Greg Damron, CFO of MU Health Care

Summary

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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.

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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]

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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]

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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]

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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]

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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]

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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]

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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]

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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]

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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]

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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.

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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.

Transcript

[A]

This is Madeline Ashley with the Becker CFO and Revenue Cycle podcast. And I'm excited to be joined today by Greg Dameron, CFO of University of Missouri Healthcare. Greg, thanks for being back on with me. Excited to chat with you today.

[B]

Likewise, thanks for having me.

[A]

So, for some of our listeners who might not have gotten a chance to connect with our last podcast we did together, do you mind just sharing a little bit about yourself and your organization?

[B]

Yeah, sure. So, Greg Dameron, I'm the Chief Financial Officer here at the University of Missouri Healthcare. I've been here now just over a year. So glad to share some of those experiences with the audience today. University of Missouri Healthcare. We're part of the University of Missouri System, the flagship university and academic medical center for the state. Serve a service area of 25 counties in mid Missouri, roughly $2 billion in revenue. And you know, we are a primary provider of care at the primary care level as well as tertiary quaternary care levels for mid Missourians. And super excited to be here today with you.

[A]

Awesome, Greg, thanks so much for sharing that background. So as you mentioned, you've been with MU Healthcare for a little over a year. Really does fly. I'm sure you think that as well. But do you mind sharing with me maybe two to three defining moments during your time in this role maybe are just some lessons that you've learned that have kind of helped shape your approach to leading the system's financial strategy.

[B]

Yeah, I think coming into the role, I probably underappreciated this a little bit, but in terms of, you know, coming out of COVID and working on initiatives that would help improve our, our operating margins, I, I expected to be a little bit more focused on the operational side. And what I realized pretty quickly with, you know, with the assistance of my colleagues here, was that, you know, we really needed to spend some time focusing on the top line in terms of our revenue. So we are, as I mentioned before, we're the largest provider in our area. We're counted on for healthcare across those 25 counties, particularly when there are critical times as we've experienced in the last several years. And most of what's around us in terms of other providers are independent rural hospitals. To a large extent. Ten of those hospitals have closed in Missouri since 2012, four of those that happened in the last six years. So we're filling in vital, vital areas in our service area with, with our services. And that means we have to be here for the long haul for people, and so making sure that we've got a sustainable Source of revenue is really important. So those, those are kind of the areas we've been focused on. Where it's become, where it became defining for the year was in terms of working with our largest commercial payer in the area. We started early on this, not too long after I got here in terms of renegotiating our contract and just recently, nearly a year later, have had finished that, but we were out of network for almost four months. And so I would say that was quite defining for me and probably in a lot of ways for our organization that, you know, got a lot of lessons out of that in terms of alignment, organizational alignment. That's a pretty gut wrenching set of circumstances to be, you know, facing down and you really have to have everybody on board. So this is from the board of curators, who was our governance all the way down to our frontline patient facing clinicians and staff. So everybody had to be on board with what we were doing or at least understand it and what their role was in it. Of course, we didn't intend to be out of network. We expected kind of like a lot of other negotiations, you know, to come down towards the end and get to a deal. But fortunately in this case, it didn't happen. We had to stand our ground again because we need to be here for mid Missouri over the long haul, so.

[A]

Right.

[B]

Yeah.

[A]

I appreciate you kind of sharing, you know, some, some of these defining moments and lessons learned. I had a question for you, though. You touched on rural health care a little bit. And part of the one big beautiful bill act that everyone has seen and probably dove a little deeper into is that Rural Health fund program. And Dr. Oz, I just reported this recently, but Dr. Oz mentioned that applications for that open up in September. So I wanted to see if you could share any details there just on kind of how you're monitoring this program, how this might affect MU health care. Anything you can share?

[B]

Yeah, sure. I think we're in the same boat as most everyone else on this. We are rural. We have a lot of partners in our rural area and we have close connections with the state of Missouri. Those applications come through the state. And so we're in, you know, conversation with, with our colleagues at the state level to try to understand, you know, what, what that might look like, what they're thinking about, how we can fit into that as, as we move forward. You know, I think every state will, you know, come up with a program. It's pretty. At least as I've understood it today. You know, it's not terribly well defined. It sounds like there's a lot of discretion for, at the federal level in terms of those, you know, approving those applications. There's also a lot of discretion, it sounds like, in how those funds can be used. So I, you know, I think it's kind of wide open right now.

[A]

Yeah, definitely. A lot of the other financial leaders I've spoken with have said almost exactly that. It's just that there's still a lot of open ended questions and more to learn there, you know, and this ties kind of into my next question for you. Could you share maybe some steps you've taken to build resilience amid continued pressures, industry pressures on labor supply costs, reimbursement rates, everything we're seeing right now?

[B]

Sure. I think the key one was the one I mentioned. So we got that closed up. I think we've gotten to a good spot again with our largest commercial payer. We have spent a lot of time working with the state this year on reimbursement issues, particularly in light of the, you know, the one big beautiful bill and some of the changes that will happen there. The state was also underway with a program to move their reimbursement methodology to more of a case rate for inpatient services. And so we spent a lot of time working there to make sure that we were protected. We were able to, you know, get a little bit of additional reimbursement through those programs. And then, you know, I think we've been focused all year on improving our operations and growing at the same time. So as I mentioned, you know, we're having to fill in a lot of the, the niches out there and in our area that are, you know, kind of been left, left empty with some of the closures. We've looked at other opportunities as well to partner with other organizations to grow. And then internally, I think everybody needs to be, you know, highly focused on their operation. We've got to do, take advantage of some of the time we were out of network to work on, you know, capacity management in a different way, which I, you know, we're trying to make sure that we carry that forward as we get back in network here and, and look at how do we get better throughput through our system. So. Which was a challenge before.

[A]

And could you share some top financial priorities that you're looking into for the rest of 25 into 2026 and how you plan to achieve these?

[B]

Yeah, I mean, the most immediate thing is, you know, get, get ourselves back.

[A]

Yeah.

[B]

You know, in terms of working with those patients that were out of network, getting them reconnected with their providers, working with our, that large commercial payer on, you know, billing issues and, and so forth. So, you know, for the next few months, I think that will occupy a lot of our bandwidth. I mentioned volume and revenue, you know, just trying to make sure we're back on the same trajectory we were before we got out of network. Looking for growth opportunities in the area. This year I think will be big as we kind of turn, you know, turn past the issue with being out of network. And then, you know, we're, since you brought it up, we're, you know, continuing to analyze the impacts around the one big beautiful bill, looked at our, you know, risk management strategies around that. What is our response, how does it sort of play out over time and how do we need to, you know, change our course potentially around that. All while staying focused on our commitments around providing high quality care and training the next generation of health professionals.

[A]

And I want to circle back quickly just following the out of network situation and recently striking that deal. Could you share maybe some advice for other financial system leaders that might be going through something similar or just any other lessons learned there or plans in place to ensure something like this doesn't happen in the future?

[B]

Yeah, I think, you know, our, our issues that you know, we were facing, you know, they didn't happen overnight, they were accumulation of a number of years. And so we, we needed to make a pretty reasonable course correction with some of our reimbursement and that had to happen. And so that, that was a focus. I think when you're facing the situation of having to make a tough call about being out of network like that, I think I mentioned earlier the biggest advice I would give is just get buy in and alignment from all your stakeholders. We've got a lot of positive response from the community in terms of, you know, this, how they valued our services. I mean, yeah, our patients were not terribly happy about the situation. That would be an understatement. But I think we, we had a lot of goodwill going in and I think that's probably another area is 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.

[A]

Some great advice there and some insights. And I gotta ask you again, so just to kind of wrap everything up today, you know, as we've touched on just some of some of the industry challenges we're seeing right now, could you share some advice for the generation of health system CFOs, maybe you know, early on in their career, right now are about to come into the, to the industry.

[B]

Yeah. I think as you're, if you're coming up and looking for that CFO role, I think trying to get out and take on some challenges that may just be a little bit beyond your, your comfort level.

[A]

Right.

[B]

That's, that's always a good way to, to grow, to be noticed within your organization as a team member that people can count on to get things done. I think that probably one of the areas that finance leaders are not, you know, not terribly well prepared for and which has, I think become a much bigger part of the job is around communication, particularly to external stakeholders, legislators, your employers and the community. So it's not just your governance and it's not just your team members inside your organization, which is I think historically been where we've been focused as finance leaders. But I think in the future we have to evolve and be able to connect the dots for more people around how do financial issues impact the delivery of healthcare in their communities? The last piece, early in your career, I would get as involved in operations as possible. Understanding how things work, what, what people deal with on a day to day basis, that gets you a lot of credibility and a lot of goodwill if you understand their challenges. Even when you're trying to, you have to make a tough call sometimes. They're not going to like as long as they, they know you understand where they're, they're coming from. That does help quite a bit.

[A]

No, some strong advice there, particularly on the, on the communication aspect of things. I've also had some finance leaders tell me that's, you know, it's, it's important for leaders to come out from behind the desk, crunchy numbers and connect with their communities.

[B]

You know, we're not the most, 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.

[A]

No, no. Well, you know what I will say in, in defense of Some, some great CFOs I have talked to, I've definitely chatted with some, some pretty outgoing people. So hey, I think communication is always key. Greg, it's been such a pleasure chatting with you. I truly appreciate you taking the time today and excited to connect with you again down the line.

[B]

Yeah, I look forward to it. This has been a good journey with you so far and look forward to potential future conversations.

[A]

Me too. Thanks so much, Greg.

[B]

All right, thanks, Madeline.