HJAR May/Jun 2024

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2024 11 area was having people available to work, other healthcare providers, other nurses. Staffing was the second barrier even then. It was just because who really wants to come to a small town, a rural area, and work? Editor Arkansas faces unique health challenges, and rural health is certainly among them. How do you address those challenges? Collier It's easier now compared to how it was in the ‘80s. Now, we're much more strategic about what we are doing. We know where we're going and what town. We know what specialty that we're going to put into a certain area. When we started, it wasn't like that; it was whatever came our way. Someone or some entity would come to us and say, "Would you come into our town and do this, this, and this?" To me, that's amazing — It’s almost spiri- tual. I have so many stories that people have come to me to invite us to come into a town, and we really don’t even want to go there. Our latest was in Fulton, Kentucky. We have a doctor up there — he's not retired, but he's in his 80s — and he just really wanted us to have a clinic there or close to a recovery inpatient facility. Man, at first, it seemed like so much work and in the middle of nowhere. Fulton County is really the poorest county in Kentucky. But we did agree to put in a clinic there, and we got some grants and had some emergency funding; and it's up and running. There's something like that all the time. In Mississippi, we were working withMemphis Baptist, and they wanted us to put a clinic in Pontotoc. Have you ever heard of Pontotoc? Editor No. Collier The medical director of Memphis Baptist asked me, "Have you ever heard of a town in Mississippi called Pontotoc?" I said, "No sir, I haven't." Anyway, they had a clinic there and we went; we're still there — probably going to go there next week. So, that's how we get into towns that we didn't even know we were going to. It'll be on the invitation of someone; it's almost always a personal relationship. I have this little weird thing that I like to do to network with people. It's that old deal that if you help as many people as you can to get what they want, then you're going to reap all those rewards and have a network that's amazing. We've done that and we've preached that, and our leadership does the same thing. I don't know if you've seen our leadership, but T.J. Whitehead, our presi- dent, CFO [chief financial officer]— he's a younger guy, forties — is very well known in his circles, in the financial circles. Joy Miller is our chief strategy officer, and she's the president of the Arkansas Rural Health Association. Then we have one guy, Chris Gibson, who's on the city council up at Jonesboro. He's been on that city council for 16 years, and he doesn't miss the meet- ings. Clint Shackelford was a superintendent up in the north mountains of Arkansas. We have those kinds of people continuously just looking for connections. Now, when I said that we don't really get into running a hospital, we do have a pol- icy of trying to be a friend to the hospitals. Hospital politics and clinic politics are dif- ferent. I don't know if you know that. We're not owned by a hospital or run by a hospital. Now, a lot of clinics are owned by a hospital. So, we try to work with all the hospitals and that's a full-time job because in our catch- ment area, we might have 15 or so hospitals. Editor That's changed, hasn't it, where the hospitals are running the clinics now? Collier Yes, it sure has. Editor How do you feel about that? Collier Well, I'm okay with it because our mission is that we accept everybody, and with our financial structure, we accept all payers — Medicare, traditional Medicare, Medicaid, and even uninsured people who don't have anything. I think we're running about 7% uninsured, but that's okay. Hospitals can't run their hospitals, especially their clinics like that. Editor So, your payer mix is 7% uninsured. What about Medicaid? Collier It's 50-ish, and then Medicare splits the other proportions — Medicare Advantage and Medicare traditional. Editor How are you doing with the reimbursements for Medicaid in Arkansas? Do you have any suggestions to the folks that hold the purse strings? Collier Well, I think it's a great program. I think it's money well spent, and we certainly appreciate it and put it back into our people and our towns. Arkansas is a great state for that. We have always followed our Medicaid regulations for years through different governors and different Medicaid directors — we've always kept an eye on it — and for me, it's something Arkansas can be proud of, if we can just continue with what we're doing. Editor So, you're fine with the level of reimbursement? Collier Yeah, I want tomake sure I don't draw any political enemies. But I guess if we can balance the budget, and I think that’s where we are, it's fine. Editor That's nice to hear. Collier I know that they cut off some people — disenrolled I think is what they called it. And each state's different. What you're looking at in Arkansas is just good, old American poverty. That's what we're trying to address. Well, then you get into the politics that maybe there are some that don't want to just give something to a person of poverty. The advantage that ARcare has … we could look at all three of our states and we see the differences. We have great reimbursement in Kentucky. In Mississippi, it's not so great — they hadn't expanded