Syntellis Performance Solutions and HFMA FALCO Survey Reveals More than Half of Healthcare Finance Teams Experienced Negative Impacts on Operating Margins in 2020

New findings underscore the need for data and analytics to prepare for long-term financial impacts of COVID-19

CHICAGO — February 18, 2021 As hospital and health system revenues and volumes decreased over the past year, expenses have continued to rise, creating a challenging situation for healthcare finance teams. Today, in partnership with HFMA’s Financial Analytics Leadership Council (FALCO), Syntellis Performance Solutions released new survey findings which reveal that, in response to these challenges, healthcare finance leaders plan to adjust their capital planning in the year ahead, and leverage new tools, data, and analytics to improve decision-making.

“In a typical year for hospitals and health systems, declining revenue and volume would equate to decreased expenses — but we know that 2020 was not a typical year,” said Steve Wasson, Executive Vice President and General Manager at Syntellis Performance Solutions. “We set out to understand how finance teams were managing this unprecedented time and found that healthcare finance leaders are looking to improve their capital planning and budgeting processes and use modern tools and solutions to manage the long-term impacts of COVID-19.”

Data from Syntellis’ Axiom Comparative Analytics platform showed that, compared to 2019, 2020 hospital operating margins dropped 4.9 percent (excluding CARES Act funding) and discharges decreased 10 percent, contributing to a 14.4 percent increase to total expenses per adjusted discharge. To understand how finance teams managed these circumstances, Syntellis partnered with HFMA FALCO to survey finance leaders about their plans for the future. Five key themes emerged from the survey of 115 healthcare finance professionals:

  • Changes in the payer mix and increased unemployment will have lasting impacts: Layoffs and changing patient populations had significant impacts on healthcare finances. More than half (55 percent) of respondents experienced a negative impact on operating margins with 90 percent aiming to reduce expenses in the year ahead.
  • Planning processes changed as a result of declining revenue and operating margins: Finance teams adapted their processes to rise above the challenges of COVID-19 and identified opportunities to improve for future scenarios. Nearly three-quarters of respondents (71 percent) indicated that they will adjust capital planning processes in 2021.
  • Sharp declines in patient volume highlight the need for diversified revenue streams: Although volumes declined throughout much of the year, 40 percent of respondents were optimistic that they would return to pre-pandemic volumes in the next year. However, for teams that typically budget for growth, pre-pandemic volumes would mean coming in below budget in 2021. By looking at performance levels in different areas of the organization, healthcare leaders may be able to identify improvement opportunities to prepare for decreased volumes elsewhere.
  • Increased expenses drive the additional need for agility: Hospital expenses were higher in 2020 than in 2019, with only two months — April and May — showing year-over-year decreases in total expense and total labor expense. This trend leaves healthcare organizations with two options: hold current expenses with the hope that volumes will recover or find new ways to decrease costs. To combat this, more than two-thirds (67 percent) of respondents stated they would deploy tools to optimize labor productivity, which is a strong area of focus for many healthcare providers given the national nursing shortage.
  • Data and analytics solutions will be key for recovery: When faced with volume and revenue pressure and increased expenses, respondents recognized that data and analytics solutions will empower finance teams to identify potential challenges and opportunities for improvement. Seventy-one percent of respondents stated they will prioritize comprehensive performance management, and 60 percent plan to introduce rolling forecasting capabilities.

"This research revealed that healthcare finance leaders need access to stronger data and analytics to manage unpredictable market conditions," said Kermit S. Randa, CEO of Syntellis. "By adopting new performance management and reporting tools, finance teams will be able to make more informed decisions and continue to elevate the finance office as a strategic center of the organization.”

Survey responses were collected in December 2020 as part of Syntellis’ partnership with HFMA FALCO. On March 2, 2021, Steve Wasson, EVP and General Manager, Data and Intelligence Solutions at Syntellis will moderate a webinar featuring HFMA FALCO committee members from Essentia Health (Minnesota), Mercy Health (Missouri) and Northern Light Health (Maine). For more information and to register, visit this page.



HFMA’s FALCO, Financial Analytics Leadership Council, is a group of Financial Analytics executives that convenes to share information, best practices and create a network of peers within the healthcare community. If you are a financial executive that would be interested in learning more about HFMA’s FALCO, please contact Chuck Alsdurf, Director, Professional Practice, HFMA, at


About Syntellis Performance Solutions

Syntellis Performance Solutions, previously Kaufman Hall Software, provides innovative enterprise performance management software, data and analytics solutions for healthcare organizations. Its solutions include enterprise planning, cost and decision support, and financial and clinical analytics tools to elevate organizational performance and transform vision into reality. With over 2,800 organizations and 450,000 users relying on its Axiom and Connected Analytics software, combined with No. 1 rankings from Black Book Research and an HFMA Peer Review designation for six consecutive years, Syntellis helps healthcare providers acquire insights, accelerate decisions and advance their business plans. For more information, please visit

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