At the recent HealthLeaders CFO Exchange, CFOs shared strategies to stabilize operations, strengthen rural care, and embrace AI-driven decision-making.
At the recent HealthLeaders CFO Exchange, CFOs from across the country shared how they are navigating one of the most challenging financial landscapes the healthcare sector has ever faced.
From rural survival strategies to workforce development and AI adoption, several themes emerged. Here are five key takeaways tailored for healthcare finance leaders.
1. Diversify to Survive: Where Rural Providers Are Leaning
Rural hospitals are finding creative ways to stay viable amid persistent staffing shortages, dwindling reimbursements, and community needs that are rapidly evolving. One strategy: Converting hospital-based clinics into Federally Qualified Health Centers (FQHCs) to unlock new reimbursement opportunities and stabilize primary care access.
They're also expanding behavioral health programs to fill care gaps and bring in new revenue, especially in communities with limited resources.
Also, rather than trying to build every specialty in-house, they are forming strategic service line partnerships and leveraging telemedicine to reduce overhead while maintaining access.
Notably, many CFOs emphasized the importance of working with state legislators to fund rural GME programs and trauma designations, reminding policymakers that rural access is a shared responsibility.
2. AI Isn't Just for Tasks; It Accelerates Decisions
AI was a dominant topic, with a focus on practical, everyday applications in healthcare operations. CFOs discussed using tools like Microsoft Copilot, ChatGPT, and Power BI to drive faster decision-making and reduce administrative overhead.
AI is also increasingly being used beyond data entry and reporting, from grant writing to revenue forecasting to compliance tracking. MercyOne, for example, has fully integrated Copilot across its organization, making the shift from "tool adoption" to integrated real-time strategy formulation.
But CFOs shouldn't get too caught up in the potential of AI without considering governance. Leaders emphasized the importance of holding teams accountable to tech usage, embedding productivity expectations into implementation, and clearly defining data use in contracts with vendors.
3. Break Down Silos and Repurpose Labor Strategically
The traditional boundaries between departments are becoming blurred. Revenue cycle is one area where finance and clinical operations are working more closely to align revenue performance with care delivery.
With labor costs rising and hiring still difficult, CFOs shared strategies to "let nurses be nurses" by offloading repetitive tasks, even exploring robotics for supply chain automation and surgical prep. Some systems are investing in bedsore prevention tech to reduce nurse workload and improve outcomes.
Succession planning is also gaining traction, with finance leaders building internal coaching programs in collaboration with HR. For CFOs, the goal is to develop leaders from within and reduce reliance on external hires and contract labor.
4. CFOs Must Be Community Advocates
Especially in rural markets, hospitals aren't just care providers, ; they are economic engines. CFOs discussed how storytelling and local philanthropy are increasingly crucial to reinforcing their value. Highlighting warm and "fuzzy" stories of impact alongside hard financials can build community trust and donor investment.
Health systems are solidifying their role as a foundational pillar of the local economy through internship programs for high schoolers, housing stipends for staff, and efforts to recruit local residents into healthcare careers.
5. Build Financial Resilience Through Scenario Planning and Strategic Cuts
Lastly, with looming changes to CMS reimbursement and volatile payer contracts, many CFOs are preparing for the worst. Some are creating a "doomsday file" of articles and projections to inform board members and executive teams about potential financial shocks.
Other CFOs are reevaluating trauma designations and consolidating service lines to cut costs while still preserving their critical service offerings. Additionally, GPO collaborations with other systems are helping reduce supply costs and standardize procurement.
Above all, CFOs agreed that resilience comes from flexibility, leaning into current tech, investing in talent, and staying mission-focused in times of uncertainty.
Marie DeFreitas is the CFO editor for HealthLeaders.
KEY TAKEAWAYS
CFOs are using FQHC conversions, behavioral health expansions, and strategic partnerships to sustain access in rural communities while controlling costs.
Tech tools are being used not just for efficiency, but to accelerate strategic planning, forecasting, and even grant funding.
Breaking down departmental silos, repurposing staff, and making tough service line decisions are helping systems stay agile through reimbursement shifts and staffing shortages.