What HFMA Annual 2025 Made Clear: It’s Time to Rethink Healthcare Finance

Coming off the 2025 HFMA Annual Conference in Denver, one thing was evident: the pressure on healthcare finance teams isn’t easing up; it’s evolving.

From major Medicaid policy changes and AI adoption to workforce shifts and growing fraud concerns, the conversations we had on the show floor and in the sessions, all pointed to the same takeaway. Finance teams aren’t just being asked to do more. They’re being asked to do it faster, smarter, and with fewer resources. 

That includes everyone in the office of the CFO. From AP clerks and managers to controllers and VPs, teams across finance and revenue cycle are feeling the impact. Here’s what stood out to us, and why it matters for healthcare organizations looking to close out 2025 stronger. 

AI Is No Longer a Side Project. It’s a System Requirement. 

AI and automation were everywhere this year, and not just inside the exhibit hall. From keynote stages to breakout panels, the message was loud and clear: if your finance operation still runs on spreadsheets and workarounds, it’s time to rethink the approach. 

In futurist Zack Kass’s keynote, he introduced the idea of "unmetered intelligence," and the buzzword caught on. For healthcare finance teams, however, the conversation felt much more practical. We heard real-world examples of how automation is helping teams process invoices faster, avoid fraud, and reduce burnout. 

In sessions like “Meet JeSSI: AI-Driven Revenue Cycle Solutions,” leaders talked about embedding AI into everyday workflows, not just saving it for special projects. Teams are looking for tools that make work easier right now, whether that’s auto-routing invoices to the right approver or using natural language queries to surface payment bottlenecks in seconds. 

For AP teams, this means fewer spreadsheet-driven audits, fewer missed early-pay discounts, and fewer errors that slow things down at month-end. The expectation has shifted. AI isn’t something to experiment with later. It’s a requirement now. 

Denials Continue to Drain the Revenue Cycle 

Revenue cycle leaders focused heavily on denials this year. Denial volume is rising, causes are growing more complex, and manual resolution efforts are mounting. 

In the “Clinical Revenue Cycle Transformation” session, we heard from several health systems about their efforts to move upstream. The focus was prevention. Clean data at the start of a process can prevent days, or even weeks, of rework on the back end. 

That same logic applies to AP. If an invoice shows up without a PO, or if the line items don’t match the receiving data, the entire process grinds to a halt. You end up chasing vendors, holding up payments, or overpaying for something that was never received. 

The takeaway was simple. In both AP and revenue cycle, clean inputs equal cleaner outcomes. And automation is the key to getting there. 

Fraud Prevention Is a Team Sport Now 

Fraud dominated every conversation we had, and not just the big headlines. Attendees were focused on real, day-to-day concerns like verifying supplier banking changes and catching duplicate payments before they go out. 

Sessions on cybersecurity and resilience touched on everything from business email compromise to rising check fraud. In one panel, finance leaders pointed out that fraud is no longer just an IT issue. It’s a finance issue. And it’s a vendor-management issue. And an AP issue. 

The good news? More teams are adopting proactive approaches. We saw interest in multi-layered defenses that include bank account validation, virtual cards for high-risk payments, and role-based permissions that make it harder for approvals to get hijacked. 

For AP teams, it means having the right guardrails in place, without slowing things down. Manual processes are still one of the biggest fraud risks, and the industry is moving toward platforms that help teams prevent problems before they happen. 

Workforce Pressures Are Fueling the Push for Automation 

We heard it repeatedly: staffing remains a challenge, especially for transactional roles like AP processing and cash posting. This year, however, the conversation shifted from filling roles to reshaping them. 

In “Workforce Resilience and the Rev Cycle,” speakers emphasized that teams aren’t just trying to do more with less. They’re trying to give people better work. Repetitive, manual tasks aren’t just inefficient. They’re a top contributor to burnout and turnover. 

Finance leaders told us they’re looking for automation that helps junior team members focus on exceptions, not data entry. Controllers and AP managers want to spend their time solving problems, not tracking down approvals or matching remits by hand. 

This shift isn’t just about productivity. It’s about retaining institutional knowledge, reducing onboarding time, and creating roles that people actually want to stay in. And while improving the day-to-day experience is key, many teams are finding that the root of the frustration isn’t just the task, it’s the tool. That’s where tech integration comes into focus. 

Integration is Beating Feature Sets 

One subtle but consistent theme emerged: tech stack fatigue. Many teams juggle too many disconnected tools. The result: more manual work, more data gaps, and more frustration. 

In the session “Linking ERP, EHR, and Treasury Data for Real-Time Risk,” panelists showed how bringing data together in a single system is helping organizations make better decisions, faster. But that kind of visibility only works if your systems connect in the first place. 

We heard from AP managers struggling to bridge gaps between invoice systems and ERPs. We talked to controllers dealing with separate tools for vendor onboarding, approvals, and payments. Everyone is looking for fewer logins, fewer workarounds, and fewer handoffs. 

This year, integration took center stage. The question isn’t just “what does this tool do?” It’s “what does it connect to, and how fast can it flex when policies or processes change?” 

What we heard again and again: success won’t come from piecemeal solutions. It’ll come from systems that are connected, intelligent, and built for change. 

What Comes Next

HFMA 2025 provided clear direction for healthcare finance's future. Teams are under pressure to move faster, reduce risk, and stretch limited resources. But they’re not looking for band-aids. They’re looking for better systems. 

Whether it’s AP automation, fraud prevention, or smarter integrations, the goal is the same: simplify the work, support the people doing it, and strengthen the foundation for what comes next. 

If you’re exploring ways to modernize AP without adding complexity, this is a good place to start. Streamlining AP in Healthcare: A Path to Efficiency and Compliance breaks down practical steps for building efficiency and staying ahead of regulatory change.