Fractional CFO vs full-time CFO for healthcare clinics
TL;DR: For most clinics under $20M in revenue, a fractional CFO delivers the strategic depth you need at a fraction of the cost. A full-time CFO starts making sense above $20M or when daily financial complexity, multi-entity structures, or active M&A require a dedicated seat. Below: cost, commitment, healthcare expertise, and where each model fits.
Option A
Fractional CFO
Part-time CFO engagement, typically 10-20 hours per week. You get senior financial leadership without the full-time salary, benefits, or long-term commitment. Common for clinics between $2M and $20M in revenue.
Option B
Full-Time CFO
Salaried executive on your payroll, 40+ hours per week. Dedicated entirely to your organization. Typically justified when the complexity of your financial operations requires daily strategic oversight.
| Category | Fractional CFO | Full-Time CFO |
|---|---|---|
| Annual cost | From $48,000/yr (Sorso fractional CFO starts at $4,000/mo) | BLS counts CFOs among chief executives, whose median annual wage was $213,990 in May 2025, $197,090 in health care and social assistance, before benefits, payroll taxes, bonus, or equity |
| Commitment | Month-to-month or quarterly contracts | Salaried employee with benefits package |
| Healthcare expertise | A fractional specialist works with several clinics at once, which sharpens their read on payer mix, denial rates and reimbursement trends. Deep pattern recognition across payer mixes, denial rates, and reimbursement trends. | Depends on the hire. Most full-time CFOs come from general finance and learn healthcare on the job. |
| Weekly availability | 10-20 hours/week, structured around your financial calendar | 40+ hours/week, full-time presence |
| Scalability | Scale hours up or down as needs change. Add hours during M&A, reduce during steady state. | Fixed cost regardless of workload. Over-resourced in quiet months, potentially under-resourced during growth. |
| Time to value | 2-4 weeks. Specialists have playbooks from dozens of similar clinics. | 3-6 months. Needs to learn your operations, team, and industry from scratch. |
| Exit cost | 30-day notice. No severance, no recruiting fees. | Severance, recruiting a replacement, and a 3-6 month gap with no finance leadership. |
| Strategic depth | Broad pattern recognition from multiple engagements. Knows what works because they have seen it work elsewhere. | Deep institutional knowledge of your specific organization. Better for complex multi-entity structures. |
| Management overhead | Self-directed. Shows up with a framework and runs it. | Requires management, performance reviews, career development, team integration. |
| Best for | Clinics $2M-$20M wanting CFO-level thinking without CFO-level cost | Organizations $20M+ with daily financial complexity requiring full-time presence |
Fractional wins for clinics under $20M. Full-time makes sense above that.
If your clinic does $2M-$20M in revenue, a fractional CFO gives you the strategic financial leadership you need for a fraction of a full-time hire's cost, which Sorso estimates at about $242,000 a year with benefits. You get a specialist in clinic finance instead of a generalist learning healthcare on your payroll. Above $20M, or if you have complex multi-entity structures, daily treasury management, or active M&A, a full-time CFO starts to make sense. But even then, many $30M+ groups start fractional and only go full-time when the volume of daily decisions justifies the cost.
Frequently Asked Questions
Can a fractional CFO handle a clinic with multiple locations?+
Yes. Most of our engagements are multi-location practices. The fractional model works well here because location-level P&L analysis, provider productivity tracking, and payer mix optimization follow repeatable frameworks. We have built these frameworks across dozens of multi-site clinics.
How many hours per week does a fractional CFO actually work?+
Typically 10-20 hours per week, concentrated around your financial calendar. Month-end close gets more attention. Mid-month might be lighter. The hours flex based on what is happening in your business, not an arbitrary schedule.
What if I outgrow the fractional model?+
That is a good problem to have. We help you hire a full-time CFO when you reach that stage and ensure a clean handoff. We have done this several times. Some clients keep us in an advisory capacity even after hiring full-time.
Is a fractional CFO the same as a part-time controller?+
No. A controller runs monthly close, reconciliations, and internal controls. A fractional CFO uses those clean statements to build forecasts, model growth scenarios, and guide capital decisions. Different jobs, different skill sets. Many clinics need both: a fractional CFO usually works alongside your controller or bookkeeper, not instead of them.
How quickly can a fractional CFO start making an impact?+
You should see concrete findings within the first 30 days, well before a full-time hire would finish onboarding. By week two, we have identified the biggest financial leaks. By month two, we have a strategic financial plan with specific targets. Compare that to a full-time hire who spends their first quarter just learning your systems.
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Founder of Sorso and a CFA charterholder. Before Sorso, Stan spent 19 years in corporate finance at institutions including UniCredit and Société Générale — managing a $450M loan portfolio and making senior partner at a major mezzanine lender by 29 — then built a fractional CFO firm exclusively for outpatient healthcare clinics.