Why CFOs Are Skeptical of Benefits ROI Claims

For years, the benefits industry has relied on a familiar formula:

Engagement rate + member satisfaction + projected savings = ROI.

But today’s CFOs are no longer accepting that equation at face value.

In an environment defined by margin pressure, rising healthcare costs and increased capital scrutiny, finance leaders are asking a harder, more disciplined question: Show me the real financial impact – not the model.

And increasingly, traditional ROI narratives don’t hold up under that lens.

The Trust Gap in Benefits ROI

CFO skepticism isn’t cynicism. It’s financial discipline.

Many digital health and benefits ROI claims rely on modeled savings drawn from literature, short-term utilization shifts or engagement metrics framed as economic value. While these indicators may signal program performance, they are not the same as sustained, attributable medical cost reduction.

Finance teams are trained to interrogate assumptions. They want to understand:

• What population was measured?
• Was there a valid control group?
• How long were outcomes sustained?
• Are savings net of vendor fees?
• Is impact measurable at the total cost of care level?

When ROI depends on projections, selective cohorts or vendor-reported metrics without independent validation, credibility erodes quickly. That erosion creates a widening trust gap between HR and Finance.

Healthcare Spend Is Now a CFO-Level Priority

Healthcare is no longer simply an HR-managed benefit line item. For many employers and health plans, it is one of the top three operating expenses.

With trend rates rising year over year, incremental solutions that promise modest savings without clear attribution fail to resonate. CFOs are looking for measurable impact on overall cost trend – not isolated wins in narrow categories.

They are asking:

• Does this reduce total cost of care, or shift utilization elsewhere?
• Are we layering point solutions that create fragmentation?
• How does this integrate with our broader cost strategy?
• What is the multi-year financial trajectory?

If those questions cannot be answered with rigor and clarity, the default position becomes caution.

The Fragmentation Problem

Over the past decade, organizations have accumulated digital health providers targeting specific conditions – weight management, MSK, behavioral health, diabetes, hypertension and more.

Individually, many show promising results. Collectively, they often create operational complexity, duplicative outreach and disconnected reporting.

From a CFO perspective, fragmentation introduces risk:

• Overlapping vendor fees
• Conflicting incentives
• Inconsistent measurement methodologies
• Limited visibility into aggregate impact

Innovation without integration can actually obscure financial performance instead of improving it.

What CFOs Actually Want

The path forward is not fewer digital health benefits – it is better accountability.

CFOs respond to:

• Transparent methodologies
• Independent validation
• Clear attribution models
• Multi-year performance tracking
• Net savings analysis tied to total cost of care

They want digital health ROI – alignment between clinical outcomes and financial performance. They want confidence that investments are reducing trend, not simply generating engagement metrics.

Rebuilding Confidence in Benefits ROI

To regain credibility with finance leaders, benefits strategies must evolve beyond vendor-level ROI claims. Organizations need integrated reporting, coordinated care pathways and measurable impact across populations.

The future of benefits value will not be defined by participation rates alone. It will be defined by demonstrable cost containment, sustained outcomes and financial transparency.

CFO skepticism is not an obstacle – it is an opportunity.

It is a signal that the market is maturing. That proof matters. That accountability matters.

And that the next generation of benefits solutions must be built not just to engage members, but to stand up to financial scrutiny.

‍What to Look for in a Benefits Solution That Can Pass CFO Scrutiny

Not all digital health programs are built to withstand the rigorous financial evaluation that today's CFOs apply. When assessing vendors or evaluating your current benefits portfolio, the right solution should be able to answer yes to a short but critical set of questions.

Does the vendor measure outcomes at the total cost of care level, not just within their own program? Do they offer independent validation of results — not just proprietary dashboards? Can they demonstrate savings that are sustained over multiple years and net of their own fees? Do they integrate with your existing benefits ecosystem, or add to the fragmentation problem?

If the answer to any of these is unclear, that is meaningful signal. The organizations achieving real financial accountability in benefits are not necessarily spending more — they are spending smarter, consolidating point solutions, and demanding the kind of transparent, integrated reporting that holds up in a CFO review.

The question is no longer whether your benefits programs produce results. It is whether you can prove it.