Episode Overview

In this episode of the Becker’s Healthcare Podcast (August 21, 2025), host Madeline Ashley interviews Greg Damron, CFO of University of Missouri Health Care (MU Health Care), about his experiences leading the financial strategy of a major academic medical center in mid-Missouri. The discussion covers Greg’s first year as CFO, the challenges of maintaining revenue and operational resilience in a rural healthcare landscape, the impact of state and federal policy changes, lessons learned from a significant out-of-network negotiation, and advice for current and future healthcare financial leaders.

Key Discussion Points and Insights

1. Background on Greg Damron and MU Health Care

[00:16–01:17]

• Greg Damron is the CFO at University of Missouri Healthcare, a $2 billion academic medical center serving 25 counties in mid-Missouri.
• MU Health Care is a primary provider at all levels—primary to quaternary care—for the region, especially critical as rural hospitals have closed at an alarming rate.
• Quote:

  “We are the primary provider of care at the primary care level as well as tertiary quaternary care levels for mid Missourians.” — Greg Damron [00:37]

2. Defining Moments and Lessons in Greg’s First Year as CFO

[01:42–04:39]

• Initial expectation was to focus on operations, but Greg quickly realized top-line growth (revenue) was equally crucial, especially post-COVID.
• The closure of ten rural hospitals in Missouri (four in the past six years) increased MU Health Care’s vital role.
• Most defining experience: A year-long negotiation with their largest commercial payer, which led to being out-of-network for nearly four months.
• Lessons learned: Emphasized importance of organizational alignment—from board to frontline clinicians—during crisis.
• Quote:

  “That’s a pretty gut-wrenching set of circumstances... You really have to have everybody on board.” — Greg Damron [03:16]

3. Navigating Rural Health Policy and Funding

[04:40–06:22]

• Discussed the open-ended nature of the new Rural Health Fund Program associated with the “One Big Beautiful Bill.”
• MU Health Care is engaged in ongoing discussions with state officials, with many details and fund uses yet to be clarified.
• Quote:

  “It sounds like there’s a lot of discretion at the federal level...how those funds can be used. So I think it’s kind of wide open right now.” — Greg Damron [05:46]

4. Building Financial Resilience Amid Labor and Reimbursement Pressures

[06:22–08:34]

• MU Health Care focused on closing the payer contract and state reimbursement strategies, especially in response to the new bill and moving state Medicaid toward case-based reimbursement.
• Initiatives to fill care gaps left by closed rural hospitals and explore growth partnerships with other healthcare organizations.
• Capitalized on being out-of-network to improve capacity management for better system throughput.
• Quote:

  “We’ve looked at other opportunities as well to partner with other organizations to grow. Internally, everybody needs to be highly focused on their operation.” — Greg Damron [07:38]

5. Financial Priorities for Late 2025 and 2026

[08:34–10:04]

• Immediate priorities: Reconnecting out-of-network patients, resolving billing with the commercial payer, restoring growth trajectory.
• Continual analysis of changes from the “One Big Beautiful Bill” with a focus on risk management, operational adaptation, and commitment to care quality and workforce training.
• Quote:

  “Looking for growth opportunities in the area...analyzing the impacts around the one big beautiful bill...all while staying focused on our commitments around providing high quality care and training the next generation of health professionals.” — Greg Damron [09:20]

6. Lessons from the Out-of-Network Negotiation

[10:04–11:38]

• Advice for other financial leaders: Secure robust stakeholder alignment before and during payer negotiations.
• Emphasize community goodwill and maintain focus on patient-centered values, even during difficult decisions.
• Quote:

  “If you focus on doing the right things by your patients, by your employers, by your staff and your team members, you’re going to come out okay.” — Greg Damron [11:24]

7. Advice for Emerging Healthcare CFOs

[12:02–13:45]

• Take on challenging assignments beyond your comfort zone to grow and be recognized as a reliable team member.
• Modern finance leadership now requires strong communication skills—especially with external stakeholders and the broader community, not just internally.
• Early-career focus: Gain deep operational understanding to earn credibility and better navigate difficult decisions.
• Quotes:

  “Take on some challenges that may just be a little bit beyond your comfort level...that’s always a good way to grow.” — Greg Damron [12:09]
  “Finance leaders are not terribly well prepared for...communication, particularly to external stakeholders, legislators, your employers, and the community.” — Greg Damron [12:28]
  “Get as involved in operations as possible.” — Greg Damron [13:12]

8. The Evolving Role of the CFO

[13:45–14:29]

• Madeline and Greg both stress the importance—and challenge—of communication for healthcare finance leaders.
• Quote:

  “We’re not known to be the most extroverted individuals out there in terms of being finance leaders. So you have to work on it and focus on it.” — Greg Damron [13:59]

Notable Quotes & Memorable Moments

• “That’s a pretty gut-wrenching set of circumstances... You really have to have everybody on board.” — Greg Damron [03:16]
• “If you focus on doing the right things by your patients, by your employers, by your staff and your team members, you’re going to come out okay.” — Greg Damron [11:24]
• “Finance leaders are not terribly well prepared for...communication, particularly to external stakeholders, legislators, your employers, and the community.” — Greg Damron [12:28]

Timestamps for Important Segments

• 00:16–01:17: Greg Damron introduces himself and MU Health Care’s mission and scope.
• 01:42–04:39: Defining moments, including the out-of-network experience with a major payer.
• 04:40–06:22: Discussion of the Rural Health Fund Program and federal funding uncertainties.
• 06:22–08:34: Strategies for financial resilience and adaptation.
• 08:34–10:04: Financial priorities going forward into 2026.
• 10:04–11:38: Advice for systems facing out-of-network negotiations.
• 12:02–13:45: Forward-facing advice for health system CFOs and the evolution of the role.

Summary

This episode presents a candid look at the complexities and evolving demands of the healthcare CFO role, especially in a post-pandemic, rural-centric landscape. Greg Damron shares both the challenges and hard-won lessons from his first year at MU Health Care, emphasizing revenue strategy, organizational alignment, responding to policy shifts, and the growing importance of communication and operational know-how for financial leaders. The insights and practical advice are a valuable resource for anyone navigating healthcare finance leadership today.