Podcast Summary: Becker’s Healthcare Podcast

Guest: Sara Bradley, CFO of UNC Health Southeastern
Host: Becker's Healthcare (Madeline)
Date: August 28, 2025
Length: ~15 minutes

Episode Overview

This episode features Sara Bradley, CFO of UNC Health Southeastern, in conversation with Madeline from Becker’s Healthcare. The discussion centers on Sara’s diverse healthcare background, the unique challenges and strengths of UNC Health Southeastern, key healthcare financial trends, and the operational and cultural changes fueling recent success at her organization.

Guest Background & Introduction to UNC Health Southeastern

[00:13–05:28]

• Sara Bradley's Career Journey

  • Over 22 years in healthcare finance, beginning in physician consult (1995), then correctional healthcare, and finally acute care hospitals across four states.
  • First CFO role in 2010 in Hot Springs, Arkansas.
  • Educational background: Accounting degree, CPA, and MBA (healthcare management emphasis).
  • Experience working in multiple states provided insight into the variations in Medicaid programs.

• About UNC Health Southeastern

  • Sara joined as interim CFO in 2022 and became permanent after four months.
  • UNC Health Southeastern has a management agreement with UNC Health since 2021, with most systems (finance, IT, EPIC) fully integrated—except payroll and some pharmacy systems.
  • Largest employer in Robeson County, North Carolina's poorest and least healthy county.
    • Majority-minority community: large Lumbee Indian, African American, Hispanic, and growing Haitian Creole populations.
    • "Quite a challenging community and environment to be in for health care. But that makes it fun." — Sara Bradley [00:23]

• Geographic Context

  • Located about 1 hour, 15 minutes inland from Wilmington and Myrtle Beach.
  • Community hospital serving around 20,000 people, employing ~10% of the town.

Key Trends in Healthcare Finance

[05:28–07:55]

1. Financial Sustainability

• Ongoing margin pressure and cost containment remain top priorities, given rising costs and tight revenues.
• “Financial sustainability is definitely something that stays front and center for me ... especially in what we would consider a safety net hospital that is so important to the community.” — Sara Bradley [05:59]

2. Unpredictability of Government Pay Rates

• Focus on changes in government pay structures—specifically the implications of the “one big beautiful bill” (OB3) for North Carolina.
• Special concern for regions like Robeson County, where Medicaid rates and population ratios magnify impact.
• "We're highly focused on, you know, what we can do to address that when it comes to fruition ... we have a couple of years to get ready for it." — Sara Bradley [07:41]

Strong Financial Year & Contributing Factors

[07:55–11:04]

State Medicaid Program: HASP

• In 2023, North Carolina implemented the Hospital Access and Stability Program (HASP), which approximates Medicaid managed care reimbursement to average commercial rates.
  • For every $1 received for Medicaid managed care, the hospital is reimbursed roughly an additional $1 through HASP (with 80/20 federal-state match funding).
  • Over $50 million in HASP funding contributed to a positive financial year.
    • “This year we had over 50 million in HASP funding on our books. And so that put us into the black significantly.” — Sara Bradley [09:44]

Operational Improvements

• Decreasing contract labor and stabilizing staff.
• Building out revenue cycle teams to better manage challenges with managed payers.
• Ongoing cost-cutting and efficiency initiatives.
  • “We've worked hard over the last three years to, you know, decrease contract labor, get that out of, you know, out of our cost structure as much as possible and kind of try to stabilize our staffing.” — Sara Bradley [09:52]

Growth, Quality & Future Outlook

[11:04–14:34]

Community Economic Impact & Quality Metrics

• UNC Health Southeastern acts as a key economic driver in Robeson County.
• Growth in provider recruitment: 77 providers added since 2020.
• Improvements in quality scores, star ratings, mortality and readmission rates.
  • “We've seen significant improvement in quality, our quality scores, we've moved up in our star ratings ... starting to really see the needle move on things like mortality and readmission rates.” — Sara Bradley [11:28]

Internal Culture and Satisfaction

• Employee satisfaction and patient satisfaction rates have risen significantly.
• Meeting/exceeding HCAHPS targets for both emergency department and medical practices for the first time in years.
  • “We've also seen a tremendous amount of improvement in our employee satisfaction ... We met our target both on the hospital HCAHPS side for the ED and the overall hospital rating, and then also for our medical practices.” — Sara Bradley [13:49]

Focus for the Coming Years

• Plans to further lower readmissions and average length of stay (care management initiatives).
  • “We're going to be able to focus a lot more on lowering readmissions and trying to get our length of stay under control ... both are initiatives heavily driven by care management, which happens to report to me.” — Sara Bradley [12:16]

Memorable Quotes

• On the challenge of serving Robeson County:
  “I don't know if you know anything about Robinson County in North Carolina, but we are the poorest and least healthy county in the state of North Carolina. So it's quite challenging. And we are what they consider a majority minority community made up of the Lumbee Indian tribe, as well as African American, Hispanic. And then we actually are kind of growing a Haitian Creole population.” — Sara Bradley [04:35]

• On the positive impact of financial improvement:
  “We've just come off this really good year and hope to be able to have a good, positive, you know, couple more years in front of us before we have to start really dealing with the impact of what's in that bill. So we're excited about that.” — Sara Bradley [10:45]

• On organizational change and momentum:
  “Our culture has just really evolved in the last couple of years ... we're excited about the momentum we have going into the new fiscal year to be able to leverage some of this stuff that we've learned over the last 12 to 24 months to be able to face what's coming.” — Sara Bradley [12:59]

Notable Segments / Timestamps

• [00:13] Sara’s introduction and career journey
• [04:35] Demographics & unique challenges of Robeson County
• [05:56] Financial sustainability and government pay trends
• [07:55] Impact of the new OB3 bill for Medicaid
• [08:27] HASP program’s financial impact
• [09:44] Success factors in recent financial performance
• [11:28] Provider growth and quality score improvement
• [12:16] Focus on readmission and length of stay reduction
• [13:49] Employee/patient satisfaction achievements

Takeaways

Sara Bradley highlights the unique economic and social landscape of Robeson County and the pivotal role UNC Health Southeastern plays. The hospital’s recent financial turnaround owes much to state and federal Medicaid adjustments as well as improved operational discipline. Sara’s leadership focus: sustaining this momentum, deepening community impact, and preparing for looming regulatory changes—with a strong emphasis on culture, quality, and staff engagement.