Build a resilient revenue cycle through proactive denial prevention

Cost pressure is no longer cyclical. It’s structural. Healthcare CFOs have managed through margin pressure before, but what’s different now is permanence.

Rising labor costs, escalating denial rates and increasingly unpredictable payer behavior are no longer short-term disruptions, they’re embedded in the operating environment. According to a 2024 HFMA survey of 135 health system CFOs, 96% cite higher labor costs as their top margin pressure driver, while 84% point to lower payer reimbursement as a leading cause of weak operating margins. At the same time, 82% report that payer denials are higher than pre-pandemic levels, directly increasing both revenue risk and cost to collect. 
 

CFO snapshot: The cost reality

Source: HFMA Health System CFO Pain Points Study

For financial leaders, this isn’t just a revenue problem. It’s an efficiency, consistency and stability problem.
 

The hidden cost of a fragmented revenue cycle

The same HFMA research shows CFOs now spend nearly one quarter of their time on revenue cycle and denial issues, which is time pulled away from strategic growth, capital planning and transformation initiatives. Fragmented documentation, coding and audit workflows quietly drive rework, manual reviews and downstream appeals that inflate administrative costs without improving outcomes. 

As outlined in our CFO playbook, cost discipline has become as critical as revenue growth, especially as health systems contend with duplicated effort across siloed teams and inconsistent financial visibility. Traditional revenue cycle tools often focus on recovery after dollars are lost, rather than preventing leakage in the first place. The result? Margin erosion that feels increasingly out of a CFO’s control.
 

Why prevention is becoming a finance imperative

High-performing finance organizations are shifting their focus upstream, addressing financial risk before claims are submitted rather than chasing denials after the fact.

Our CFO playbook frames this shift around three priorities:

• Preventing leakage early by improving documentation and coding accuracy before claims leave the organization
• Embedding intelligence into workflows so teams focus effort where financial risk and revenue value are highest
• Aligning clinical and financial performance to ensure quality, compliance and reimbursement move together 

This approach to denial prevention reduces cost per case by eliminating unnecessary rework and automating low-risk tasks while preserving scarce clinical and financial expertise for higher-value work.
 

What CFOs are seeing in practice

Preventing denials upstream avoids all the downstream rework that overtaxed teams simply don’t have capacity for today. It can be the difference between margin and no margin.

That insight reflects a broader truth CFOs recognize: Every avoidable denial carries both a revenue impact and a labor cost. In an environment where staffing remains constrained, reducing administrative friction is itself a margin strategy.
 

Predictability is the new performance metric

External pressure isn’t easing. A Deloitte survey of U.S. healthcare finance leaders found 73% are concerned about revenue growth and operating profitability, driven by regulatory uncertainty, cost volatility and payer dynamics beyond their control. 

In this context, predictability matters as much as topline performance. Finance leaders aren’t just looking to recover lost revenue, they want earlier visibility, lower cost to collect and more reliable financial outcomes without disrupting care delivery. 

When clinical documentation, coding, audit and revenue integrity workflows are connected, CFOs gain confidence in forecasting, compliance and margin protection. Even under sustained pressure.
 

Transformation to drive standardization and margin improvement

By embedding sophisticated models into end-to-end documentation, coding, audit and revenue integrity workflows, finance leaders can move from manual recovery to reliable prevention. Instead of tools that only flag issues or advise on what to do next, the next wave of automation will complete more of the work—standardizing decisions, accelerating exception handling and reducing avoidable denials. Over time, that means clearer payment rules, a more complete and accurate clinical record and tighter alignment between care delivered and how it is represented for reimbursement. And it frees clinical and financial experts to focus on the complex, high-impact cases supported by expert-driven tools as close to the point of care as possible.

Jason Burke is the vice president of revenue cycle solutions at Solventum.