CFOs are under pressure, with legal probes, cyber threats, and workforce challenges reshaping priorities. Here are the most popular stories for CFOs on HealthLeaders through the first half of the year.
: Key themes in healthcare finance this year so far? Turbulence and transformation.
This year is a pivotal one for healthcare finance, molded by high-stakes legal scrutiny, operational realignment, cybersecurity exposure, proactive clinical stewardship, labor and retention crises, and mounting technical debt. Together, these issues reflect a sector under pressure to balance fiscal responsibility, compliance, and innovation.
Here are the top six finance stories of 2025 (so far):
1. UnitedHealth in the Spotlight: DOJ Probes Surge
UnitedHealth Group is facing escalating pressure as multiple Department of Justice (DOJ) investigations—both civil and criminal—focus on alleged Medicare Advantage up‑coding and kickback schemes. A new criminal probe targeting its Medicare Advantage billing practices began in summer 2024, while a civil case is following Wall Street Journal revelations of aggressive diagnosis practices . Publicly, UnitedHealth denies wrongdoing, but its stock has plunged more than 50% from its early-year highs.
2. Cyberattacks Reveal Critical Operational Gaps
The aftermath of the Change Healthcare breach and other cyberattacks has prompted CFOs to rethink disaster preparedness. Following one incident, Greater Baltimore Medical Center CFO Laurie Beyer led rapid, cross-functional incident response teams that pivoted operations and segmented networks to limit fallout The lesson is clear: Outdated systems are not only operational liabilities, but financial catastrophes in waiting.
3. Technical Debt: A Quiet Budget Bomber
Technical debt is a stealthy cost driver. HealthLeaders reports show that deferred IT upgrades — from aging ERP systems to fragmented EHRs — increase security vulnerabilities, operational inefficiencies, and compliance risks . CFOs are now tasked with establishing continual benchmarking, prioritizing ROI-driven refresh cycles, and collaborating closely with CIOs to reduce future costs.
4. Bankruptcy Rates Remain Alarming
Healthcare bankruptcies persisted at elevated levels in 2024 with 57 Chapter 11 filings, the second-highest in six years. Rural, senior care, and pharmaceutical sectors were hit hardest. Notably, midsize provider bankruptcies (liabilities between $10M–$100M) remain a concern. CFOs serving vulnerable providers should proactively engage in community and payer coordination to preserve essential care access amid financial distress.
Retention as a Strategic Financial Lever
Northern Light Health’s CFO-led turnaround hinged on thoughtful retention and workforce development strategies. After deep losses in 2024 ($100M in operations, $620M in debt), leaders restructured administrative roles, doubled clinical staffing, modernized scheduling, and forged partnerships with nursing schools and local colleges. This model illustrates how targeted investment in people is critical to restoring revenue and quality.
Operational Efficiency Through Clinical Waste Reduction
MultiCare Health’s aligned intervention program highlights the financial upside of eliminating clinical waste. Through a collaboration with Epic and IllumiCare, MultiCare has achieved big savings by reducing clinical waste. CMO Arun Mathews shared how the system did it and how much work went into physician alignment with the new program. CFOs should not overlook the importance of collaboration with medical teams to uncover clinical and financial stewardship opportunities.
Strategic Imperatives for CFOs
Risk of Deferred Investment: Organizations that delay IT modernization, cybersecurity defenses, or workforce stability are increasingly vulnerable, not only to operational shocks but also to market and regulatory disruptions.
Need for Interdisciplinary Governance: CFOs are aware of their elevated role beyond finance: coordinating with legal, compliance, IT, clinical, and HR to mitigate threats and capture value, . Now is the time to act on the expanding duties.
Shift Toward Value-Driven Models: Waste reduction, retention strategies, and tech modernization are becoming core portfolio decisions. CFOs must view these as critical drivers of sustainability as the industry pushes forward.
Regulatory Reckoning: The DOJ’s intensified scrutiny of billing practices and MA models signals a new frontier of compliance risk. Proactive audit protocols, tighter coding oversight, and external benchmarking are non-negotiables.
Marie DeFreitas is the CFO editor for HealthLeaders.
KEY TAKEAWAYS
DOJ crackdowns are raising the stakes for billing and compliance.
Tech gaps and cyber risks are becoming major financial liabilities.
Retention and waste reduction are key to financial turnaround for CFOs.