The state of healthcare finance is shifting — and fast. And that’s creating ripple effects for the collection industry. According to Deloitte’s 2025 U.S. Health Care CFO Survey, 84% of healthcare finance leaders are worried about business conditions due to looming policy changes, macroeconomic pressures, and supply chain disruptions — especially from tariffs, which is a marked changed from their outlooks earlier in the year. Meanwhile, 73% are concerned about revenue growth and operating profitability, and many are bracing for continued high medical loss ratios in Medicare Advantage.
This shift in sentiment marks a change from the previous year’s outlook, which was more optimistic.
The big drivers of concern:
- Tariffs and supply chain uncertainty: Imports make up about 20% of the average U.S. hospital’s expenses. New tariffs on drugs, medical equipment, and supplies could increase costs by 15% or more, executives warned.
- Regulatory uncertainty: Health plan finance leaders cited potential changes to drug pricing provisions in the Inflation Reduction Act — such as shifting catastrophic drug costs to plans — as one of the most impactful concerns.
- Medicaid reform: Lower reimbursement rates and eligibility reductions could leave hospitals managing more uncompensated care.
By the numbers:
- 84% are concerned about business conditions stemming from potential policy changes, macroeconomic uncertainty, and supply chain disruptions.
- 73% are worried about revenue growth and operating profitability.
- >90% are investing in strategic growth levers (M&A, alliances, value-based contracts), but only 28% of health systems and 25% of health plans say M&A efforts have had a strong impact.
- 53% of health systems report strong impacts from transformative technologies like generative AI and cloud — but only 33% report strong impact from investments in core technology upgrades like EHRs or ERP systems.
- Only 31% of health systems and 41% of health plans report that efforts to optimize services or business lines have generated strong results.
What healthcare CFOs are doing (and where they’re falling short):
- Margin improvement with high-impact levers: Deloitte recommends healthcare finance leaders adopt a holistic margin improvement approach — balancing growth, cost-cutting, and smart capital allocation. Yet many CFOs report they’ve seen limited ROI from current strategies.
- Growth via M&A and partnerships: Nearly all respondents are pursuing mergers, alliances, or value-based contracts, but few say those efforts are yielding strong results.
- Cost reduction through outsourcing and service review: Despite the potential to cut costs up to 28%, a surprising number of finance leaders are not prioritizing outsourcing or optimizing underperforming service lines.
- Technology investment: Investments in data modernization, gen AI, and cloud have delivered only moderate impact so far — signaling a missed opportunity to drive efficiencies and improve decision-making.
