Latest / Becker’s Healthcare Podcast / Greg Damron, Chief Financial Officer and Interim School of Medicine Executive Director of Finance at University of Missouri Health Care

Transcript

Greg Damron, Chief Financial Officer and Interim School of Medicine Executive Director of Finance at University of Missouri Health Care · Becker’s Healthcare Podcast

• 0:02
  - There's a small circle of people who truly
• 0:04
  - understand what it takes to lead a health
• 0:05
  - system right now. The decisions are enormous.
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  - The variables are constantly shifting, and the stakes
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  - of getting a call wrong don't stay contained.
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  - That's not a complaint. It's a structural reality.
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  - And it's why the most effective c suite
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  - leaders are deliberate about where do they go
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  - to pressure test their thinking.
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  - Becker's fourteenth annual CEO and CFO roundtable
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  - brings together more than 1,500
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  - executive level attendees
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  - and nearly 400 speakers for four days built
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  - around growth, financial sustainability,
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  - workforce strategy, and the leadership questions that don't
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  - have easy answers.
• 0:39
  - Join us November second through the fifth in
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  - Chicago.
• 0:42
  - For the agenda and event details,
• 0:45
  - visit beckershospitalreview.com
• 0:47
  - and click on the events tab in the
• 0:49
  - upper right.
• 0:51
  - This is Laura Dirda with the Becker's Healthcare
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  - podcast. I'm thrilled today to be joined by
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  - Greg Damron, chief financial officer of the University
• 0:58
  - of Missouri Healthcare. Greg, Greg, it's a pleasure
• 1:01
  - to have you on the podcast today.
• 1:03
  - Thanks, Laura. It's great to be here. Absolutely.
• 1:06
  - Now I'm excited for our conversation. I know
• 1:08
  - we're gonna dig into some of the cool
• 1:09
  - things you've been doing at the University of
• 1:11
  - Missouri Healthcare as well as how you're thinking
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  - about the future. But before we get to
• 1:15
  - that, can you tell us just a little
• 1:16
  - bit more about yourself and your background?
• 1:19
  - Oh, sure. So I am, you know, chief
• 1:22
  - financial office here here at, University of Missouri
• 1:25
  - health care. I've been here,
• 1:28
  - just over two years now,
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  - and have been in
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  - academic medicine
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  - for most of my career in finance going
• 1:36
  - back,
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  - you know, almost twenty five years now.
• 1:40
  - So so deep experience there,
• 1:44
  - previous experience at other,
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  - academic medical centers in Arizona,
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  - Georgia, and
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  - North Carolina. So I've also seen a lot
• 1:53
  - of the country
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  - as well.
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  - So glad glad to glad to speak with
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  - you today.
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  - Absolutely. Well, I think to get us started
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  - here, could you give us a quick state
• 2:05
  - of the union? What's gone well this year,
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  - and what are you focused on for the
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  - rest of 2026?
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  - Sure. I mean, just a little background. I
• 2:12
  - mentioned my tenure here.
• 2:14
  - Our executive team,
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  - largely has been
• 2:17
  - in place now for, you know, two to
• 2:20
  - four years. So pretty young team,
• 2:23
  - and we're really starting to see, you know,
• 2:25
  - a lot of
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  - the a lot of the projects and efforts,
• 2:30
  - you know, start to come to fruition in
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  - terms of implementation.
• 2:33
  - And,
• 2:35
  - many of the things we've been talking about
• 2:36
  - for the last several years,
• 2:38
  - together,
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  - really are are starting to to come come
• 2:42
  - into view.
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  - So that that's exciting for us. We've got,
• 2:48
  - a lot of great people here, and,
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  - MU Health Care, as we call it,
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  - has had, you know, tremendous growth over the
• 2:57
  - last,
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  - ten or so years, a lot of tremendous
• 3:00
  - organic growth. And, you know, we're focused on
• 3:03
  - getting the organization prepared for for the next
• 3:05
  - phase of its journey.
• 3:08
  - So this year has gone well in the
• 3:09
  - sense that we, you know, wrapped up you
• 3:11
  - know, we're on a on a 06/30,
• 3:14
  - fiscal year. So we wrapped up our last
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  - fiscal year,
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  - which, you know, saw a lot of drama.
• 3:19
  - We were out of network with our major
• 3:21
  - commercial payer,
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  - for a hundred days at the beginning of
• 3:25
  - the the time and spent spent really the
• 3:27
  - rest of the year,
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  - you know, trying to
• 3:32
  - sort of regain regain that trust with those
• 3:35
  - patients and and
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  - deal with some of the aftereffects,
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  - of that,
• 3:41
  - and
• 3:41
  - are now sort of looking to pivot towards
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  - the future.
• 3:45
  - So for the remainder of this year,
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  - we're focused on some really fundamental things.
• 3:52
  - You know, we just are now launching,
• 3:54
  - a culture innovation effort in our organization.
• 3:57
  - As I mentioned, it's grown tremendously.
• 4:00
  - We've added Capital Regional Medical Center down in
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  - Jefferson City
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  - a couple years ago. We've got, you know,
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  - clinics now,
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  - over pretty much our entire geography that is
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  - a 25 county
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  - area here in Mid Missouri,
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  - and, you know, a lot of new new
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  - team members. And,
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  - really wanna, you know, create a,
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  - you know, sense of,
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  - cohesiveness
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  - and and get everybody oriented around,
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  - you know, the same vision,
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  - for for who we are and and what
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  - we can be and and how we work
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  - together.
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  - So that's a big, big effort that's launching
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  - now,
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  - that will pay dividends.
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  - We did,
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  - at the end of,
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  - our last fiscal year over the summer,
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  - we did a number of
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  - reorganization
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  - efforts around,
• 4:47
  - our workforce and some of our clinical footprint.
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  - So we need to finish finish those efforts
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  - out,
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  - as well over the remainder of the year.
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  - We're looking ahead around our technology.
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  - We're we're on some pretty dated
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  - technology as it relates to both our enterprise
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  - resource planning system and our electronic health record,
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  - and we have,
• 5:11
  - RFPs out right now, that we'll be working
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  - on over the rest of the year,
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  - and and be making some decisions there. So,
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  - you know, planning out, you know, some some
• 5:21
  - pretty heavy lifts over the next few years
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  - around technology.
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  - And then at the same time,
• 5:27
  - looking at major projects on, you know, how
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  - do we
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  - modernize the way we fund and compensate our
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  - faculty who, of course, are the backbone of
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  - what we do as an academic medical center,
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  - how we really are rethinking our ambulatory
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  - access and scheduling to be more
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  - consumer friendly, a lot of effort
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  - and thought into
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  - our commercial
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  - business and how do we attract
• 5:52
  - more commercial patients
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  - and how how do we make it easy
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  - for people to access,
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  - our caregivers who, you know, once they once
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  - they get through a lot of our administrative
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  - processes are, you know, thrilled,
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  - to
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  - our patients are thrilled to be cared for
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  - by our teams here, but it's you know,
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  - we're we're getting in our own way. And
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  - so we're
• 6:13
  - very much focused on that. And, of course,
• 6:16
  - with the ever,
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  - increasing,
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  - you know, arms race with the payers,
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  - you know, we we're having to step back
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  - and look at our revenue cycle organization and
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  - how do we
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  - how do we think about that and and
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  - strengthen that. And that's that's a project that's
• 6:32
  - launching right now as well. So we've got
• 6:35
  - it seems like a lot for the last
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  - half of the year here,
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  - but really, really will launch us off into
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  - the next calendar year really well, I think.
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  - Absolutely. And, you know, I think a lot
• 6:47
  - of it, as you were mentioning, was interconnected
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  - in terms of thinking through how the organization
• 6:51
  - is transforming, what it's going to need, in
• 6:54
  - order to
• 6:55
  - be effective in this next era of health
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  - care delivery from the workforce to technology,
• 7:01
  - to the different relationships and partnerships you have.
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  - And in your seat as a CFO, how
• 7:06
  - do you really make sure that you are,
• 7:08
  - building it and and growing for the future?
• 7:12
  - Yeah. So
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  - fundamentally, all of these things are are geared
• 7:16
  - around that.
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  - You know, most I I mentioned most of
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  - the growth here has been
• 7:23
  - organic,
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  - you know, with with the exception of the
• 7:27
  - integration with Capital Regional Medical Center, which had
• 7:29
  - been a long term,
• 7:31
  - partner of the organization.
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  - So that wasn't, you know, that wasn't completely
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  - new.
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  - But, you know, as we look at our
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  - our region and our impact to the state,
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  - you know, we realize that to be effective,
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  - we're going to have to grow in different
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  - ways, and we don't have all of that
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  - completely nailed down yet as far as what
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  - we wanna do.
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  - But the common denominator there is that all
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  - of our infrastructure, all of our workforce, all
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  - of our processes, you know, it it
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  - it will have a return on investment for
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  - us to to work to focus there now
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  - and be ready for,
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  - you know, what what we have ahead of
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  - us, whatever that may look like.
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  - And and, by the way, you know, address
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  - other issues out in the marketplace,
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  - related to, you know, as you referenced, a
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  - number of changes going on right now in
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  - the industry. So we, you know, certainly have
• 8:28
  - our eye eye to that as well, but
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  - really trying to strengthen our organization so that
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  - we can,
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  - grow and have have a continued impact in
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  - our region.
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  - That makes a lot of sense. And, you
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  - know, when you do think about the future,
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  - what are the headwinds that you keep your
• 8:43
  - eye on and that you're preparing for?
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  - Yeah. I think I've said this before in
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  - different ways.
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  - You know, on
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  - on previous
• 8:53
  - podcasts
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  - that, you know, there is a
• 8:56
  - I'm just gonna put it under the the
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  - broad heading of affordability, and and you just
• 9:00
  - see this crop up and up and up,
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  - and and we think about that. It's like,
• 9:04
  - well, who who's paying the bills
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  - and what are they doing? And whether it's
• 9:08
  - the federal government and you look at HR
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  - one,
• 9:12
  - and reimbursement changes there,
• 9:14
  - you know, we may not we may not
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  - like
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  - the the method necessarily,
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  - and we certainly don't like the the,
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  - you know, challenge it presents. But on the
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  - other end of that, you know, the federal
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  - debt just passed, you know, $40,000,000,000,000,
• 9:31
  - and
• 9:32
  - there does not seem to be a concerted
• 9:34
  - effort at the federal level to really rein
• 9:36
  - that in.
• 9:39
  - You know, that that that will continue to
• 9:41
  - be a pressure point,
• 9:42
  - and it will happen no matter what party
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  - is in,
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  - in the administration.
• 9:47
  - I just,
• 9:49
  - for instance, solve,
• 9:51
  - an analysis that,
• 9:53
  - Yale had done around,
• 9:55
  - the,
• 9:56
  - what, you know, what savings might there be
• 9:59
  - in a Medicare for all type situation,
• 10:02
  - which has been, you know, recently
• 10:04
  - revived. And, you know, if you kind of
• 10:06
  - dig into that, a lot of the assumptions
• 10:08
  - there or a big chart a big chunk
• 10:10
  - of the assumption is that
• 10:12
  - you're basically pushing Medicare rates down,
• 10:15
  - onto the providers,
• 10:17
  - which, of course,
• 10:18
  - you know, are on the lower end of
• 10:20
  - rates we receive. And so there's just a
• 10:22
  - savings, you know, through a reimbursement change that
• 10:24
  - occurs there to the to the government.
• 10:26
  - Same thing with employers.
• 10:28
  - You know, our experience being out of network
• 10:31
  - last year,
• 10:32
  - with,
• 10:33
  - with Anthem,
• 10:35
  - you
• 10:36
  - know, made us realize that, you know, there
• 10:38
  - is a an affordability,
• 10:41
  - crisis brewing out there. I think, you know,
• 10:43
  - there's a lot been a lot of press
• 10:44
  - on it,
• 10:45
  - for employers.
• 10:47
  - And, you know, a lot of it is
• 10:49
  - certainly focused on,
• 10:52
  - you know, the pharmaceutical end of things,
• 10:55
  - PBMs, and so forth. But,
• 10:58
  - again,
• 10:59
  - it it comes down to, you know, those
• 11:02
  - employers are running up against their own fiscal
• 11:04
  - constraints and and the ability to to afford
• 11:06
  - health care
• 11:08
  - for their employees.
• 11:09
  - And, you know, their their choices are figure
• 11:11
  - out how to
• 11:13
  - pay less, provide less,
• 11:16
  - or
• 11:17
  - shift more of that cost,
• 11:19
  - over to their to their their people. And,
• 11:22
  - you know, there's a there's a tension there.
• 11:24
  - So no matter how you look at it,
• 11:27
  - we've got to be much better than industry
• 11:30
  - at trying to help figure out ways to
• 11:33
  - solve the problem that are that are real.
• 11:37
  - I think, you know, previous efforts, I'm not
• 11:39
  - saying that there hasn't been progress made, but,
• 11:43
  - you know, I think a lot of the
• 11:45
  - the work around
• 11:46
  - value based,
• 11:48
  - care and so forth, you know, ultimately
• 11:51
  - ended up
• 11:53
  - coming down to, you know, efforts around
• 11:56
  - coding and documentation
• 11:58
  - and just sort of better presenting the types
• 12:00
  - of care we're we're providing.
• 12:02
  - You know, it was always,
• 12:04
  - you know, complex and expensive,
• 12:06
  - and we maybe weren't describing it as well
• 12:09
  - as we could have. But, you know, with
• 12:11
  - with
• 12:12
  - incentives to do so, we we certainly did.
• 12:15
  - And,
• 12:16
  - I think that,
• 12:18
  - you know, the challenge now is to, you
• 12:20
  - know, how do we pull the different pieces
• 12:22
  - to our very fragmented
• 12:25
  - health care system writ large,
• 12:28
  - you know, nationally,
• 12:29
  - such that we can really affect some change
• 12:31
  - to,
• 12:34
  - you know, the affordability piece of it.
• 12:39
  - That makes a lot of sense. You know,
• 12:41
  - a lot to consider and think about, and
• 12:43
  - I really appreciate your thoughts on
• 12:45
  - value based care
• 12:47
  - that increase
• 12:48
  - cost of care across the board,
• 12:50
  - for employers, for patients, and others. I think
• 12:53
  - a lot to, take in and and seems
• 12:55
  - like a lot of challenges, but also I
• 12:57
  - know many opportunities. So could you talk about
• 13:00
  - some of the things in ways that you're
• 13:01
  - looking at growth over the next two to
• 13:03
  - three years too?
• 13:06
  - Yeah. This one, like I said earlier,
• 13:09
  - we're
• 13:10
  - we're sort of going through this process right
• 13:12
  - now. There's been a lot of work,
• 13:15
  - this past year,
• 13:17
  - in terms of,
• 13:19
  - you know, how we think about this internally,
• 13:22
  - how do we get ourselves aligned. You know,
• 13:24
  - we are an academic medical center, so we
• 13:27
  - we also have to make sure we're aligned
• 13:29
  - with our,
• 13:31
  - school of medicine partners and,
• 13:33
  - the faculty who are both, you know,
• 13:36
  - you know, faculty of the school of medicine,
• 13:38
  - but they're also our our clinicians
• 13:41
  - and get everybody on the same page as
• 13:43
  - to what what we're doing. So I I
• 13:45
  - think,
• 13:47
  - you know,
• 13:48
  - we're we're definitely interested in,
• 13:52
  - our,
• 13:53
  - immediate neighborhood.
• 13:55
  - So the 25 counties in in Mid Missouri,
• 13:58
  - there are a lot of independent
• 14:00
  - small hospitals.
• 14:02
  - This is a very rural area,
• 14:05
  - and they're under a lot
• 14:07
  - of stress.
• 14:08
  - And,
• 14:11
  - you know, I think some growth will happen
• 14:13
  - for us there, but it may not be
• 14:15
  - in ways we really want, unfortunately,
• 14:19
  - through, you know, additional hospital closures
• 14:21
  - or,
• 14:22
  - you know, other disruptions out there.
• 14:25
  - And so we're we're trying to plan around
• 14:28
  - with, okay, what do we do in different
• 14:31
  - scenarios?
• 14:33
  - Again, it will one way or another lead
• 14:35
  - to some growth,
• 14:37
  - and that's probably what we'll see
• 14:39
  - in the next two to three years. I
• 14:41
  - think our our larger plans that we're thinking
• 14:44
  - about would be
• 14:46
  - kind of in that three plus year out,
• 14:48
  - you know, standpoint while we get ourselves prepared.
• 14:55
  - Got it. That is helpful to understand. I
• 14:58
  - think,
• 14:59
  - truly, you know, sounds like opportunities
• 15:02
  - for growth and development and ways to continue
• 15:05
  - to provide access to care to the community
• 15:07
  - is top of mind. So,
• 15:09
  - very, very interesting. Before we wrap up our
• 15:11
  - conversation, I wanted to ask about leadership too.
• 15:14
  - Who do you admire as a leader really
• 15:16
  - from any industry and why?
• 15:18
  - Sure. Yeah. I know. I there's a lot
• 15:20
  - of great people out there, but, you know,
• 15:22
  - one person that always impresses me when I
• 15:25
  - come across them, and I've had
• 15:28
  - had many opportunities to to listen to them
• 15:30
  - in different settings is, is Jamie Dimon at
• 15:33
  - JPMorgan.
• 15:34
  - I think he's a phenomenal leader,
• 15:37
  - runs
• 15:38
  - a phenomenal company that, you know, when he
• 15:41
  - when he took it over,
• 15:43
  - you know, had a great brand. Right? And
• 15:45
  - the JPMorgan
• 15:46
  - brand has always been very strong, but it
• 15:48
  - wasn't amongst all
• 15:50
  - the the major banks, it wasn't the, you
• 15:52
  - know, certainly wasn't the strongest.
• 15:55
  - It wasn't particularly innovative at the time. And,
• 15:59
  - he's just turned that into, you know, the
• 16:01
  - leading, you know, financial organization and arguably in
• 16:04
  - the world.
• 16:06
  - And,
• 16:07
  - you know, he's he's super disciplined.
• 16:09
  - He's an amazing communicator.
• 16:12
  - He's led his organizations through, you know, great
• 16:15
  - change over time,
• 16:17
  - super focused on risk,
• 16:20
  - balance sheet management, which I think it's, you
• 16:22
  - know, it's not always appreciated.
• 16:24
  - You know, CFOs are, you know, often looked
• 16:26
  - at to to talk about
• 16:29
  - operating margins and and those sorts of things,
• 16:32
  - but being very thoughtful about your balance sheet
• 16:35
  - is,
• 16:36
  - is one of those things that is often
• 16:38
  - goes unappreciated.
• 16:39
  - So, I I just think he's
• 16:41
  - just fantastic leader and,
• 16:45
  - you know,
• 16:46
  - see where see what how he finishes out
• 16:48
  - his career here.
• 16:51
  - And he's definitely fascinating and and certainly somebody
• 16:54
  - who has had many twists and turns. And
• 16:56
  - then,
• 16:57
  - like you said, it'll be interesting to see
• 16:58
  - what he does next. So thank you so
• 17:00
  - much for joining us on the podcast today,
• 17:02
  - Greg. This has been
• 17:03
  - a really fun conversation.
• 17:05
  - I I think,
• 17:06
  - truly
• 17:07
  - inspiring to think about what you're doing,
• 17:10
  - and and how, you know, you're looking at
• 17:12
  - the future of health care. So I appreciate
• 17:14
  - your time today, and we'll be excited to
• 17:15
  - see you as well at our CEO CFO
• 17:17
  - roundtable. I know you'll be speaking on a
• 17:19
  - panel and digging deeper into some of the
• 17:20
  - things we talked about today too. So it'd
• 17:22
  - be great to see you in person.
• 17:24
  - Wonderful. Thanks for having me, Laura.