UNCC Health CFO warns Medicaid cuts, workforce strain and policy changes threaten local care

Will Bryant, chief financial officer at UNCC Health, told a Caldwell County Economic Development luncheon that hospitals and health systems are operating under sustained financial pressure that could threaten services in smaller communities.

Speaking to business and civic leaders, Bryant said the industry’s current financial model depends on cross‑subsidies and that Medicare and Medicaid pay substantially less than the cost of care. “On Medicare … we lose about 20 cents on the dollar on average,” Bryant said, describing how payer mix and reimbursement trends compress hospital margins. He added that health systems that employ physicians can face large losses on practitioner services: “hospitals and health systems who employ physicians lose almost … $300,000 per physician that they employ.”

Bryant warned of policy headwinds that his organization expects will intensify those pressures. He said changes to federal programs and the expiration of some Affordable Care Act premium subsidies contributed to coverage losses in North Carolina this year. Bryant described a roughly 900,000‑person enrollment pool through ACA plans and said about 20% did not reenroll after subsidies ended, leaving “roughly 200,000 people” uninsured in the state, a shift he said would increase financial strain on safety‑net providers.

Workforce shortages were another central concern. Bryant cited survey data showing a substantial share of nurses do not plan to remain in bedside roles in three years, and he described efforts at UNCC Health to improve staff engagement and retention. He said technology — including ambient‑scribing tools and clinical record‑summarization software — can improve clinician efficiency and patient experience but must be deployed with provider oversight.

Bryant also outlined UNCC Health’s local footprint and recent investments in Caldwell County, saying the system is expanding ambulatory services and planning a rural care center in the county that could be a multimillion‑dollar investment. He framed those investments as part of economic development, noting that health systems are often among a community’s largest employers and that access to care affects broader workforce productivity and business recruitment.

Dr. Lowry, who introduced Bryant, and Caldwell County Economic Development Director Ashley Bowling both emphasized the local economic role of health‑care investment during the luncheon. Bowling opened the program by noting more than $40 million in new investment and 166 new jobs in Caldwell County for 2025.

The luncheon continued with awards and local economic development announcements; Bryant’s remarks did not include any formal commitments to specific county actions or votes.