"The CFO role has fundamentally shifted from being called in after the deal is baked to asking 'does this make sense?' from the beginning. I find myself leading from the front rather than from the back."
The role of the healthcare Chief Financial Officer (CFO) is undergoing a profound shift. No longer defined by financial stewardship alone, today’s CFO operates at the intersection of strategy, operations, and enterprise performance, shaping decisions that define organizational direction and long-term sustainability.
As health systems scale in complexity and financial pressures intensify, the expectations placed on CFOs are expanding faster than traditional pathways can support. Drawing on proprietary research and in-depth interviews with system-level CFOs, this report examines how the role is evolving, where capability gaps are emerging, and what organizations can do to strengthen financial leadership across enterprise levels.
This Report Explores
- The expanding mandate across operational and strategic finance, and how that balance continues to shift
- The leadership capabilities that distinguish high‑impact CFOs
- The career pathways and experiences that prepare leaders for system‑level CFO roles
- The growing gap between CFO expectations and existing talent pipelines
- The organizational choices that enable CFOs to operate effectively at enterprise scale
This report is intended for healthcare Chief Financial Officers, Chief Executive Officers, board members, and senior leaders across health systems navigating increasing financial and operational complexity. It will also be relevant for finance and strategy leaders preparing for enterprise‑level roles, as well as those responsible for developing leadership pipelines and strengthening organizational capability in finance.
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The Healthcare CFO: Leading Financial and Strategic Transformation at Scale
Our Contributors
We are deeply grateful to the Chief Financial Officers who generously shared their time, experiences, and insights for this research. Their candor and real‑world expertise form the foundation of this report, and we extend our sincere appreciation for their willingness to engage in thoughtful dialogue on the challenges and opportunities shaping the future of healthcare finance.
Jennifer Alvey, Senior Vice President and Chief Financial Officer at Indiana University Health
Adam P. Anolik, Chief Financial Officer at University of Rochester Medical Center
Mike Blair, Senior Vice President and Chief Financial Officer at CentraCare
Mark Bortnem, Chief Financial Officer at Essentia Health
Richard Carrico, Chief Financial Officer at Baptist Health
Matthew E. Cox, Executive Vice President and Chief Financial Officer at Corewell Health
Dennis E. Dahlen, Chief Financial Officer at Mayo Clinic
Robin Damschroder, Executive Vice President, President of Value-Based Enterprise and Chief Financial Officer at Henry Ford Health
Weldon Gage, Executive Vice President and Chief Financial Officer at Texas Children's
Scott Hawig, Executive Vice President and Chief Financial Officer at BJC Health
Todd Hofheins, Chief Financial Officer at UCHealth
Matt Huff, Executive Vice President and Chief Financial Officer at Geisinger Health
Dawn Javersack, Senior Vice President and Chief Financial Officer at Nicklaus Children's Health System
Alec H. King, Executive Vice President and Chief Financial Officer at Memorial Hermann Health System
Warren Ladner, Senior Vice President and Chief Financial Officer at Southern Illinois Healthcare
Matthew Streeter, Chief Financial Officer at North Country Healthcare
Andrew Zukowski, Chief Financial Officer at ECU Health
