Report: Healthcare CFOs don’t feel prepared to make enterprise decisions

Healthcare financing is extremely complex…duh. But it seems like even the money experts are struggling, according to a report by consulting company Deloitte published earlier this month.

While almost three-quarters of healthcare CFOs (74%) said they’re expected to be “regularly or heavily” involved with enterprise decisions related to consumer affordability, access, and patient experience strategy, only 41% said they feel equipped to do so, the report found. This suggests CFOs may need updated reporting structures, more collaboration with leadership across departments, and more access to data to measure program results, the authors wrote.

The survey, conducted this spring, included responses from 32 finance leaders from health systems with over $1 billion in revenue and 32 finance leaders from health plans that have 500,000+ members.

The findings. With financial pressures in healthcare escalating, the CFO role has expanded to work closer with other executives who address clinical, operational, and strategic issues, according to the report.

“A CFO has a greater span of considerations under their job title and what they do day to day than they have in the past,” Alicia Janisch, vice chair and US healthcare sector leader at Deloitte and lead author on the report, told us.

But financial leaders don’t feel like they have what they need to properly meet these expectations, the report found. For example, 75% of respondents said they’re expected to be involved in decisions around mergers, acquisitions, and growth planning, but only 44% said they feel prepared for these tasks.

Part of the problem, Deloitte reported, is that organizations are not quite designed with the 2026 CFO in mind. In other words, there are “data environments, reporting structures, and operating models that predate the CFO’s expanded enterprise role,” the report read.

What now? Deloitte’s biggest takeaway? CFOs should be more embedded into organizational operations, meaning “organizations may need to redesign the finance operating model around enterprise value creation, rather than functional oversight alone,” the report said.

Finance leaders need to understand how a range of choices—from operational and clinical to technological—affect an organization’s margins, risk exposure, capital needs, and growth. Building these skills will require CFOs to get closer insights into strategic decisions as well as more have influence over them.

Say a hospital wants to invest in new AI tools. CFOs need to understand the ROI and clinical effectiveness of the tool to make sure investments are working in real time, according to Janisch.

“Is that investment what we thought it was? Do we need to pause? Do we need to stop?...What is the total ROI that we expected versus what we saw in the results?” Janisch said. “Using the data is important, but really being embedded throughout the process is even more important and critical in the times ahead.”