Cone Health’s nurse-well-being initiative demonstrates that targeted workforce investments can generate measurable labor-cost savings, improve quality-linked reimbursement, and strengthen organizational stability, all within a single fiscal year.
A year after launching a systemwide nurse-well-being initiative, Cone Health reports more than $4 million in savings, driven primarily by improved retention, reduced absenteeism, and a more stable, higher-performing nursing workforce.
After speaking with the system’s CNO, CFO, and the RN who created the program, the financial strategy was clear: Nurse well-being is no longer a “soft” investment, but a grounded labor-cost reduction strategy.
Lower Turnover = Lower Labor Premiums
CFO Andy Barrow framed the financial impact bluntly:
“The financial thesis is largely a cost-avoidance play,” he said. “Lower turnover and lower absenteeism mean lower vacancy, so avoidance of backfilling staff at premium rates, whether that’s overtime or traveler rates.”
Each avoided nurse loss, Barrow noted, represents “tens of thousands of dollars” in costs prevented spanning overtime, traveler utilization, recruitment, and orientation.
Given that roughly 50% of Cone Health’s expenses lie in labor, Barrow emphasized that stabilizing the nursing workforce is one of the few levers that materially moves the margin. Reducing travelling-nurse reliance in particular is a priority.
“We continue to combat the need for travelers and contract labor in our market,” he said.
Beyond labor savings, Barrow connected nurse well-being to measurable quality and financial outcomes.
“A stable, healthy workforce… leads to better patient outcomes through reduced fatigue, better monitoring and documentation,” he said.
These quality improvements can generate reimbursement upside where payer contracts reward performance.
“Where the reimbursement model accounts for that, we can certainly make the correlation to nurse well-being and the culture we’ve created,” he said.
Fast ROI
Vi-Anne Antrum, Cone Health’s CNO, calls the initiative the fastest, most impactful clinical investment the system has made.
The program, created by registered nurse, author, and coach Diane Sieg, takes a ‘train the trainer’ approach to deliver compounding results. The program is set up to train internal coaches to train future generations of ‘champions’ and coaches that empower nursing staff with self-leadership.
Nurses reported improvements not just at work, but at home:.
“We’ve actually had people… talk about the tremendous impact it’s made for them, not only professionally, but with their families,” Antrum said.
This relief from emotional and mental strain allowed nurses to focus more fully on patient care, an effect Antrum says translated directly into clinical quality gains, which lead to further gains in dollars saved.
Reimbursement & Retention
Antrum highlighted the operational and cultural dividends from the program.
“You have the benefits of continuity of care—an experienced workforce that you’re not having to perpetually retrain in your policies and procedures,” she said.
The initiative strengthened Cone Health’s employer brand, and now one-third of new orientation cohorts consist of returning nurses. Every returning nurse represents avoided recruitment and onboarding costs, direct savings that accumulate quickly across a large workforce.
Perhaps the most concrete example was a dramatic improvement in pressure injury prevalence.
“We were at 0.7% as a system and the benchmark is 3.11%,” Antrum said. “So we are top decile on that key metric for PSI-90.”
For CFOs, the significance is immediate: PSI-90 performance is embedded in both commercial upside models and federal pay-for-performance programs.
“[pressure injury prevalence] hits a bunch of those reimbursement metrics… all of the upside incentives from our private payers, and it’s part of our CMS pay-for-performance programs,” she said.
Antrum emphasized that well-being investments created the conditions for these outcomes by reducing cognitive overload and turnover, two silent drivers of quality variation and cost.
She also noted the investment was paired with a structured retention framework, reinforcing stability and continuity of care, two elements that lower labor costs and reduce quality-related penalties.
Barrow is unequivocal about the financial return of the organization’s nurse well-being initiative. The math, he says, is straightforward: The cost of the program is a fraction of the labor expenses it prevented.
“The cost of the investment is a lot less than the $4 million that we would have spent had we not retained those nurses that we've been able to tie back to the program,” he notes.
With retention gains tied directly to reduced reliance on travelers, lower turnover, and fewer orientation cycles, the financial effect is clear.
While Barrow says he typically prioritizes strict measurement, he said this is an area where the correlation is undeniable.
“I’m usually a big advocate for precision, but… the correlation between what we've done with the well-being initiatives and building a culture of well-being is closely enough correlated with the results… that the attribution is pretty easy to me,” he said.
Metrics That Matter for CFOs and CNOs
The well-being initiative highlights the importance of tracking shared metrics that link staff engagement to financial outcomes.
“We’ve been able to reduce our turnover and improve our retention year over year for nursing since we instituted this program,” Antrum said.
She also noted that employee engagement survey results, which held steady or slightly increased despite national declines, are a critical indicator of workforce health.
From the CFO perspective, operational and financial metrics provide the clearest signal of return on investment:
“I keep my eye on retention and turnover rates, overtime usage, contract labor for nursing… and productivity at the department level,” Barrow said. “There’s a benefit when we run more efficiently… I haven’t seen as many areas where we run 110%–115% for multiple pay periods in a row, which speaks to… better retention and less short-staffing.”
Together, these shared data points allow both clinical and financial leaders to monitor the impact of well-being initiatives, linking workforce stability to reduced labor costs and improved efficiency.
Takeaway for CFOs
Cone Health’s experience illustrates that nurse-well-being programs can yield a direct, quantifiable financial return. Cost avoidance from reduced turnover, reduced absenteeism, lower reliance on premium labor, and fewer orientation cycles—plus incremental reimbursement tied to quality—combined to generate more than $4 million in just a 12-month impact.
Dennis Dahlen explains why the system is prioritizing ecosystem-building, long-term flexibility, and commercial discipline as it advances the Mayo Clinic Platform and prepares for rapid shifts in digital and agentic AI.
As Mayo Clinic accelerates its digital transformation through Mayo Clinic Platform_Insights, an initiative designed to give health systems of all sizes across the globe access to digital expertise, data-driven insights and clinical knowledge, CFO Dennis Dahlen says the system is taking a deliberately long-term, ecosystem-first approach, one that he believes is essential for innovation to truly flourish.
A Broader Definition of ROI
Facing the same cost pressures, labor constraints, and reimbursement uncertainty challenging so many health systems across the country, Mayo Clinic is taking a deliberately long-term view in how it evaluates return on investment for its Platform Insights and emerging technology initiatives.
Dahlen, who has led financial strategy at major health systems since 1999 and served as the national chair of the HFMA, describes the approach as intentionally flexible in the early phases of innovation.
"I'll admit to using a lighter touch here at Mayo Clinic on return parameters for these investments … in developmental areas including the platform," he said.
While acknowledging that these investments will eventually be held to traditional business metrics, he stresses that enforcing rigid ROI thresholds too early would risk choking off its transformative potential.
Dahlen recalls Mayo board member Eric Schmidt advising the organization to suspend ROI rules for projects in early development so as not to "kill them before they manifest anything useful."
For Dahlen, the long-term payoff isn't just financial, ; it's structural.
"The long-term ROI… is to support the development of an ecosystem… that will allow everyone to accelerate discovery and advance medicine through more meaningful collaborations across the globe," he said.
Some of that value, he adds, is "really big and really hard to put numbers to, but also really game-changing for the human species."
Even with early-stage flexibility, Mayo maintains an enterprise-wide capital allocation discipline, one Dahlen says has helped it achieve high performance.
"The new space isn't an afterthought. It's almost off the top — first call on capital for these developmental areas," he said.
Leadership sees investment in innovation as essential to maintaining industry position.
"If you stay in the leadership position you have to chart your own course… choose your own pace and keep moving," he added.
Rather than betting on individual technologies, Mayo is building an adaptive ecosystem that can absorb new tools as they emerge.
Dahlen even notes that "Agentic AI… wasn't even on our radar when we started Mayo Clinic Platform and now it represents a significant enabler and contributor to the potential of this platform ecosystem."
This adaptability, he said, allows "course corrections to incorporate new tools… changing market conditions, or even innovations from others."
A Commercial Model for Sustainability
Mayo is not treating its platform as a cost center.; the new entities created through the initiative are expected to generate returns, according to Dahlen.
"We do expect them to create value for us and others and provide tangible financial rewards in the forms of both royalty and equity, which Mayo Clinic then reinvests into patient care, discovering more cures and educating the healthcare workforce of the future," he said.
Generative and agentic AI expand those opportunities, he says, creating "whole new streams of innovation… that expand the horizons" of what the ecosystem can support.
How Mayo Assesses ROI on Digital Tools
Dahlen acknowledges that digital health tools often fall outside traditional financial models, but argues that "with enough discernment you can find a sort of traditional ROI measure. There's value created somehow."
Mayo grants "a grace period upfront" for early-stage development, especially within platform initiatives. But expectations tighten as products near commercialization.
"Once you get to the point of a commercially viable or minimum viable product and you want to start scaling it, that's the point where we start to put in more rigorous ROI requirements," he said.
Borrowing from venture-capital discipline, Mayo examines burn rate, capital needs, expected returns, and timing:
"How am I going to get it back and in what time frame? How long does it take for the flywheel effect to establish itself?" he said.
The Strategic Message for CFOs
Rather than investing in point solutions with limited shelf life, Mayo is designing a structure that can continuously integrate new capabilities.
"It's not in any way a point solution — it's that holistic ecosystem that solves for myriad challenges and iterates as users add more and better data." Dahlen said.
As CFOs navigate rapid digital change, Mayo's model offers a roadmap: Invest in adaptable architectures, balance strategic patience with commercial rigor, and ensure long-term financial durability by letting the ecosystem, rather than any single technology, anchor the strategy.
The American Medical Association (AMA) has adopted new minimum standards for alternative payment models (APMs) tailored to rural hospitals, aiming to stop financial losses, preserve essential services, and give hospital CFOs stronger leverage with payers.
Rural health systems are under severe financial pressure. Many serve low-volume, older and sicker populations, face high rates of uncompensated care, and are increasingly forced to shut down critical service lines such as obstetrics, emergency care, behavioral health, and cancer treatment. In response, the AMA recently adopted a set of APM standards specifically designed for rural hospitals, establishing industry-backed benchmarks to support sustainable reimbursement models.
See how healthcare finance leaders are re-centering mission, workforce, and operational discipline to guide tech-enabled transformation.
As health systems navigate rising labor costs, inflationary pressure, and accelerating digital innovation, CFOs are reshaping their strategic role. Today’s CFOs must balance the promise of advanced technology (particularly AI), with the realities of workforce constraints, process fragmentation, and mission stewardship. The emerging consensus: sustainable transformation begins with people, process, and purpose.
Jonathan Ma, CFO of Sutter Health, has made that framework central to his approach.
Speaking at HFMA’s annual conference in Denver, Ma cautioned against chasing
"technology as a standalone solution."
Meaningful change, he said, requires alignment across three interdependent pillars: “A tech fix without the right people and shared purpose won't deliver sustainable outcomes. All three of those components are interrelated.”
That philosophy feeds directly into Sutter’s capital allocation strategy. With technologies such as AI tools promising efficiency gains but delivering uneven results, Ma’s team applies a multifaceted scorecard that integrates quantitative ROI with mission alignment. The framework isn’t static though. Criteria are regularly updated as market conditions and technologies evolve. In a time defined by cost pressures and value-based care, Ma emphasizes agility by monitoring operational and balance-sheet metrics to balance long-term resilience with near-term realities.
Just as critical is collaboration. Ma maintains tight communication with the CEO, COO, and clinical leaders to ensure that financial discipline supports, rather than compromises, clinical excellence. Within the finance team, he reinforces a culture rooted in transparency and a high “say-do ratio”—a principle his CEO champions.
“Credibility and reliability are how you build trust across frontline teams,” he said, emphasizing direct feedback loops and open dialogue.
Across the industry, other CFOs are echoing similar themes. The push to integrate AI and automation is real, but so are the risks of adopting technology prematurely or without governance. Finance leaders must partner closely with CTOs and CIOs to understand technological trajectories, evaluate development and training costs, and assess legal and liability risks.
As AdventHealth Director of Finance Kaitlyn Anderson put it, "Our goal is not to replace our workforce with technology, but to help our workforce be more effective and efficient... while also improving their experience when taking care of patients."
That balance, technology as an enabler, rather than a substitute, is becoming a defining leadership competency.
At UChicago Medicine, CFO Chris Allen underscores another essential principle: fix the process before adding the technology.
"More times than not, the problem is really the process,” Allen said. "If you throw new technology on a broken process, it’s still broken."
Allen also brings attention to the human dimensions of finance. Decisions around expense reductions or labor adjustments must be grounded in compassion.
"You can't be a finance person in this industry without a heart," he said.
Compassion, in his view, is not just a moral imperative, it's foundational to trust, alignment, and organizational stability.
These leaders signal a shift in healthcare finance: technology matters, but people, process, and purpose matter more. And it is the CFO who increasingly orchestrates that balance.
Hospital labor costs continue to climb, posing persistent margin pressure. For CFOs, short-term fixes are no longer enough.
Recent data from the Kaufman Hall "National Hospital Flash Report," says what many in the C‑suite have long feared: Labor costs remain stubbornly high and are steadily rising across nearly every region and hospital size.
In September, labor expenses per day rose 2% month‑over‑month and 5% year‑over‑year. On a year-to-date basis, costs sit 5% above 2023.
For CFOs, this is not just a short-term staffing shock; it is a structural financial challenge that demands long-term strategic planning, not reactive firefighting.
A Structural Challenge
Labor remains the single biggest line item in hospital spending. According to a recent report from the American Hospital Association (AHA), total compensation and related labor expenses now account for about 56%–60% of all hospital costs.
Between 2021 and 2023, hospitals absorbed more than $42.5 billion in additional labor costs. Over that same period, numerous hospitals turned to expensive contract staffing firms to fill persistent workforce gaps, which only added pressure on margins.
Even as contract‑labor usage moderates from pandemic peaks, the cost level remains high, and this especially goes for smaller or rural hospitals where staffing pools are limited.
Meanwhile, wage growth has consistently outpaced inflation. For example, advertised salaries for registered nurses have increased well beyond general economic inflation over recent years.
In short: labor inflation is no longer episodic — it's ambient. For CFOs, treating it as a "short-term problem" is no longer viable.
For CFOs
With more than half of operating expenses tied to labor (and rising), any margin plan must account for sustained cost escalation. Even modest wage upticks, contract‑labor premiums, or overtime costs could potentially erode operating profits very quickly, especially for larger health systems where volume and acuity are high.
As costs rise, reimbursement (especially from payers) rarely keeps up. The AHA notes that Medicare and Medicaid payments have lagged behind inflation, creating a widening gap between cost and reimbursement.
That dynamic increases the urgency for CFOs to control costs internally, since external revenue levers may provide only small instances of relief.
Lastly, smaller hospitals (under 25 beds), with limited staff pools and fewer operational levers, recorded 5% year-over-year labor cost increases. For these organizations, even small wage increases or shortages can destabilize entire operations.
Mid‑size hospitals, too, are squeezed: they feel the competition for talent but lack the negotiating power of large systems. For many, long-term survival may hinge on alliances, shared services, or even consolidation.
Strategic Long-Term Workforce Sustainability
Given these pressures, CFOs must shift from short-term cost containment toward sustainable workforce and operational strategies, which should include:
Investing in retention, internal talent pipelines, and training. Reducing reliance on expensive contract labor begins with building and retaining in-house talent. Investing in learning and development and leadership training can help reduce premium pay and turnover.
Restructuring care and staffing models. Consider alternative scheduling (e.g., more flexible shift structures), task-shifting (delegating non-clinical tasks to lower-cost staff), and leveraging roles like nursing assistants or scribes to absorb functions that don't require highly trained clinicians.
Leveraging technology and automation where feasible. As workforce and operational pressures intensify, many CFOs are exploring technology‑driven solutions to help manage staffing and reduce labor overhead.
Exploring strategic consolidation, shared-services models, and networked staffing. For smaller or rural hospitals especially, aligning with larger systems, or pooling services like staffing, supply chain, and administrative functions may enable economies of scale and more stable cost structures.
Embedding labor-cost forecasts into strategic financial planning. Given the consistent 4%–6% annual cost growth, CFOs should bake sustained labor inflation into multi-year capital planning, debt service assumptions, and expansion strategies. This gives more clarity around labor costs rather than assuming a return to pre‑pandemic cost structures.
St. Christopher's Hospital for Children CFO Edward Bleacher explains how communication, payer strategy, market vigilance, and disciplined capital management define modern pediatric financial leadership.
Children's hospitals face a fundamentally different economic reality than adult health systems. With limited access to Medicare revenue, heavy reliance on Medicaid, and local demographic volatility, pediatric CFOs often must lead through tighter margins, more unpredictable demand cycles, and a political landscape that directly shapes funding.
Bleacher has served as CFO at St. Christopher's Hospital for Children for the past five years. During this time, his leadership approach has shifted from a focus on traditional finance skills to an emphasis on communication, collaboration, and organizational alignment.
Bleacher says the technical competencies of healthcare finance do not differ dramatically between pediatric and adult settings. What changes is how a CFO leads.
"It starts with communication," he says, emphasizing the need to build partnerships and rally diverse stakeholders around shared challenges.
While his team provides the financial analysis, operational drivers lie across the enterprise.
"I have to rely on operational leaders and help them understand how their actions or inactions impact the financials and our short- and long-term viability," he says.
This leadership model requires speed and adaptability. Pediatric environments move quickly, demanding the ability to pivot and reprioritize in real time. And communication extends far beyond internal teams. Bleacher notes the critical need to maintain sustained dialogue with boards, senior leadership, staff, insurance partners, and policymakers. For pediatric systems in particular, these relationships are strategic lifelines.
Payer Mix and State-Level Policy Dependence
Bleacher is candid about the most significant financial differentiator in pediatrics: The payer mix.
"We are outside of the realm of Medicare," he says. "Most of the children are covered by Medicaid."
With Medicaid administered at the state level, funding structures vary widely, requiring the organization to rely heavily on government relations.
“Our strategies tend to focused on finding common ground with our governors, our county leaders, and city mayors,” he said, noting how localized policy decisions directly shape system performance.
While Medicaid remains central, pediatric hospitals must also diversify their payer mix. That requires attracting commercially insured patients, often through employer relationships, brand visibility, and quality performance.
"It's important to have a balance amongst your payer mix," he said, noting the close tie between financial strategy and the organization's broader marketing and positioning efforts.
Cost Strategy: Tight Margins and Disciplined Capital
For St. Christopher's, balancing rising costs with the need to invest in strategic growth begins with operational discipline.
“The better we are with our efficiencies and our productivity, the more we can drive excess margin that affords us more funding to invest in capital to invest,” he explained.
But in a system with a heavy Medicaid footprint, "margins are tight," he says, "and it leads us into really difficult decision-making."
Capital prioritization becomes a rigorous comparative process. The team evaluates each investment using standard ROI and cash-flow analyses, comparing programmatic investments not only to each other but also to potential returns in financial markets.
"We have a sense of what our ‘hurdle rate' is," Bleacher said, describing how the hospital weighs clinical expansion against the option of investing those dollars elsewhere.
Complicating matters, pediatric hospitals face significant nondiscretionary capital needs.
"Equipment runs through its useful life [and] facilities need to be maintained," he noted. These unavoidable expenses further compress the resources available for growth.
Creative financing helps stretch limited capital. The organization uses a mix of operating and capital leases to spread costs over time and align investment with utilization ramp-up.
This structure, Bleacher said, "more aligns dollars out with dollars back in from a return perspective."
Market Dynamics: Birth Rates, Migration, and Unpredictable Demand
Bleacher cautions against assuming pediatric demand follows industrywide trends. Adult healthcare utilization is rising in large part due to the aging Boomer population. Pediatrics, however, is subject to demographic forces that shift unpredictably.
"Birth rates and the cycles that influence that" play a direct role in determining pediatric volume. Economic conditions—particularly those influencing family planning—affect the number of children in a region, while migration patterns create further volatility.
Cities change quickly, he said, driven by crime, school quality, and neighborhood stability. For a hospital located "within the heart of the city," these fluctuations can alter demand.
Because of this volatility, pediatric hospitals must be vigilant market monitors.
"It's all part and parcel to managing and monitoring what the demand is for pediatric services in your market," he said.
Community Impact
Bleacher’s personal reflections on the closure of Crozer Medical Center underscore the stakes of financial decision-making. The closure, located in Chester P.A. is near his home town. It left vulnerable communities without essential services. He linked the outcome to “short-sighted budget cuts” in public programs and a misalignment between private equity motives and community health needs.
“Most of my career has been nonprofit… focused on direct benefit to the communities regardless of their ability to pay,” he says. “That is not really the primary focus of private equity’s profit play in healthcare… and the two create a broken dynamic.”
He urges financial leaders to consider community impact when evaluating transactions.
Partnerships and Strategic Focus
Bleacher described the hospital’s approach to scope management and partnerships. St. Christopher’s focuses on being excellent in select areas while ensuring patients with more tertiary needs receive care at appropriate facilities.
“We’ve defined our scopes to be as excellent as we can at what we do and acknowledge what we don’t do,” he said.
Partnerships, rather than independent expansion, are now central to the hospital’s strategy as the market consolidates.
“We’ve pivoted to partnerships with other health systems,” he said, recognizing collaboration as a financial and operational necessity for many small to mid-sized pediatric providers.
A 2.6% OPPS increase arrives with new site-neutral cuts and policy shifts that could offset gains.
CMS has issued its final 2026 rule for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payments. The rule modestly raises payment rates, but pairs that with multiple policy changes that could erode financial gains for many providers. The net effect will vary significantly across health systems, particularly depending on site of care, service mix, rural vs. urban location, and reliance on historically higher outpatient reimbursements.
Here’s what it could mean for CFOs:
The 2.6% OPPS bump should be treated as a baseline assumption, but not a windfall. Net gains will vary widely depending on how much of a hospital’s volume is outpatient drug administration, off-campus HOPD, or ASC. For now CFOs should also run scenario analyses that account for: site-neutral reductions; 340B recoupment impact; shifting procedure mix (IPO list elimination); and potential quality-reporting or transparency penalties. For hospitals serving high volumes of Medicare beneficiaries, it may be wise to reevaluate service location strategy. For instance, consider shifting certain services on-campus or to inpatient settings if feasible and clinically appropriate. Finally, invest in revenue-cycle and compliance infrastructure (e.g., price transparency, reporting systems) — failure to comply may erode margins.
Check out this breakdown of the key impacts for CFOs.
The American Medical Association’s new minimum standards for rural-focused alternative payment models aim to counteract widespread financial losses and service line closures in rural hospitals.
The American Medical Association (AMA) has taken a decisive step to address the mounting financial crisis in rural health care.
At its recent interim meeting, the ATA adopted minimum standards for alternative payment models (APMs) aimed specifically at strengthening the sustainability of rural hospitals.
What the Policy Does
With many rural hospitals serving older, sicker populations with low patient volumes and high rates of uncompensated care, the strain is severe. According to the AMA, nearly half of rural hospitals operate at a loss, forcing many to curtail or shut down vital services such as obstetrics, emergency departments, behavioral health, and cancer care.
To counter this, the AMA’s newly adopted APM standards set a new stage for payment models designed for rural settings. The plan’s key provisions include:
Fixed-cost payments on a predictable schedule that are not volume-driven, ensuring hospitals can cover essential capacity even during lulls.
Adequate rates for variable services, guaranteeing that payments reflect the true cost of delivering episodic or fluctuating care.
Reasonable patient cost-sharing, to avoid burdening rural residents.
High-quality, evidence-based care, delivered by physician-led teams, with accountability and transparency.
Reduced administrative burden, so that rural providers aren’t drowning in red tape.
The AMA says it is committing to monitoring these reforms, educating rural stakeholders, and advocating to ensure that funds earmarked for rural hospitals are used appropriately.
Reinforcing Signals
This move comes amid growing alarm over rural hospital closures, and AMA data suggests the financial bleed in rural hospitals is worsening. At the same time, the American Hospital Association (AHA) has highlighted how Medicare Advantage (MA) plans are exacerbating the problem, as many MA plans reimburse rural hospitals well below cost, delay payments, and impose administrative hurdles.
In earlier policy efforts, the AMA has pushed for capacity payments (to sustain essential services), compensation for on-call and standby physicians, and adjustments to quality metrics to reflect the low-volume nature of rural hospitals.
For CFOs
The AMA’s APM standards sends a clear signal that payment reform is not just a physician-driven issue, but also about the drive to preserve rural care. For CFOs at rural or system-affiliated hospitals, this could shape contract negotiations with payers, especially when considering value-based models or pilot APMs tailored for rural settings.
CFOs should prepare for:
Leverage in value-based care conversations: CFOs should use the AMA standards as a benchmark when designing or renegotiating APMs with commercial payers or Medicare. The fixed-payment and cost-sharing guidelines may strengthen your case for capacity-based payments.
Risk modeling: These standards reduce volume risk exposure by embedding predictable, fixed-cost payments. CFOs should stress-test financial models incorporating these payment structures.
Administrative efficiency: With AMA emphasizing minimized administrative burden, hospitals may push for simplified reporting and claims processes in new APMs, improving bottom-line efficiency.
Quality metrics alignment: CFOs’ quality measurement portfolios may need recalibration to reflect evidence-based care without penalizing low-volume services, which is also a change that may align better with physician-led team-based care.
New guidance from CMS limits state use of provider-tax schemes, potentially saving taxpayers $200 billion over 10 years, with major implications for Medicaid financing.
The Centers for Medicare & Medicaid Services (CMS) has issued preliminary guidance under the One Big Beautiful Bill Act (OBBBA) that curbs states’ use of healthcare-related provider taxes. These taxes previously allowed states to generate additional Medicaid funding, but CMS argues they created opportunities for abuse and cost-shifting onto federal taxpayers.
These top ten stories show where CFOs are focused.
For CFOs, 2025 has delivered a year defined by financial crosswinds, strategic recalibration, and heightened federal scrutiny, all conditions that demand both steady stewardship and bold decision-making from the industry’s financial leaders. As balance sheets tighten and revenue pressures build, CFOs are being asked to navigate challenges that stretch beyond the traditional finance domain: regulatory uncertainty, workforce instability, payer-provider tension, cyber risk, and the capital-intensive shift toward value-driven care delivery.
The ten most-read CFO stories of the year reveal a profession under pressure, but also one demonstrating remarkable resilience and creativity. From the Department of Justice’s widening probe into UnitedHealth’s market power to the wave of healthcare bankruptcies reshaping the provider landscape, the year’s news captured both seismic shifts and quiet inflection points that will shape the next decade of healthcare finance.
CFOs also turned to stories that offered practical, hard-won lessons, from building high-retention cultures amid labor shortages to strengthening financial defenses after cyberattacks. At the same time, the sector’s largest systems, including Providence and Kaiser Permanente, provided case studies in revenue integrity, payer negotiations, and long-term investments in care delivery models.
Other top stories highlighted systemic risks that demand CFO attention: the potential for up to $25 billion in hospital revenue losses due to Medicaid disenrollment, the operational fallout from federal funding uncertainty, and the perennial question of capital deployment, including whether to buy or rent essential medical equipment.
Together, these stories illuminate where finance leaders are looking for clarity, where they’re finding solutions, and how they’re preparing for the financial realities of 2026 and beyond.
