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3 Investments CFOs Should Prioritize in 2024

Analysis  |  By Amanda Norris  
   November 16, 2023

The CFO of the Hospital for Special Surgery details its three financial priorities for 2024 and why other finance leaders should do the same.

2023 was a tumultuous year for hospital and health system CFOs. Even though CFOs saw some financial relief as revenue increases offset rising expenses and operating margins began to stabilize, 2023 was far from easy.

Unfortunately, 2024 is likely to be just as bumpy.

CFOs will need to continue to be strategic in 2024 as they aim to maintain healthy operating margins and a strong balance sheet. In this article, Stacey Malakoff, the CFO of New York-based Hospital for Special Surgery (HSS), details the three financial initiatives she will be focusing on to ensure financial success in 2024 and why other CFOs should prioritize the same.

When planning financial goals for the new year, CFOs need to think about 2024 in the context of long-range strategic plans and financial projections, Malakoff says. 

“It is imperative for CFOs to continue to maintain healthy operating margins, strong philanthropy, and a strong balance sheet—all while still making the critical strategic investments that will ensure future success,” according to Malakoff.

Here are three of HSS’ 2024 financial priorities that other CFOs should consider as well:

Its people and culture 

More so than ever, it is imperative that HSS invests the appropriate resources to ensure that it can recruit and empower the most talented clinical and ancillary staff to ensure the highest quality patient experience and support planned expansion and growth, Malakoff says.

“Empowerment includes investments in professional development, employee engagement, safe work environment, and wellness and resiliency,” Malakoff says.

For example, HSS is approaching its fourth year with a best-in-class, internal wellness program led by a U.S. Special Forces veteran who is also a nurse.

Patient access

“We have lots of opportunity to expand access as demand for HSS expertise is high and growing throughout the NYC tri-state area, nationally, and internationally as consumers and employers increasingly understand the importance and variability of quality in musculoskeletal health,” Malakoff says. 

That’s why HSS is investing in the transformation of its NYC main campus to a more ambulatory setting and complex joint/spine center. HSS is also opening new regional locations, increasing capacity and service offerings at several current regional locations, and expanding its physical footprint in Florida. 

“Additionally, we invest in improving access to knowledge in many ways, such as the HSS eAcademy which provides continuing medical education to specialists in 145 countries,” Malakoff says.

All of these major investments need to be made in a carefully planned manner to ensure the highest standards of care and prudent financial management, she says.

Operational efficiency

A continued focus on efficiency is imperative given expense inflation and other economic pressures affecting healthcare providers, Malakoff says.

“Investing in our priorities requires that we find efficiency and economies throughout the organization,” she says. That’s why, Malakoff says, HSS’ financial and operations leadership teams are collaborating to capitalize on synergies and address needs that have been reshaped significantly by the rapidly changing environment. 

“One example of this is our focus on optimizing space and capacity utilization across all facilities and service lines,” she says.

Amanda Norris is the Associate Content Manager of Finance, Payer, Revenue Cycle, and Strategy for HealthLeaders.


2023 was tough. CFOs will need to continue to be strategic in 2024 as they aim to maintain healthy operating margins and a strong balance sheet.

To acheive this, one CFO details the three financial strategies she will be utilizing to ensure financial success in 2024 and why other CFOs should prioritize the same.

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