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.
For CFOs, this study highlights where the focus should be.
Earlier this year the Healthcare Financial Management Association (HFMA) published its "CFO of the Future" study. For CFOs, this study points to three main takeaways.
The study points out that artificial intelligence (AI) is everywhere — but governance is lagging. According to the study, the majority of health systems are already using AI (finance, revenue cycle, clinical areas), but few have a mature governance structure or fully defined strategy.
It also highlights that new skills and roles are emerging in the C-Suite. CFOs recognize that future success requires skills beyond traditional finance: innovation, digital technology, and payer relations are increasingly important.
Another imperative is strategic technology investment, which is now core to financial resilience. In the face of cost pressures and revenue uncertainty, CFOs are leaning into technology especially, (AI and automation), to improve efficiency, reduce labor burdens, and optimize revenue cycle operations.But to maximize value, these investments must align with risk management, capital planning, and the organization's long-term financial strategy.
Check out these three tailored key takeaways for CFOs from the study.
CFOs are no longer financial gatekeepers of health systems, they’re strategic business partners.
For CEO Ben Wells, transitioning from CFO to CEO required a major mindset shift from managing numbers to inspiring people. Drawing on his operational finance background, he describes adopting more of a “head coach mentality,” one that is focused on motivating teams, fostering collaboration, and turning strategic opportunities into action.
In this episode of HL shorts we hear from Ben Wells, Reid Health’s newly appointed CEO. Wells transitioned internally from the CFO to CEO. Listen to his take on the industry shift of CFOs stepping into CEOs roles.
With topics that range from Medicaid disenrollment to AI adoption, five recent studies offer a sharp look at the market, margin, and management trends shaping healthcare finance.
For CFOs navigating 2025’s turbulent financial landscape, the signal is getting harder to hear through the noise. Policy volatility, outpatient migration, workforce instability, and digital disruption are reshaping health system economics.
Five recent studies aim to cut through the complexity, providing data-driven insights that can help CFOs strengthen margins, recalibrate forecasts, and future-proof their capital strategies. Each offers a clear takeaway for financial leaders seeking to balance today’s pressures with tomorrow’s opportunities.
1. How Four Different Medicaid Disenrollment Scenarios Would Impact Hospitals’ Net Revenue and Income, by Kodiak Solutions
Kodiak Solutions’ latest analysis models four potential Medicaid disenrollment scenarios, using data from more than 2,100 hospitals and 300,000 physicians. The results are sobering: Hospitals could lose as much as $25 billion in annual revenue as Medicaid rolls contract and the uninsured population rises. The ripple effects, including higher uncompensated care, rising bad debt, and weakened margins, could test liquidity across the sector.
CFO takeaway: Reassess bad debt assumptions and payer-mix forecasts now. Medicaid disenrollment is a direct line to your income statement.
2. Healthcare Research Report: The Growth of Ambulatory Surgery Centers, by Colliers.
Ambulatory surgery centers (ASCs) generated $45 billion in revenue in 2024, with growth projected to reach $57 billion by 2030, according to a recent industry report. As reimbursement models evolve and outpatient technology advances, ASCs are becoming the preferred setting for many procedures, promising both efficiency and profitability.
CFO takeaway: Reevaluate your system’s ASC strategy. Joint ventures, capital partnerships, and volume migration models can safeguard margins as inpatient-to-outpatient shifts accelerate.
Crist Kolder Associates’ 2024 Volatility Report found that healthcare CFOs now average 4.8 years in their role, shorter than in most other industries. Turnover reached 14.2% in the first half of 2024, a three-year high. The pressures of regulatory change, cost containment, and digital transformation are driving both burnout and board scrutiny.
CFO takeaway: Invest in leadership resilience. Building robust finance teams and succession pipelines is as critical as capital allocation in a volatile talent market.
4. Hospital Equipment and Supplies Market Size, Share and Trends, 2025 to 2034, by Precedence Research
According to a Precedence Research survey, some 46% of U.S. hospitals rented equipment in 2024, indicating a growing trend of hospitals turning to rental to manage budgets.
CFO takeaway: Analyze equipment forecasting data as well as health system operations to determine when to rent and when to buy.
5. The Healthcare C-Suite’s Take on AI, by Sage Growth Partners
A Sage Growth Partners study underscores that while healthcare executives see AI as essential to long-term competitiveness, it’s also viewed as one of their top operational challenges. Leaders cited data quality, cost, and governance as key barriers to adoption.
CFO takeaway: Treat AI as a financial transformation initiative, not just a technology. Budgeting for data infrastructure and workforce upskilling will define whether AI boosts or burdens your bottom line.
From Medicaid funding risk to digital transformation, today’s financial landscape demands that CFOs pair short-term risk management with long-term strategic positioning. Each of these studies offers a signal worth heeding, and a roadmap for the finance function’s evolving role in health system sustainability.
CFO Chris Allen is guiding the financial framework for UChicago Medicine’s dynamic plan that balances bold investment in oncology with cost discipline and flexibility amid regulatory shifts.
Chris Allen took on the role of CFO at UChicago Medicine two months ago. Now he is honing in on his finance strategy and expectations for his team.
His leadership approach emphasizes service and curiosity, as well as positioning finance not as gatekeepers but as strategic partners and advisors.
In this episode of HL Shorts we hear from UChicago Medicine’s CFO Chris Allen on one of the biggest consistent struggles for CFOs: balancing financial discipline with forward-thinking innovation.
Almost 4 in 10 disputes submitted to the IDR process are deemed ineligible by insurers.
A recent joint report from America's Health Insurance Plans (AHIP) and the Blue Cross Blue Shield Association (BCBSA) found that insurers identify roughly 39% of all disputes submitted to the federal independent dispute resolution (IDR) process under the No Surprises Act (NSA) are ineligible, and that rate rises to about 45% for non-emergency service disputes.
Both payers and providers face mounting costs and delays as IDR entities struggle to filter invalid cases, complicating cash flow for health systems.
How can CFOs strategize for smooth claims processing? Check out these five tips.
As turnover rises and expectations expand, CFOs are redefining their influence; from financial stewards to enterprise strategists and even future CEOs. The role's evolution demands new skills, deeper relationships, and a broader vision of what value means.
For CFOs, survival and success require more than mastering of the health system's balance sheet.
With turnover rates climbing and responsibilities widening, the CFO's seat has become both one of the most powerful and precarious in the industry. In healthcare today, CFO survival requires new strategies, sharper skills, and broader alliances.
According to the Crist Kolder Associates Volatility report, CFO tenure now averages 4.8 years, ranking near the middle across sectors but below industries like financial services and technology. In the first half of 2024, CFO turnover surged to 14.2%, its highest level in three years.
Retirement plays a role, with 55% of departing CFOs moving into board work or retirement last year, but so do performance challenges, burnout, and a shifting career landscape. Among large health systems, 60% of CFOs have been in their roles for 2.5 years or less, underscoring just how volatile the post has become.
Yet as volatility rises, so does opportunity.
What CFOs Are Saying
At UChicago Medicine, CFO Chris Allen describes a profession that has evolved far beyond its accounting roots.
"At the beginning of my career, a CFO was really about the numbers," he said. "Now CFOs blend into all aspects of a healthcare institution, partnering with strategy, partnering with operations. That's where you can most directly affect the organization's bottom line."
He noted that financial results are no longer the goal but the outcome of effective strategic leadership.
This expanding lens is also reshaping the executive pipeline. Ben Wells, who transitioned from CFO to CEO at Reid Health this year, says the move reflects a broader trend.
"Finances are a challenge right now," he explained. "Leaning on people with expertise in that space lends itself well. The role of the CFO has become increasingly complex and operational."
Wells believes that today's finance leaders already function as deputies to the CEO, leading reimbursement strategy, operational initiatives, and value-based care efforts that require a systemwide, collaborative view.
"CFOs are touching more departments than they ever have," he said, "and that prepares them to step into the CEO role."
CEOs agree that CFOs are needed and wanted as strategic partners to help oversee the organization.
Still, technical expertise alone won't secure that path for finance leaders. Kurt Barwis, CEO of Bristol Hospital, warns that strategic intellect must be paired with interpersonal strength.
"You can't put a CFO at the top of your organization if they have no people skills, no interpersonal skills, and, most importantly, no self-awareness," he said.
Stephanie Schnittger, CFO of UVA Health, agrees, adding that transparency is central to sustaining credibility.
"The CFO has to be among the most trusted leaders in an organization for it to be financially viable and sustainable over time," she noted.
How CFOs Can Rise to the Challenge
As the expectations of CFOs continue to expand, a few clear strategies can help them strengthen their impact and longevity:
* Integrate beyond finance. Partner closely with operations, clinical leadership, and strategy teams to translate financial insights into actionable performance improvements.
* Prioritize communication and trust. Build transparency across the C-suite and front lines—especially around financial realities and trade-offs—to foster credibility and alignment.
* Invest in leadership development. Seek mentorship, executive coaching, and exposure to board governance to prepare for succession pathways, including the CEO role.
* Focus on agility and resilience. Embrace change management skills and adaptability to navigate volatility in reimbursement, workforce costs, and capital markets.
* Lastly, cultivate emotional intelligence. Technical finance mastery is essential, but the ability to lead with empathy and self-awareness will more so define lasting success.
