Quick Overview

  • A recent survey by Deloitte, one of the Big Four accounting firms, shows that financial executives in the healthcare industry are facing a critical gap between "expectations and enablement," which affects their performance in corporate decision-making. The survey results are based on annual interviews with CFOs from 32 health plans and 32 healthcare systems.
  • 73% of healthcare CFOs said they are expected to "regularly or deeply participate" in corporate decisions in key areas such as consumer affordability, mergers and acquisitions, and growth, but only 49% believe they are fully prepared. This results in an average gap of 24 percentage points between the board and leadership's expectations for CFO involvement in decisions and their actual decision-making capabilities.
  • The report notes: "As financial pressures in the healthcare industry intensify, decisions that were once primarily viewed from clinical, operational, or strategic perspectives may now carry more direct economic impacts, thereby expanding the role that the finance function is expected to play."

Deep Insights

Amid persistent economic headwinds, boards and executive teams expect CFOs to participate broadly in decision-making across multiple areas. However, the survey shows that in seven key areas, CFOs reported gaps between participation expectations and their self-assessed readiness, including consumer affordability and patient experience, mergers and acquisitions, and technology transformation decisions (such as the adoption of generative AI and agentic AI).

Deloitte stated that the readiness gaps in these seven areas may "reflect a mismatch between the expanded expectations of CFOs and the organizational systems designed to support the finance function." Financial leaders often sit at the intersection of business strategy decisions and can provide a unique perspective to help evaluate "enterprise trade-offs," but the report notes that healthcare CFOs generally indicate a lack of the necessary support to fulfill this role.

The survey shows that readiness gaps are most pronounced in decisions regarding consumer affordability, access, and patient care strategy. 74% of CFOs said they are expected to participate, but only 41% believe they are sufficiently capable, a gap of 33 percentage points. In contrast, the gap in technology is smaller—64% of CFOs said they are expected to participate, and 48% believe they are well-prepared—but the report warns that this gap may shift as organizations increase investment and innovation in emerging technologies such as AI.

The report states: "Technology remains central to enterprise transformation, especially as organizations invest in artificial intelligence, automation, and data modernization. If CFOs are expected to play a greater role in these decisions, this gap could become more pronounced."

Deloitte believes that the persistent mismatch between expectations and support may stem from the fact that many finance functions were established when the CFO's role was narrower, lacking the reporting structures or data environments needed to support the expanded role of modern financial executives. The report notes: "If these systems do not undergo corresponding changes, financial leaders may have to influence corporate decisions without the necessary information and support."