes disciplined evaluation and strong partnerships to align services with both patient needs and fiscal realities.
Revenue cycle remains the biggest lever
Looking ahead, Rice identifies revenue cycle performance as the most immediate opportunity for financial improvement.
“Revenue cycle is probably our biggest opportunity…whether it’s from denials from your payers and reducing those,” she said.
Like many finance leaders, she points to payer-related administrative burden as a persistent inefficiency.
“We dedicate a significant amount of time on the back end to ensuring appropriate reimbursement from insurance companies,” she said.
To address this, Rice is taking a hands-on, structured approach, which involves tracking initiatives closely and sharing progress transparently with leadership and the board.
For CFOs, her strategy reinforces a familiar but increasingly urgent reality: sustainable margin improvement depends on disciplined revenue cycle execution, tight operational alignment and a clear understanding of the organization’s baseline.
Marie DeFreitas is the CFO editor for HealthLeaders.
KEY TAKEAWAYS
Rice is prioritizing a system-wide financial and operational baseline, with a sharp focus on revenue cycle and capital visibility.
She views quality, patient experience and physician engagement as primary drivers of financial performance—not separate from it.
Administrative burden from payers and denials management remains the most immediate margin improvement opportunity.