Roby Brock: Welcome to this edition of the Northwest Arkansas Business Journal Report. I'm your host, Roby Brock. Health care has been a roller coaster ride for executives in the state of Arkansas over the last year. Between state and federal changes, nothing seems too certain. I caught up with Washington Regional CEO Larry Shackelford, whose hospital system is celebrating its 75th anniversary this year, to discuss more. He's our interview on today's Northwest Arkansas Business Journal Report.
Joining me now, Larry Shackelford. He is the CEO of Washington Regional Medical Center. He is always a good person to have on the program and to talk to about all things health care. How are you today, Larry?
Larry Shackelford: We are doing really good. Thank you for the chance to sit down and visit.
Roby Brock: Well, we are going to start with the 75th anniversary for Washington Regional Medical Center, which was originally the Washington County Hospital. It may have even had an earlier name than that. But reflect a little bit on the past and what this 75th anniversary kind of means to you.
Larry Shackelford: Well, back in 1950 we did open, and it was Washington County General Hospital when it opened in the fifties, 50 beds. And we have seen tremendous growth over that 75-year period, growing from a small local hospital to the regional health care hub. Today Washington Regional has around 425 beds and has been recognized as a regional leader in many areas of health care.
Roby Brock: You know, you're talking to one of the most famous people ever to be born in Washington County General Hospital. Did you know that?
Larry Shackelford: I know that Mr. Roby Brock was born there. And you know, it certainly for me and my family has a great place as well. Both my brother and sister were born at Washington Regional. My kids, my grandkids. I didn’t know at the time, even my wife was born at Washington Regional. So it really has had a huge impact. And I think lots of folks look back to those happy times when kids are born. But Washington Regional has also been there for folks in not so happy times when they were ill or injured. And our goal of trying to improve health care. And then I think, unfortunately, I’ve known many people who spent their last days here at Washington Regional, and what that has meant for those patients and their families is really important as well.
Roby Brock: Let's talk about where you guys are poised for growth. You and I will not be here in the next 75 years, but you are laying the foundation for the next 75 years. Kind of what's on the short-term, five, 10-year horizon for Washington Regional?
Larry Shackelford: Well, if you look back, the move that our board did in the late eighties to become a private nonprofit working with the county, the decision to leave the old North College location, which was safe and it served people for many years, to come to North Hills, was a really huge step. Since that time, we've doubled our campus, gone from originally around 350,000 feet to over 750,000 feet now. And that means our campus currently is getting full.
So we have been working with the Drake Farms development. We've purchased 30 acres there. I think that will grow over time. And if you think about what things you used to have to be in the hospital a long time for that can now be done in the outpatient, how that's changed in the last five to 10 years, we think that's going to continue to change moving forward. So we think that campus will give us the ability to make our main hospital as highly acute as it can be, and to really focus on those outpatient things at Drake Farms moving forward.
Roby Brock: I do not have to tell you that this is maybe not the most stable time in health care when you look at policy and just what's going on. We've had some major changes at the federal level. We certainly are seeing some things from the last legislative session that’ll play out here at the state level. This is a general question for you, but just give me an assessment of where you think health care is right now, and how difficult is it for you as a CEO, as a leader of an organization, to really map out where financially things may be over the next year, two years, three years? You know, for lots of businesses doing five-year planning, 10-year planning is just a part of their business, of their DNA. In health care in Arkansas that's really hard right now.
Larry Shackelford: You're right. Some of the changes that have come out of Washington lately are big changes. I think fortunately, some of what could have been really impactful — if the FMAP formula or the provider tax funding had been impacted — that would have been devastating. I think the unknown is when you do re-enrollment more frequently, when you add work requirements, what's the default if patients do not complete the paperwork timely? If they don't complete it accurately, do they lose coverage? And they're still coming to ERs like Washington Regional to seek care. And they often don't know that they don't have coverage until it's theirs. So I think that's going to be something we're going to have to really keep our eye on — helping patients that have resources that qualify for Medicaid or expansion, being sure they can keep those.
Roby Brock: I'm sorry. Go ahead.
Larry Shackelford: Well, there are some Band-Aids that have been proposed. I think Congress has passed — I think Arkansas will receive about $500 million for rural health care funding. I'm not sure if Washington Regional qualifies. You probably do, just because pretty much the whole state qualifies as rural at this point. That does not seem like a big enough Band-Aid, although it is appreciated. $500 million over five years doesn't really go as far as you'd think it would in health care.
Roby Brock: But just give me some assessment of do you think our federal and state leaders are acutely aware of what your needs are? And do you think that we might see some more action on that front?
Larry Shackelford: Yes, I do. And you're right, $500 million seems like a big, big number. But it doesn't go very far. It's going to be interesting to see how rural is defined. Is the fact that we're in a metropolitan service area, does that exclude us from access to those funds? And I think part of the challenging nature of these are one-time funds. So how do you best use one-time funds that are nonrecurring to really move rural health care forward in Arkansas?
I do think our leaders are listening. They're asking the right questions. And this is going to be an opportunity, whether that is investment in technology, investment in better EMR systems, whether it's — there are some hospitals in Arkansas that have been there for a long time. When those buildings were built, they weren't built for the type of care that needs to be done now. So potentially there could be some funds to either update or, in some places, maybe even build something more modern that would meet the needs of rural Arkansans.
Roby Brock: That's Larry Shackelford, CEO of Washington Regional Health System. You can catch our full interview at nwabusinessjournal.com. That's all for this edition of the Northwest Arkansas Business Journal Report. I'm Roby Brock. We'll see you next time.
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