Andy Zukowski, Chief Financial Officer at ECU Health

Andy Zukowski, CFO of ECU Health and the Brody School of Medicine, addresses the financial and operational strategies required to sustain a rural academic safety net health system amidst significant reimbursement pressures. Facing a 10% state provider-based payment rate reduction and looming federal policy shifts in 2027, the system is pivoting toward new care models, including the launch of North Carolina’s first rural emergency hospital. Strategic growth initiatives focus on expanding physical capacity by finishing shelved hospital floors and increasing ambulatory surgery access, alongside technology investments to streamline the patient financial and clinical experience. Navigating these uncertainties requires a leadership mindset that balances long-term growth with a rigorous focus on financial fundamentals. By prioritizing patient access and multi-year strategic planning, the organization aims to mitigate the impact of budget shortfalls while maintaining its commitment to serving over a million residents across Eastern North Carolina.