HJAR Jul/Aug 2026

DIALOGUE 16 JUL / AUG 2026 I  HEALTHCARE JOURNAL OF ARKANSAS Editor Do you think that’ll change in our lifetime? Barnes I don’t know how old you are. I’m 66. I don’t think it’s going to change in mine. Editor It just seems unfair, especially when the health outcomes in a state like Arkansas are low, that the system would get lower reimbursement. Barnes It is a real challenge. We’ll continue to see efforts made. I’m not sure the DRG payments will be changed, but . . . the Medicare payments, I think we may see other changes. As you know, legislation was introduced last year that would require commercial payers to pay providers in our state at the average of the bordering states, which would be a significant increase payment to Arkansas providers. Editor Who pulls that number up? Is it Texas? Barnes All the surrounding states have rates that are significantly higher than us for commercial payers. Editor Why is that? Barnes I guess the insurers have been able to keep rates low, and I think that question you asked is the same question others have asked, which is why there has been discussion in some of the legislative committees about it. Obviously, premiums are used to pay for healthcare. Currently, most healthcare is paid on a per-service basis, meaning it is fee-for-service. Utilization rates impact the amount of expenditure from the healthcare dollar, too. I think we will see more alternative payment models in the future because fee-for-service is going to continue to be challenged. Providers can’t make it on the continued downward spiral of decrease after decrease in fee-for-service payments. Editor In a state with so many rural communities, what is the right balance between bringing patients to Little Rock for highly specialized care and bringing more care closer to where people live? Barnes Great question. We certainly want to be nearby and neighborly for patients, but there are some things that really need more tertiary care. So the very complex things will need to be transferred. We are certainly hoping that we can develop programs that allow us to help manage patients closer to home in some of these smaller hospitals, which would help those hospitals and the patients. Editor Do you have a system in place when a family member or someone from a rural community has to drive far to see their loved ones at the hospital, where they can stay at a reasonable rate or for free? Barnes No, we don’t have that. That’d be wonderful to have. We don’t have a hotel. Editor What one bold idea would you like Arkansas to consider if the state truly wants to become healthier? Barnes That’s a great question. Certainly increased activities. We know that step counts matter. The more active we are, the more it helps with lots of things like obesity, hypertension. And so, if we could have a program where we are indoctrinating or teaching our children in schools throughout our state the importance of exercise and activity and continuing that through adulthood, that would help. It’s not really a bold idea, but it’s a pretty basic idea that is tough to accomplish. Editor How should UAMS use its college of public health and statewide partnerships to move beyond treating illnesses more toward prevention? Barnes Obviously, if we have lots of data from our college of public health work we’ll continue to use that to educate and work with others to show the importance of managing chronic disease and preventing chronic disease. Sometimes it may not be prevented, but if you catch it early and start treating it early, you can certainly negate the long-term significant effects from those diseases. Editor You mentioned research earlier. What areas of research or clinical innovation at UAMS do you believe have the greatest potential to change lives in Arkansas? Barnes Well, certainly the work we’re doing in cancer is significant. There are many things being done that can lead to earlier discovery as well as more specific treatment. And so, anything we can do that helps the treatment of cancer helps not only Arkansans but the world at large, and it’s wonderful to be in an institution that has researchers who are answering those kinds of tough questions. We have some other areas of excellence. Obviously, I’m biased as an orthopedic surgeon, but I’ve had the opportunity to work with our metabolic bone disease group here and they do incredible work. You may have seen that recently we announced something called a Razorback Catalyst Research Program. It’s a combined effort between the University of Arkansas at Fayetteville and UAMS. Charles Robin- son, their chancellor, and I, each contrib- uted chancellor funds to establish this pro- gram to do combined research. So we will have a program dedicated to seeing that our two institutions work together in research because we are totally convinced that we can accomplishmore working together. And the first group awarded is a group working on the effects of GLP meds on bone and muscle. So I think there’s going to be a sig- nificant amount learned from that work. We have some really phenomenal researchers