We brought together 50 healthcare finance leaders. This is what we learned
Each year, Cedar convenes a group of senior healthcare finance leaders for our Finance Leadership Council, a unique community where some of the most experienced CFOs and revenue cycle executives in the country come together to talk honestly about what’s working, what’s disruptive, and what’s next.
This year, we brought together nearly 50 leaders from across the country. If I had to sum up this sentiment in one word, it would be: reality and determination.
Everyone in the room knows how difficult this moment is. Profits are shrinking, policies are unstable, and affordability has become a defining pressure point for patients and providers. However, what struck me most was the sense of shared purpose. Despite all the resistance they face, these leaders aren't just trying to survive—they're trying to create something better.
This is what we learned.
1. Leadership means embracing multiple truths simultaneously
Leaders who thrive in today’s environment don’t choose between compassion and discipline, innovation and stewardship. They are doing both.
Several CFOs spoke candidly about the pressures that make “either-or” thinking tempting — shrinking margins, rising labor costs and payer instability. When a spreadsheet is unbalanced, every decision feels like a zero-sum game. But those who find a way forward are clarifying these trade-offs, linking decisions to mission, and aligning teams around shared values. As one leader said, “Long-term values follow values.”
During the discussion, executives emphasized the need to manage the realities of competition rather than boil it down to bad choices: protecting profits and protecting people, automating workflows and strengthening relationships, investing in artificial intelligence and supporting workforce stability. These are not opposing goals—they are complementary.
People are also cautiously optimistic about the economy. Many leaders see AI as a deflationary force that can increase efficiency and help build long-term financial sustainability. Attendees shared real-world examples, from using automation to free up teams for higher-value work, to reinvesting savings into patient needs and maintaining stability amid payer volatility and operational uncertainty.
Bottom line: Meaningful progress is not radical change. It’s thoughtful, measurable action backed by leaders willing to take principled risks—because in this environment, standing still is a bigger gamble.
2. Success is being redefined – from transactions to trust
In the past, healthcare financial success was measured by collecting metrics such as costs, denial rates, or revenue cycle efficiency. These are still important. But the most forward-thinking systems are expanding the definition of success: How do we connect patients to the care and resources they need?
Leaders describe a clear shift in thinking: Trust is the new currency in healthcare. Financial performance and patient experience are no longer separate topics—they are two sides of the same equation. When patients don’t understand their bills or lose trust in the system, they delay care, fall behind on payments, or even disengage entirely. This harms population health and financial stability.
One in three Americans still avoid care because they can't afford it, and the average cost of a home health insurance plan is now $27,000. Finance leaders view this as a business risk, not just a social risk. Many are taking practical steps to rebuild trust—simplifying statements, increasing price transparency, and using digital communications to guide patients through complex coverage decisions.
Policy instability only heightens the urgency. With Medicaid reform on the horizon, leaders are no longer waiting for clarification from the federal government, but are partnering with community organizations, investing in eligibility automation, and deploying technology to keep patients enrolled and connected. Progressive, technology-driven readiness has become a real competitive advantage.
Artificial intelligence is also reshaping conversations. The question is no longer whether to use it, but how to use it responsibly. Several leaders described using agent AI to assist staff and patients—for example, automating eligibility checks or recommending the next best course of action—enabling teams to focus on high-impact human interactions rather than administrative churn. The winner will not be the best algorithm, but the organization that uses artificial intelligence and technology to restore trust.
3. Affordability is now a growth strategy
Affordability used to be a patient experience issue. Now this is a strategic one. Since 2010, median household income has increased by about 22%, while deductibles have increased by more than 200%. For the millions of Americans who fall into the ALICE category—asset-limited, income-constrained, employment — An unexpected medical bill can destabilize everything.
Leaders view affordability as a core driver of patient loyalty, system solvency and long-term growth, calling for a paradigm shift: from a system that treats all patients the same to one designed for individual realities.
The next chapter in healthcare finance is defined by navigation—anticipating obstacles, providing alternative paths, and guiding patients to affordable care before a crisis occurs. In this model, success depends on being a trusted guide who helps patients navigate complex systems with empathy, accuracy, and proactive support.
Some systems are already building digital safety nets to protect against loss of coverage — integrating Medicaid enrollment, financial counseling and community support into front-end workflows. These efforts are not philanthropy; They are long-term investments in patient retention and community health.
The larger shift underway is toward what many are calling the age of healthcare navigation—an era in which systems not only respond to affordability barriers but anticipate them, guiding patients to sustainable care before a crisis strikes.
bottom line
My takeaway from this year’s Finance Leadership Council is that healthcare finance is entering a new chapter, one defined not by cost cutting but by connection.
Leaders who thrive are those who can see both sides of every equation: mission and profit, empathy and efficiency, innovation and trust. They build organizations that not only withstand policy shifts and economic pressures, but use them as catalysts for progress.
If this year’s conversations are any indication, the future of health care finance will not be determined by who can do more with less, but by who can do more for people.
About the author:
Florian Otto, MD, PhD, Co-Founder and CEO of Cedar
Florian is an accomplished entrepreneur and former physician who now drives the growth of Cedar's business and sets the overall direction for all aspects of Cedar's operations. Prior to founding Cedar, Florian was an executive at Zocdoc, driving commercial adoption of the platform. Florian also founded a group buying company in Brazil (ClubeUrbano), which was eventually acquired by Groupon. After the acquisition, he became CEO of Groupon Brazil and developed the company into one of Groupon's three major international markets. Florian began his business career in McKinsey & Company's Healthcare practice as a strategy consultant. Florian holds an MD, PhD and PhD from the University of Freiburg in Germany.
Photo: Sergei Karkimulin, Getty Images
