Becker’s Healthcare Podcast — Episode Summary

Guest: Andy Barrow, CFO of Cone Health
Host: Madeline Ashley, Becker’s Healthcare
Date: September 5, 2025
Duration: ~16 minutes

Episode Overview

This episode features Andy Barrow, Chief Financial Officer at Cone Health, discussing the current healthcare landscape from a financial and operational perspective. Barrow provides in-depth analysis on regulatory and payer trends, workforce challenges, and Cone Health’s approach to strategic growth, technology, and equity initiatives. The episode offers valuable insights for healthcare executives, finance leaders, and anyone interested in the future of healthcare delivery.

Key Discussion Points & Insights

1. Andy Barrow’s Background and Overview of Cone Health

• [00:20] Barrow outlines Cone Health’s size, regional footprint, and integrated scope. The system serves over a million encounters annually, employs 13,000+ staff, and is comprised of hospitals, ambulatory care centers, urgent cares, and more.
• Quote:

  “Cone Health is a not-for-profit integrated healthcare system… headquartered in Greensboro. We serve over a million encounters annually to around 400,000 unique patients… We are also a member of Risant Health, an extension of Kaiser Foundation Hospitals, which we joined in December of 2024.”
  — Andy Barrow [00:20]

2. Major Trends Being Monitored at Cone Health

Barrow identifies—and elaborates on—several critical trends closely monitored by Cone Health leadership:

a. Regulatory and Government Environment

• [02:12] Intense focus on Medicaid payment structures, coverage eligibility (especially post-HR1), and ongoing state-specific challenges.
• Barrow also watches the impact of tariffs, 340B issues, and site-neutral payment regulations.
• Quote:

  “There’s a lot that falls under [the regulatory] category… the impact to Medicaid payment levels and Medicaid coverage eligibility stemming from HR1 at the top of that category. North Carolina has a unique set of Medicaid challenges right now.”
  — Andy Barrow [02:15]

b. Payer Trends and Behaviors

• [03:07] Notable volatility from both government and commercial payers, with frequent changes to payment practices—sometimes without advance notice.
• These unpredictable changes challenge stability and planning, affecting both revenue and Cone Health's own Medicare Advantage plan.
• Quote:

  “CMS and states and payers will change payment practices sometimes through normal rulemaking and sometimes without much notice, making it very hard to plan and feel stable.”
  — Andy Barrow [03:38]

c. Workforce Sustainability and Labor Costs

• [04:30] Persistent shortages, especially among nurses, physicians, and key practitioners, compounded by ongoing reliance on contract labor post-COVID.
• Workforce burnout (clinical and non-clinical), the aging workforce, and impacts of education costs are outlined as ongoing challenges.
• Quote:

  “We are still very dependent on contract labor… We're also very aware of burnout issues with all of our staff… the aging workforce and trends around education levels…”
  — Andy Barrow [05:10]

d. Technology and AI Solutions

• Barrow connects the above workforce challenges to the importance of technology and automation to reduce burnout and boost efficiency.
• Quote:

  “The long term solutions on workforce have to include more technology to automate non value added functions for humans and put our best people and their talents onto things that add more value…”
  — Andy Barrow [05:55]

3. Workforce Recruitment and Retention Strategies

• [06:46] Cone Health is getting creative with educational partnerships, targeting new markets, and offering flexible work arrangements.
• For providers, a shift toward optimizing the skill mix, allowing mid-levels and advanced practitioners to assume appropriate duties.
• Quote:

  “We’re tapping into new markets and submarkets that we have not traditionally recruited in… offering flexibility for non-clinical areas… looking at different skill mixes that are appropriate for the right level of care…”
  — Andy Barrow [06:55]

4. Cone Health’s Strategic Vision and Exciting Developments

a. Commitment to Value-Based Care & Risant Health Membership

• [07:48] Barrow emphasizes a strategic plan through 2030, centered on value-based care—a foundational part of Cone Health’s identity.
• Membership in Risant Health (created by Kaiser Foundation Hospitals) is set to accelerate value-based care, leveraging Kaiser’s expertise.
• Quote:

  “Risant is a relatively new, not-for-profit created by Kaiser… allows us as a Risant member to bring the expertise and capabilities that Kaiser has to our health system…”
  — Andy Barrow [08:18]

b. New Ambulatory Facilities and Health Equity Initiatives

• Opening of a state-of-the-art heart and vascular ambulatory center; expansion of specialty lines.
• Growth in primary care capacity, including in underserved and rural areas, and mobile medicine deployments.

c. School-Based Telehealth Program

• [09:28] Innovative telehealth service for high-poverty schools, addressing healthcare access and absenteeism—aiming to reach 40+ schools by year’s end.
• Quote:

  “We’ve established a school-based telehealth program… to bring telehealth visit capabilities to targeted high-poverty schools. So the result is quick and easy access to care for students, fewer missed days of class.”
  — Andy Barrow [10:06]

d. Organizational Agility and Technology Upgrades

• Rollout of a new operating model for decision-making clarity and agility, improvements to financial planning and business case processes.
• Anticipation for go-live of a new ERP system in early 2026.
• Quote:

  “We are rolling out a new operating model… and upping our game on financial planning… And you know, on top of all that, we’re going live with a new ERP system at the first of the year.”
  — Andy Barrow [11:38]

5. Lessons Learned from Joining Risant Health

• [12:08] Financial strength and sustainability was core to the acquisition process.
• Barrow notes the value of maintaining local decision-making autonomy under the Risant model, while aligning with system-wide strategy.
• Quote:

  “One of the great things about the Risant model is that local decision making, and local strategy, and local branding stay in place.”
  — Andy Barrow [12:47]

6. Perspective on Growth for the Next 12–24 Months

• [13:28] Barrow sees growth as a blend of increased care access and investment returns.
• Outpatient (ambulatory) growth, both organic and via acquisition, is the priority, but inpatient services remain crucial—especially given North Carolina's Certificate of Need laws.
• Close attention to rural/urban needs, specialty services, digital care, infusion, pharmacy, and nontraditional revenue streams.
• M&A is possible longer-term “when the right opportunity comes along.”
• Quote:

  “Generally, we believe that outpatient growth is the key to success in value-based care strategies and where the puck is going, so to speak, for the entire industry… And the need for inpatient services is not diminishing… So we are looking at ways our inpatient services can grow and where that makes sense…”
  — Andy Barrow [13:51]

Memorable Quotes

• “The long term solutions on workforce have to include more technology to automate non value added functions… and put our best people and their talents onto things that add more value to the organization…”
  — Andy Barrow [05:55]

• “We’ve established a school-based telehealth program… The result is quick and easy access to care for students when they’re not feeling well, fewer missed days of class. So it’s good for the students, good for the schools, and good for the families.”
  — Andy Barrow [10:06]

• “One of the great things about the Risant model is that local decision making and local strategy and local branding stay in place. So we have a lot of autonomy to do the right things as long as… we are aligned strategically, which we are from the outset.”
  — Andy Barrow [12:47]

Timeline of Key Segments

• 00:20–01:47 — Background: Cone Health and Barrow’s career
• 02:12–06:17 — Trends: Regulatory, payers, labor, technology
• 06:46–07:34 — Workforce strategies: Recruitment and retention
• 07:48–11:25 — Strategic vision: Value-based care, Risant Health, new centers, equity, telehealth, operational upgrades
• 11:47–13:17 — Lessons learned from Risant Health integration
• 13:28–15:52 — Growth outlook: Ambulatory focus, inpatient demand, M&A possibilities

Tone and Style

Andy Barrow speaks with clarity and a systems-level view, often connecting operational, regulatory, and strategic concerns with practical examples. His tone is positive, forward-thinking, and pragmatic, emphasizing adaptability, community benefit, and organizational learning.

This episode offers a robust exploration of financial stewardship, innovation, and community-focus within a modern, regional healthcare system navigating a highly regulated, ever-evolving environment.