What does a fractional CFO do for a healthcare business?
The short answer
A fractional CFO is a senior finance person who works with your business part-time, often a few days a month. In healthcare, that usually means cash flow forecasting, pricing against funding rules, monthly reporting to owners or a board, and modelling big decisions such as a new site. You get senior judgement without a full-time executive salary.
Most healthcare businesses reach a point where the owner or manager is making six-figure decisions with numbers that are three months old. The bookkeeper keeps the ledger accurate. The accountant does the year-end accounts and tax. But nobody is looking ahead and asking whether the business will have enough cash in March, or whether the new service line will ever pay for itself.
That gap is where a fractional CFO fits. This article explains what the role covers in healthcare, how it differs from the people you already have, and how to work out whether it’s worth the money.
What does a fractional CFO actually do?
The work changes with the business, but in healthcare it usually includes:
- A rolling 13-week cash flow forecast, plus a 12-month budget that gets compared with actual results every month.
- Pricing and margin analysis against the funding rules, for example NDIS price limits, AN-ACC or Support at Home budgets, or MBS fees.
- Monthly reporting that owners, partners or a board can read in ten minutes.
- Modelling big decisions: a second clinic, a new service, a practice purchase, or a change in billing policy.
- Preparing for conversations with banks, investors or regulators.
- Working with your bookkeeper and accountant so the data coming in is right.
What a fractional CFO doesn’t usually do is day-to-day data entry, payroll processing or lodging tax returns. Those stay with your bookkeeper and your registered tax agent.
How is a fractional CFO different from a bookkeeper or accountant?
| Role | Main focus | Looks at | Typical rhythm |
|---|---|---|---|
| Bookkeeper | Recording transactions accurately | This week and last month | Weekly |
| Accountant or tax agent | Year-end accounts, tax and compliance | Last financial year | Annually, plus BAS |
| Fractional CFO | Forecasting, pricing, decisions and reporting | Next 13 weeks to next 3 years | Monthly, with ad hoc support |
| Full-time CFO | The same as fractional, plus running a finance team | Next 13 weeks to next 5 years | Every day |
In short, the bookkeeper and accountant tell you what happened. A CFO helps you decide what to do next.
When does a healthcare business need one?
There is no revenue threshold. These are the signs we see most often:
- Revenue is growing but the bank balance isn’t.
- You can’t say which services, sites or clinicians make money and which don’t.
- A funding change, such as Support at Home or the November 2025 bulk billing changes, is coming or has arrived, and you haven’t modelled it.
- Your board or partners keep asking questions the current reports can’t answer.
- You are about to sign a lease, buy a practice or hire several staff, and the decision rests on a gut feel.
How does the cost compare with a full-time CFO?
Salaries and rates vary a lot by city, sector and experience, so use your own quotes. The structure of the comparison is what matters. Here it is with round illustrative numbers, which are not our fees or a market survey:
| Cost | Full-time CFO | Fractional CFO |
|---|---|---|
| Base salary or fees | $220,000 (assumed) | 3 days a month × $2,000 a day × 12 = $72,000 (assumed) |
| Superannuation | 12% = $26,400 | Included in fees |
| Recruitment | Often a one-off fee of around 20% of salary = $44,000 (assumed) | None |
| Leave, equipment, payroll tax | Extra on top | None |
| First-year total (before on-costs) | $290,400 | $72,000 |
The superannuation guarantee rate has been 12% since 1 July 2025, according to the ATO. The other figures are placeholders, so replace them with real numbers.
The honest comparison isn’t only cost, though. A full-time CFO makes sense once you need someone running a finance team every day, often in larger aged care groups or multi-site providers. Before that point, you are paying for capacity you don’t use.
What should the first 90 days look like?
- Weeks 1 to 2: get access to the accounting system, billing data and bank feeds, and talk to the owner, practice manager and bookkeeper.
- Weeks 3 to 4: deliver a short written plan with the biggest risks and opportunities, each with a dollar estimate.
- Month 2: build the 13-week cash flow forecast and the first proper monthly report.
- Month 3: work through the top one or two items on the plan, such as a pricing fix or a billing model, and agree the monthly rhythm from there.
How do you choose the right fractional CFO?
- Ask what they know about your funding model. Someone who has never read the NDIS Pricing Arrangements or an MBS item will learn on your time.
- Ask to see an example monthly report, with names removed. If you can’t follow it, your board won’t either.
- Ask how they work with your accountant and bookkeeper.
- Agree the scope and monthly fee in writing, and make sure you can end it without a long lock-in.
If you want to see whether we are a fit, start with a frank conversation. If we’re not the right people for you, we’ll tell you.
Sources
- How much super to pay (Australian Taxation Office)
- NDIS Pricing Arrangements and Price Limits (NDIA)
- Support at Home program (Department of Health, Disability and Ageing)
This article is general information, not financial or tax advice. Worked examples use illustrative figures. Check current program rules and speak to a registered tax agent about your own circumstances.
