Healthcare is in a state of upheaval. Nowhere is this more evident than in treasury management, where the ability of a health system to be paid for its work can be jeopardized thanks to a number of initiatives that threaten to slow or halt payment—from ICD-10 to new commercial payment models to the need to effectively integrate hospital and physician practice billing and collection. At the same time, new points of revenue collection are opening up. Health systems are investing millions for better patient accounting systems. But integration between IT systems that bring money into the organization and those that catalog patient care is fraught with potential potholes. Further, consolidation in the industry means conversions of legacy systems, which provide further room for expensive delays and missteps. Mission-critical revenue and accounting systems require working capital, which can be obtained, but cost savings from all this change are expected as well. Senior financial leaders are quickly learning how to manage the transition of their health system's most critical systems without costly breakdowns.