In this first Impact Analysis from the 2012 CFO Exchange, nine CFOs take a deeper look at how they are assigning costs and driving them out at their respective organizations. The need to reduce costs—not just once, but permanently and sustainably—was top of mind for these leaders, and many felt the weight of a deck seemingly stacked against them. CFOs are grappling with declining Medicare reimbursements, value-based purchasing penalties, and a shift in inpatient volumes, while continuing to fund huge technology initiatives and expansion through physician acquisition or employment.