As health and human service executives plan for the year ahead, what are their key challenges? They are not so dissimilar from chief financial officers (CFOs) in every field. According to the recent Global CFO Survey 2025, the 2025 “top challenges” for CFOs were adapting to changing customer demands, decreasing risk exposure, leveraging technology, increasing the speed of adapting to new business models, and the talent shortage. Sounds very familiar to the strategy discussions of most executives in our field.
To address these issues, CFOs are prioritizing their investments for the year ahead. Process optimization topped the list at 58%, followed by investments in data and analytics (57%), talent management (57%), automation (55%), artificial intelligence (53%), and chatbots (50%).
In addition, CFOs indicated the use of external partners in making these plans a reality. Over half of CFOs reported plans to use external partners for digital technology enablement/automation/integration, process mapping/design, talent acquisition/training, and fractional operational positions.
We got a first hand look at the key strategic issues facing CFOs in the health and human services field—and how they are addressing those challenges—in the session, Strategically Positioning Your Organization For Financial Sustainability & Growth, at The 2024 OPEN MINDS Strategy & Innovation Institute. The session featured Deb Steinke, Chief Financial Officer at Volunteers Of America Minnesota & Wisconsin (VOAMNWI), and Traci Brown, Chief Financial Officer at Metropolitan Human Services District (MHSD).
Headquartered in Minneapolis, VOAMNWI is a $32 million provider organization serving 23,400 consumers annually through 70 programs delivered across 110 communities for children, youth, families, older adults, people with disabilities, and community reentry for justice-involved individuals. MHSD is one of ten local governing entities providing services for mental health, addiction, and intellectual and developmental disabilities (I/DD) in Louisiana—operating five clinics across New Orleans, St. Bernard, and Plaquemines Parish.
When Ms. Steinke joined VOAMNWI as the new CFO, the organization had both staffing and technology challenges in its finance operations. On the staffing side, her finance department had high turnover, leading to 60% of the positions being open and a high reliance on agency staffing solutions. When it came to technology, the team had to use inefficient manual processes because of old hardware and an unfinished electronic health record (EHR) implementation. This meant that metrics were hard to get to and financial reports were late.
To address these issues, Ms. Steinke reorganized her finance department. She added a senior director position; elevated the revenue cycle manager position to a director role, and addressed the issue of open positions by modifying the hybrid work opportunities to expand the candidate pool and eliminated the reliance on multiple interim accounting and billing roles.
To address the technology issues, Ms. Steinke made completing the implementation of the EHR a priority, terminating the use of the legacy EHR. She also created a plan to select a cloud-based enterprise resource planning (ERP) software and put that in place. In addition, she made a deliberate effort to maximize the use of their investment in Office 365 and Power BI. These combined approaches enabled her and her team to streamline operations, adopt a culture of continuous improvement, shorten the month-end close process, and reduce bad debt write-offs by 68%.
“A number of our processes and technology were outdated, and we had to update,” said Ms. Steinke. “We did this by including people from across our organization, including HR, IT, finance, and our program leaders, to thoroughly assess our needs for a new system. We then created a weighted scorecard to identify top priorities and assess vendors and established timelines, assignments, and budgets.” At MHSD, the financial sustainability challenges Ms. Brown faced were external, centering around the organization’s Certified Community Behavioral Health Clinic (CCBHC) designation and a heavy reliance on state funding. On the CCBHC side, MHSD was in year two of a four-year implementation, and the future sustainability of the program was unclear. On the funding side, 72% of MHSD’s revenue comes from state general funds and is susceptible to any budget changes at the state level.
To address these issues, Ms. Brown lead the development of a revenue diversification initiative. The initiative was multi-faceted—increasing self-generated revenue, expanding service lines around population health management, investing in telehealth and remote monitoring, creating new service line income through partnerships, and initiating negotiations for value-based care.
“We are working to forge our fiscal independence and manage our cash flow,” said Ms. Brown. “Partnerships with Louisiana State University (LSU) and Tulane University are very beneficial to our organization because they help us expand services at a lower cost. We also refined and expanded telehealth service delivery models and on-demand services to meet people where they are and help them stay engaged. We want to expand our self-generated funding, which we can leverage as savings to invest in other options or to be a safety net against any future budget cuts. As we pursue value-based care, we are focused on quality of care and efficiency. You must be prepared to shift to outcomes-based payments and a bundled payments model.” Both Ms. Steinke and Ms. Brown emphasized the need to improve quality and efficiency by leveraging technology and analytics—despite the challenges of organizational change. Ms. Brown noted, “I try to work a lot with data quality management… This is to ensure that the clinicians are getting their notes completed timely, that the bills are going out timely, that authorized services are coded correctly, and that we are getting paid for the correct level of service.” And Ms. Steinke spoke for many CFOs when she addressed the stresses of operating in a changing health and human service field. “Our organization has been around for a long time, so people had gotten stuck in how they do things. We had to change the culture…”