Navigating AI, M&A, and System Transformation at Union Health

In this episode of the Becker’s Healthcare Podcast, Madeline interviews Ian McDonald, CFO of Union Health in Terre Haute, about the organization’s transformative journey amid rapid technological change, a major acquisition, and system-wide modernization. McDonald, who brings an IT and data science background to the CFO role, emphasizes the profound impact of artificial intelligence on finance and revenue cycle management, urging leaders to focus on signal over noise in a sea of technological hype. Union Health recently acquired Terre Haute Regional Hospital—a former HCA facility—adding a third hospital to its system and creating complex integration challenges, including dual EMR systems (Cerner and Meditech) before a unified transition to Epic by January 9, 2027. McDonald highlights the importance of trusting existing teams, learning from new colleagues, and leveraging the operational and strategic advantages of the Epic ecosystem for future regional expansion. Despite the intensity of these changes, he expresses optimism about improved capacity, community impact, and long-term system resilience. Key takeaways include the need for CFOs to adopt a data-driven, principled approach to technology investment; the strategic value of learning from acquired teams during M&A; the critical importance of system integration during EMR transitions; and the potential for regional growth through Epic’s Connect capabilities. McDonald’s leadership philosophy centers on humility, collaboration, and leveraging technology not for novelty, but for real operational and community outcomes.