Axios Live: North Carolina faces health care funding, staffing gaps

RALEIGH, N.C. — Health leaders at an April 16 Axios event warned that funding uncertainty and workforce shortages are colliding in the state.

Why it matters: An inability to pay providers, augment care centers, and train new staff threatens the quality of care for residents across North Carolina.

Axios' Mary Helen Moore and Caitlin Owens moderated conversations with North Carolina Healthcare Association CEO Josh Dobson, North Carolina Nurses Association CEO Tina C. Gordon and the North Carolina Office of Rural Health director Margaret Sauer. The event was sponsored by UnitedHealth Group.

Driving the news: The North Carolina General Assembly convenes Tuesday to pass an overdue state budget that will determine Medicaid funding.

By the numbers: North Carolina is projected to face $40 billion in budget cuts over the next 10 years.

• 3.1 million North Carolinians rely on Medicaid coverage.

The staffing bottleneck is real, with 80,000 qualified nursing applicants turned away in 2024 due to limited school capacity, according to Gordon.

What they're saying: "There's a false narrative … that all hospitals and all providers are flush with cash and there's all this money. That's just not the case," Dobson said.

• "We have a lot of burnout in the workplace for all clinicians. … We have a lot of retirements from an aging workforce, and we have a significant increase in need," Gordon said.

Threat level: If the current conditions aren't addressed, "hospitals close, patients don't have places to go for care," Gordon said.

The bottom line: Providers "want to be able to take care of their patients," Sauer said. "We just want to do the best thing, and sometimes we can't if we don't have the money."

Content from the sponsor's segment:

In a sponsored View From the Top conversation, Danielle Gray, UnitedHealth Group executive vice president of corporate and external affairs, and Meg Zomorodi, University of North Carolina at Chapel Hill professor and senior associate provost for academic excellence, spoke to Axios publisher Nicholas Johnston.

• The organization announced a $3 million grant to UNC's Robert A. Ingram Institute for Healthcare Access.
• "Our community investment strategy is part and parcel of our mission … to help people live healthier lives and to help make the health system work better for everyone," Gray said.
• "Ingram's mission really centers around explore, employ and empower," Zomorodi said. "We can't be gap-filling. We need to actually be team building."