Chief financial officers in the United States are more bullish on the economy.

CFOs gave the strength of the U.S. economy an average score of 53 out of 100 — up from 49 a year ago and the highest recorded rating in the last six years, according to the Bank of America Merrill Lynch 2014 CFO Outlook survey.

The study found that 47% of CFOs expect the economy to expand next year, up from 39% in last year's survey. Forty percent of CFOs believe the economy will stay the same, compared to 36% in 2013. Just 12% expect the economy to shrink, compared to 24% a year earlier.

"Corporate cash-flow, good corporate business activity" and rising home prices are among the factors that have given CFOs reason for optimism, Alastair Borthwick, head of global commercial banking at Bank of America Merrill Lynch, said in a Tuesday conference call with media.

CFOs were slightly less positive about the global economy, which received an average score of 50 compared to 45 the previous year. But CFOs remain invested in global markets, with more than half reporting that their companies do business internationally.

"We continue to see continued interest in all forms of international operating activity, particularly since CFO outlook on global growth continues to improve as well," Borthwick said.

CFOs were upbeat about the prospects at their own firms; 54% expect sales to grow next year, while 37% expect sales to remain at the same level. Eight percent anticipate a decline in sales.

Most respondents were fairly conservative in their estimates of sales growth, with 67% predicting an increase of 1% to 10%. Fifteen percent said sales would grow by 11% or more; 15% expect sales to stay the same or decline.

The survey also polled CFOs on their top economic concerns. Health care costs were the biggest source of anxiety, receiving 67% of the vote. The effectiveness of the U.S. government was a close second, with 62% of respondents citing it as the most pressing issue. Fifty-seven percent named the budget deficit as the top potential pitfall.

While CFOs may be concerned about health care costs, 74% said their companies are ready for the Affordable Care Act. "Most companies appear quite ready to comply at this point and we're not likely to see a lot of change in the health care plans that most of these adopt," Borthwick said.

The survey, conducted in the fourth quarter, included 751 CFOs of middle-market companies — defined as companies with $25 million to $2 billion in annual sales.

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