84% of Healthcare Leaders Worried About Business Conditions, Survey Says

Most (84%) of healthcare finance leaders are worried about business conditions, according to the results of the recent Deloitte Center for Health Solutions sixth annual survey of United States Healthcare CFOs. Additional worries reported by leaders include healthcare affordability for consumers (81%) and concerns about revenue growth and operating profitability (73%).

These findings mark a shift from the December 2024 survey data from Deloitte, in which healthcare leaders showed more optimism in their 2025 predictions. Then, 71% of healthcare leaders expected improved industry profitability and 69% of leaders anticipated a rise in revenue in 2025.

Concerns over external factors—such as regulatory changes, tariffs and supply chain disruptions—now outweigh internal issues like workforce challenges, cost reduction and cybersecurity, which had ranked among the top five concerns for the past four or five years of the survey.

The survey was conducted in spring 2025 and included 64 healthcare finance leaders from 32 health plans and 32 health systems who were asked to identify their top issues and priorities in the industry. Health systems listed tariffs and policy changes as their top concern, followed by Medicaid reform and data and technology changes.

Meanwhile, health plan leaders listed drug pricing and policy changes as their biggest worries, such as modifications to the Inflation Reduction Act (IRA). This was followed by tariffs and Medicaid reform.

“Key IRA provisions for Medicare include capping annual out-of-pocket drug costs at US$2000, eliminating the coverage gap phase (also known as the “donut hole”), and shifting a greater share of catastrophic drug costs from the government to health plans,” the Deloitte team writes, including Tina Wheeler, partner and senior healthcare leader at Deloitte.

Healthcare leaders may benefit from adopting a holistic approach to margin improvement, according to results from Deloitte’s 2024 US Health Care CFO Survey, the team writes. This would require leaders to address issues by engaging in mergers and acquisitions, outsourcing services, and investing in data modernization, for example, together rather than separately. Both types of leaders answered how much they agreed with these techniques.

In 2025, 28% of health system leaders reported that they “realized the strong impact” of mergers and acquisitions, outsourcing (22%) and data modernization (28%). Among health plan leaders, 25% said they “realized the strong impact” of mergers and acquisitions, outsourcing (31%) and investing in data modernization (34%).

In the previous 2025 outlook survey, both health plan executives and health system leaders recognized the importance of consumer engagement, with 50% and 55% agreeing that they need to improve the customer experience.

Fifty-three percent of health system executives report strong impacts after using generative AI and cloud technology to engage customers, while 72% of health plans reported “moderate to no impact.”

“As stewards and operators of both stability and agility, strong financial leadership from healthcare CFOs is important for remaining responsive in today’s environment,” Wheeler and her team write. “Their leadership is important not only for maintaining financial health but also for driving long-term growth. By driving strategic investments, optimizing cost structures and enabling data-driven decisions, finance leaders can help build resilient, future-ready health care organizations.”