BY: Max Watson, Chief Financial Officer
In healthcare financial management* (HFM), the expectations of CFOs are shifting. Once seen primarily as fiscal gatekeepers, finance leaders are now being called upon to act as strategic collaborators, integrating more deeply with cross-functional teams, shaping decision-making, and contributing to long-term value creation. This evolution isn’t just theoretical. It’s playing out in real time inside organizations where finance is no longer an isolated function, but a key driver of alignment, performance, and clarity. Based on my experience in the HFM space, I believe there are practical ways finance leaders can step more fully into this expanded role.
Rethinking the Finance–Business Relationship
In many organizations, finance is unintentionally positioned in opposition to other departments. This can happen subtly, through process design, resource control, or communication patterns. The result is a dynamic where finance is viewed as a checkpoint to pass through, not a partner to work with. One analogy comes from the broader healthcare landscape: the long-standing friction between payers and providers. At its worst, that relationship becomes adversarial and inefficient. However, when those parties move toward collaboration, the outcomes improve for organizations and the people they serve. Internally, the same logic applies. When finance teams are invited into early-stage planning and strategy conversations, not just asked to validate decisions after the fact, they can offer meaningful insight. And when they consistently help others achieve their goals, trust grows and barriers fall.
Strategic Deal Collaboration: Beyond the Traditional Deal Desk
One area where this shift has become tangible is in how we structure client engagements. Like many companies, we once referred to our pricing and contract support process as a “deal desk.” But in practice, our approach is far more collaborative, strategic, and value-oriented. Traditional deal desks are transactional: sales submits a request, finance runs the numbers, and pricing is approved or declined. At TREND, our process has evolved into a strategic collaboration designed to move deals forward in ways that benefit both parties. This means exploring bundled solutions, creative pricing models, and phased engagement strategies that align our incentives with those of our clients. Rather than viewing price as a fixed output, we explore ways to structure value over time, ensuring that as clients expand their relationship with TREND, their return on investment improves. This allows us to better support outcomes, not just contracts.
Strategic Finance Means Broadening the Lens
Much has been written in recent years about the “strategic CFO.” In practice, this means something specific: understanding the organization beyond the numbers and helping connect financial performance to the broader context of growth and impact. A recent survey by Egon Zehnder found that 82% of CFOs have taken on responsibilities beyond traditional finance functions, including ESG, M&A, and corporate development. This reflects how organizations increasingly expect CFOs to help shape, not just report on, strategic direction. For healthcare organizations navigating regulatory complexity, cost pressures, and shifting payment models, this kind of financial leadership is essential. But it also requires a shift in posture: instead of asking, “Can we afford this?” finance should be asking, “How can we structure this to work?”
Bridging Performance and Purpose
A common tension in private equity-backed companies is the perceived divide between performance and purpose. On one hand, organizations need to deliver financial results, while employees and stakeholders increasingly expect a sense of mission.Finance leaders are in a unique position to connect the two. Margin, for instance, is not in conflict with mission. It’s what enables us to invest in technology, in people, and in broader reach. If an organization’s approach is improving healthcare, then scaling that model is an extension of the mission, not a detour from it. This perspective helps reframe financial metrics as enablers of progress. It also clarifies why growth matters: not as a shareholder mandate, but as an opportunity to expand impact.
Four Ways to Evolve the Finance Function in HFM
For CFOs and finance leaders looking to evolve their role, here are four principles that can guide the shift:
- Invest in relationships.
Build trust with operational and commercial leaders by understanding their goals. Relationships are the foundation of influence. - Engage early.
Finance is often brought in to validate, approve, or measure initiatives after decisions have been made. But involvement upstream—at the moment of ideation—ensures that initiatives align with enterprise value creation from the start. It also reduces the risk of investing time in strategies that ultimately won’t be viable. - Translate between priorities.
Finance can serve as a bridge between functions, aligning financial performance with operational impact. This enables more coherent, sustainable decision-making across the organization. - Stay open to adaptation.
Effective finance teams evolve. They listen, experiment, and adjust based on the changing needs of the business and the industry.
The role of the CFO in healthcare financial management is expanding. As the complexity of the industry grows, finance leaders have an opportunity to become architects of strategy, not just stewards of capital. By collaborating early, aligning incentives, and grounding performance in purpose, the modern CFO can help shape an organization that is not only financially sound but strategically equipped to drive meaningful change.
* At TREND, we use “HFM” to refer broadly to the range of financial responsibilities and services that encompass payment integrity, revenue cycle management, and beyond. It’s a framework that includes our work and the strategic priorities of our clients.
This article is part of TREND Health Partners’ thought leadership series on strengthening the healthcare financial ecosystem. We believe that true security isn’t just about technology, it’s built on culture, collaboration, and shared accountability. To explore more insights on a people-first approach to cybersecurity and revenue-cycle resilience, click here to read more from our team.