Hospital and health system CFOs have a lot on their minds heading into 2027 — from weighing how to protect their margins against decreasing Medicaid reimbursement to thoughtful adoption of technologies and artificial intelligence — there is no shortage of priorities on their plate.
Becker’s connected with Jon Alford, CFO, UW Medicine, vice president for medical affairs, University of Washington in Seattle and Robert Fries, CFO of Children’s Health in Dallas, to learn what is top of mind for their priority list heading into the new year and why.
Bracing for Medicaid policy changes
For Mr. Alford, automation is a near-term focus, driven largely by what’s brewing in Washington, D.C.
“We’re prioritizing automation,” Mr. Alford said. “As a safety-net health system, you’re representing the only level 1 trauma hospital in Washington, but also patients from across multiple states. The impacts of HR 1 and what will change with Medicaid eligibility — that’s going to put a strain on our organization.”
UW Medicine is addressing any challenges head-on.
“[We’re] looking at how we can reduce overhead costs to counteract that loss of reimbursement,” he said. “On the other side, [we’re] looking at how we can implement functionality with people, technology and processes to be able to maximize Medicaid eligibility for our patients that end up on our doorstep in an emergent or trauma situation, where we can quickly get them qualified if they do qualify. We’re putting a lot of attention into how to capture those [cases]. Then, just like everyone, how to lower our overhead to be able to survive a little bit longer in these tighter reimbursement times.”
Four priorities, one goal: Sustainable access
Robert Fries, CFO of Children’s Health in Dallas, detailed an explicit list of four priorities tied to keeping care accessible for North Texas children.
The priorities: predictable and stable Medicaid funding, thoughtful adoption of AI, timely access to care and redesigning the care model.
“As the safety-net pediatric provider for North Texas, stable Medicaid funding is essential to our ability to care for every child who needs us,” he said. “Sustainable funding supports not only the children covered by Medicaid, but also the specialized services, highly trained teams and infrastructure required to serve our entire community.”
Mr. Fries said Children’s Health sees significant potential for agentic AI to improve how they work and deliver care. He said the focus is adopting the technologies so they can improve access, productivity and quality, showing where there is a clear demonstration of return on investment.
The third priority is timely access to care. The fourth is redesigning the care model itself.
“Healthcare is becoming increasingly complex and resource intensive,” he said. “We are focused on redesigning care models to improve the efficiency and effectiveness of our teams while maintaining and enhancing the quality and experience of care for children and families.”
