What does a fractional CFO actually do?
A fractional CFO is a part-time senior finance executive who provides CFO-level work on a recurring monthly engagement instead of as a full-time employee.
Quick answer
A fractional CFO owns financial forecasting, KPI dashboards, cash flow management, capital decisions, and strategic finance work, typically delivering 10 to 25 hours per month on a retainer.
The detail
A fractional CFO engagement typically delivers six recurring work streams. First, monthly financial review, where the CFO reviews close output, identifies variances from forecast, and presents to ownership in a structured monthly meeting. Second, rolling 13-week cash flow forecasting and management, especially critical for practices with seasonal revenue patterns or growth investments. Third, KPI dashboards covering revenue, AR, productivity, and margin metrics that turn the financial statements into operating decisions. Fourth, capital allocation decisions: equipment buy versus lease, expansion timing, debt structure, partner distributions. Fifth, strategic projects: payer contract analysis, lease negotiations, M&A diligence on acquisitions or sale preparation. Sixth, banking and partner relationship management. Most engagements run 10 to 25 hours per month and meet monthly or biweekly with ownership. The work is recurring and senior; it is not project-based consulting.
Typical fractional CFO engagement runs 10 to 25 hours per month delivered as a recurring retainer.
Source: Sorso engagement data (proprietary, 2024–2026)
Median financial manager wage was $161,700 in May 2024, with healthcare-sector premiums on top.
Source: BLS OES May 2024
Fractional CFOs typically deliver monthly financial reviews, KPI dashboards, and rolling cash flow forecasts as the recurring core.
What this means for clinic owners
From Sorso
If you have ever asked 'why did we make less money this month than last?' and not gotten a clear answer within 24 hours, you have the problem a fractional CFO solves.
Related questions
How much does a fractional CFO cost?
A fractional CFO typically costs $3,000 to $10,000 per month for healthcare clinics, with most outpatient practices in the $4,000 to $7,000 range based on practice size and engagement scope.
When should I hire a fractional CFO?
Most clinics should hire a fractional CFO when they cross $2M in revenue, add a second location, raise debt or equity, or start preparing for a sale, typically 12 to 36 months out.
What is the difference between a CFO and a controller?
A controller manages historical accounting (close, statements, audit, compliance), while a CFO is forward-looking (forecasting, capital allocation, M&A, strategy). Most growing clinics need both, sequenced controller first.
What financial KPIs should I track for my clinic?
The core 8 financial KPIs every clinic should track monthly are revenue, EBITDA, net collection rate, days in AR, denial rate, revenue per provider, overhead ratio, and rolling 13-week cash forecast.
Founder of Sorso. 19 years in corporate finance. Managed a $450M loan portfolio before building a fractional CFO firm exclusively for healthcare clinics.
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