Healthcare CFOs Face a Wide Readiness Gap as Business Performance and AI Value Expectations Rise, Deloitte Survey Finds

73% of surveyed healthcare CFOs say they are expected to be regularly or heavily involved in enterprise decisions, yet only 49% feel well equipped to contributeKey takeaways CFO expectations are outpacing readiness: 73% of respondents say they are expected to be regularly or heavily involved in seven enterprise decision areas, while only 49% feel well equipped. That creates a 24-point average gap between expectation and enablement. The largest CFO readiness gaps are in the decisions that they feel matter most: Patient experience, access and consumer affordability decisions show a 33-point gap, with 74% of the CFOs surveyed saying they are expected to be involved but only 41% feeling well equipped to do so. This gap is wider for health systems than in health plans, at 38 points versus 28 points respectively. M&A and growth show a 31-point gap, and care model transformation shows a 25-point gap. CFOs are striking an optimistic outlook for business performance, but preparedness is uneven: Nearly 60% of CFOs are targeting margin improvement of at least 2 percentage points over the next two years, yet only 47% say their organizations are prepared to manage the pressures affecting margin. The research identifies access, affordability, and quality as considerations CFOs may need to navigate as they continue to focus on margin improvement — alongside other key areas of performance including capacity and risk mitigation. AI value should move from promise to proof: Across the public commentary analysis, demonstrated value narratives rose from 9% in 2023 to 19% in 2026, though public discussions still emphasize anticipated outcomes more than proven financial results. Surveyed CFOs of only 18% of AI scalers consistently measure AI's impact financially. GLP-1 and specialty drug costs are another margin gap area for health plans: 85% of surveyed health plan finance leaders expect a moderate-to-major margin impact, but only 38% report that their organizations are well prepared to manage it.Why this mattersMany healthcare chief financial officers report they are preparing for margin pressures amidst an expectation to play a broader enterprise role according to the three-part "2026 Healthcare CFO Research Series" from Deloitte. This may impact the organizational performance to deliver on their mission. The survey of 64 U.S. healthcare finance leaders — 32 from health systems and 32 from health plans — finds a 24-point gap between the CFOs expected to be regularly or heavily involved in enterprise decisions and those who feel well equipped to contribute effectively.The research also shows that some healthcare organizations are pursuing margin goals while navigating uneven preparedness across key pressure points. Nearly 60% of surveyed finance leaders are targeting operating-margin improvement of 2 percentage points or more over the next two years, including 27% targeting improvement of more than 5 percentage points. At the same time, only 47% say their organizations are well prepared to manage the external factors and enterprise capability gaps that could affect operating margins. As noted in the "Deloitte U.S. Health Care 2026 Mid-year Outlook," both sectors generally report they are entering the second half of 2026 with less room for error and a tougher operating test.Further, the survey findings show AI investment is scaling faster than financial attribution capability for many. Of surveyed organizations, 44% are AI scalers (organizations with broader GenAI deployment). Yet CFOs of only 18% of AI scalers report that they consistently measure AI's impact on revenue growth or cost savings. External market narratives also validate the survey findings. Deloitte analysis of 17,622 publicly available newsroom and press release articles across 62 health systems and health plans found that healthcare technology communications are shifting from excitement toward demonstrated value for many. Demonstrated value narratives increased from 9% of coverage in 2023 to 19% in 2026, while expected value remained the dominant framing at roughly 35% to 45% of coverage.Key quotes"Many healthcare CFOs report they are being asked to connect affordability, access, care transformation, technology and growth to enterprise value. The readiness gap between healthcare CFO expectations and enablement may be an organizational design gap. Finance leaders should be involved early with their C-suite colleagues and with access to the information involved in influencing decisions and help translate strategy into results that deliver on business outcomes and mission." Jay Bhatt, managing director, Deloitte Center for Health Solutions, Deloitte Services LP"As some organizations reach for 5 percentage point margin growth amidst internal and external factors, there is an execution and readiness opportunity. The margin story may be less about choosing between growth and efficiency and more about building the capabilities to execute both. CFOs are well positioned to bring together financial, clinical, operational, talent and strategic perspectives — but they should have access to consistent measures of value, clear accountability, and the ability to connect investment decisions with outcomes." Alicia Janisch, vice chair and U.S. health care sector leader, Deloitte Tax LLPTaken together, the findings suggest that the healthcare CFO role may be evolving from financial steward to enterprise value orchestrator working strategically and closer with C-suite colleagues to manage costs, risk, and deliver value. Organizations that bring finance leaders into decisions earlier, strengthen cross-functional planning and establish clearer measures of transformation value may be better positioned to improve margins, scale innovation and turn technology investments into measurable results.MethodologyThe survey was conducted in spring 2026 among 64 U.S. healthcare finance leaders, including 32 leaders from health systems with more than $1 billion in revenue and 32 leaders from health plans with more than 500,000 members. The survey questions examined finance leaders' enterprise role and readiness; organizational margin expectations, pressures and preparedness; and technology investment priorities, AI adoption and scaling, return expectations, and financial measurement and attribution practices. The companion media analysis reviewed 17,622 publicly available newsroom and press release articles across 62 health systems and health plans published between January 2023 and May 2026. A GenAI-enabled thematic tagging approach, combined with human-in-the-loop validation, was used to identify dominant narratives across 15 enterprise themes. Technology-focused articles were subsequently analyzed to uncover the underlying value narrative.

Healthcare CFOs Face a Wide Readiness Gap as Business Performance and AI Value Expectations Rise, Deloitte Survey Finds

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