A new report from Deloitte shows that three out of five finance leaders at large healthcare organizations aim to lift their operating margins by at least two percentage points in the next two years, with nearly 30 percent saying they’re eyeing five-point gains in that time. But the firm warns that C-suites may be over-reliant on traditional growth strategies that could run into the harsh realities of affordability and patients’ lessening ability to access the healthcare system.

Deloitte this past spring surveyed of 64 finance executives (half at provider businesses with at least $1 billion in revenues, the other at insurers with at least 500,000 members) to get a sense of how they intend to grow and how prepared they think their organizations are to hit their targets. The poll showed a large gap between goals and perceived readiness at a high level but also when zooming in on broad cost drivers such as spending on the supply chain and workforce as well as organizations’ expected ability to switch to new care or payment models.

C-suites have, are and will continue to lean on efficiency gains across their businesses, including from artificial-intelligence tools and services. And in some cases, the expected margin gains will be cases of addition by subtraction. Since the spring, the leaders of several big-name insurers have said they will get out of money-losing or low-margin business lines or jurisdictions:

• Cigna leaders said they’re pulling out of the individual Affordable Care Act market
• Executives at Elevance Health announced they’ll exit the Medicaid business in several states
• And Humana’s top managers said they’re planning to drop plans with about 600,000 members in 2027

Still, a striking take-away from Deloitte’s report is that the share of CFOs who said they’ll lean more on revenue-led strategies has risen to 50 percent from 31 percent in each of the last two years. In other words, the internal efficiency gains or dropping low-margin contracts aren’t enough on their own.