A CEO’s View of Financial Resilience

By Noah Breslow, CEO at Revecore

The word “resilience” gets used a lot in business. It has become one of those terms that can mean almost anything and, as a result, sometimes means very little. But I think the concept is important and worth taking seriously, particularly for leaders operating in complex, margin-sensitive environments like healthcare.

The organizations pulling ahead have made a conscious decision to build financial infrastructure designed to absorb volatility. That decision – the choice to build for resilience – shows in how they manage their revenue cycle.

The Macro Environment Is Demanding More

Finance leaders across industries are grappling with a period of sustained uncertainty. Global GDP growth is projected at 3.1% — below the long-run average — while inflation, though easing, remains above pre-pandemic levels. A recent Marsh McLennan analysis captured it plainly: “volatility has become more structural and not cyclical,” which is important because if volatility were cyclical, the playbook would be to wait it out. Structural volatility means the environment itself has changed.

For financial leadership, this has significant implications. CFOs who outperformed in 2025, according to Grant Thornton's survey of more than 260 finance leaders, were not the ones who predicted the environment most accurately. They were the ones who built organizations capable of responding quickly - by shifting from annual budgets to rolling forecasts, stress-testing assumptions, and allocating capital with discipline.

What This Looks Like in Healthcare

Healthcare has its own version of this story, and the issue of volatility is even more acute.

Health systems are navigating demographic shifts that are reshaping both demand for care and how that care gets reimbursed. Payer mix is moving toward government reimbursement at a time when government rates are under pressure. Uninsured volumes are rising while payer behaviors across commercial, Medicare Advantage, and Medicaid plans are growing more complex and more aggressive in ways that directly affect the bottom line.

The result is a financial environment where hospitals can deliver more care but collect less revenue than they should. Hospitals spent $43 billion in 2025 trying to collect payments insurers already owed, according to the American Hospital Association. Net revenue leakage rose approximately 25% year over year among a cohort of more than 2,300 hospitals. Behind those numbers is the same structural volatility playing out in many industries, but with less margin for error.

In a world where the pace of change exceeds the pace of planning, the competitive advantage belongs to organizations that can sense shifts early and act on them decisively.

Building the Infrastructure for Financial Resilience

The insight that has shaped how I think about this problem is simple: financial resilience ultimately comes down to infrastructure.

An organization can be committed to resilience and still be structurally vulnerable because resilience requires having the right systems, key performance indicators (KPIs), and visibility in place before the disruption arrives. Good intentions do not substitute for operational capability when the environment shifts faster than your reporting cycle.

In revenue cycle, this is especially true. Revenue cycle is where payer policy changes show up first. It is where coverage and process shifts become cash flow realities, documentation variation turns into denial trends, and patient affordability ultimately determines whether revenue is collected or written off. If you do not have the monitoring in place to understand what is happening in your revenue cycle, you are managing one of your most critical financial systems in the dark.

The organizations I would describe as financially resilient have made specific, deliberate choices: they treat revenue cycle as critical financial infrastructure rather than a back-office function; they invest in analytics and trend detection capabilities that surface leading indicators rather than lagging ones; and they have chosen partners with the expertise and data scale to detect payer behavior changes before they compound. Industry data shows that RCM teams lacking real-time access to payer performance data are consistently the most exposed when those patterns shift.

The Discipline to Act on What You Know

One element of financial resilience that often gets underemphasized is this: the discipline to act on what your data is actually telling you.

This sounds obvious but in practice it is harder than it appears. Organizations develop operating rhythms, reporting cycles, and organizational habits that create inertia. The signal may be present in the data, like a rising denial rate from a particular payer, an emerging pattern in eligibility gaps, an underpayment trend accumulating quietly in zero-balance accounts, but without the right infrastructure to surface it and processes to act on it, the signal becomes noise.

The best financial leaders I have observed across industries have built organizations that are genuinely oriented toward early action. McKinsey's CFO, Yuval Atsmon, put it plainly in a recent Fortune interview: “The worst thing is inaction.” The finance leaders navigating this environment well have internalized that, shortening the distance between insight and decision and establishing cultures where acting on early signals is rewarded rather than deferred.

That is what resilience looks like in practice.

Building for What Comes Next

The pressure on hospital finances is not going to ease in the near future. The demographic trends we are experiencing will have a long-term impact. Payer complexity has become structural. And I expect the macro environment will remain volatile in ways that are difficult to predict.

What health system leaders can control is how well they have built their organizations to handle that reality. Revenue cycle functions as the financial nervous system of a health system. When it is working well, it provides visibility and predictability — and the ability to act with confidence. When it is not, it introduces risk at exactly the moment the margin for error is smallest.

The organizations that recognize that now will have more options and more margin when the next inevitable disruption arrives.