Matthew Moore: The Arkansas Center for Health Improvement recently announced new leadership. Craig Wilson has been named president and CEO of ACHI. He’s entering his 15th year with ACHI and says that before that, he worked in private practice law specializing in health care.
Craig Wilson: And while I enjoyed that and I learned a lot through my clients’ efforts, including the Medical Society and the State Dental Association and learning all about Medicaid, I was really thrown into the deep end and learned a lot and really became, I would say, just fond of how our health care system is kind of a patchwork. It’s very different than any other nation.
I’m a native Arkansan. My family still lives in the southern part of Arkansas, so I’ve always been committed, beyond just a transactional way in health care law, to really looking at broader policies that can impact those Arkansans who have a tough time accessing quality health care. And those include a lot of my family members. So I’ve been really committed to this organization’s mission of being a catalyst — not just stepping out at the forefront of everything, but really working with partners to make positive change happen.
Moore: You are not someone who practices medicine, which is a little bit different from folks who have previously held this position. Do you see that as an asset?
Wilson: I don’t see it as a shortcoming. One of the things that we have the opportunity to do here is reach into the academic medical centers and pull expertise from those areas. So while I offer a different expertise in regulatory and health care policy, we always have the opportunity to reach into those spaces and pull from the best to advise us on the clinical expertise that we need to do the work that is needed.
Moore: I think it’s interesting when you think about the literal health improvement elements of this, that oftentimes, from my experience as a journalist talking to a lot of scientists and researchers, the health improvement isn’t lacking in the medical world or in the scientific realm. It’s really in improving the lives of Arkansans through policy and delivery. And so I would argue that having someone with your experience would be a really good fit for what you’re trying to do, right?
Wilson: Yeah, I mean, I would hope so, in your own words, right? But yeah, you’re exactly right. We’ve really focused, I think historically, on the health care space — its financing, its access, and the quality of care. And really, over the last decade, I would say in particular, we’ve expanded to focus on what are those health behaviors that are impacting people’s health and what are the environmental factors, the social needs that are impacting people’s health. And we really want to take that forward into a whole health experience.
One of the things I want to say here is we become accustomed to thinking about whole health in terms of your mental health or your social needs and how they impact your health. But also, I think we need to begin to think about those things that we often forget — like your oral health and your visual health and your hearing health — that typically have different academic pathways for clinicians. Sometimes they’re put adjacent to the medical sphere, and so we need to bring those into whole health as well.
Moore: Yeah. And I think it really speaks volumes that when we think about health insurance, dental insurance is often a supplemental thing. Vision and eye care are also supplementary as well. And so it’s kind of baked into our system. As we think about the “ruralness,” I guess, of Arkansas — as someone who grew up in southern Arkansas, having good, reliable access to an optometrist or a pediatric dentist, those are things that certainly need improving in Arkansas.
Wilson: Right. And what’s important is that we recognize that those things impact the rest of our health. You can experience cardiovascular issues as a result of poor oral hygiene. You can really experience an economic lack of opportunity as a result of poor oral hygiene or experience significant mental health issues. So the connectivity of all those things — recognizing those and really interrupting the patterns of generational neglect of those things as supplemental to your basic health — I think is one thing that we need to address.
Moore: One of the things I’ve always appreciated about the work that ACHI does is they’re often this bridge between “here is the data” and “here is good policy” to help move us all forward. How do you think about the work that has been done, whether it’s been with you in your previous role, and how do you want to see that move forward in the future?
Wilson: Yeah, you know, I still think we really want to maintain our core efforts of translating policy into digestible information and into action — informing policymakers whether they are governmental or institutional or individual or family. I think we really want to maintain that. But other things that I’m looking forward to in the future include taking that information that we develop analytically and pushing it more into the peer-reviewed literature space.
Frequently, we are very nimble and sometimes reactive to make sure that we get information into the conversation during a particular policy window. But frequently that’s where it stops. We want to take that information further and develop some manuscripts and move that into the peer-reviewed literature — and in a bidirectional fashion, too.
We have such robust data assets that we manage here — probably linked information longitudinally over time and across different data sets that’s rivaled only by maybe one or two other states. So making sure that we facilitate access to that information for researchers and others who want to access it, and helping them make the data sing — kind of like what we do — and using our analytical capacity to support them in their research aims that are aligned with our mission as well.
Moore: It’s easy to think about the health care industry and think about how it makes us healthier, but other parts of the industry consist of workforce. It consists of making sure people can afford to be in a place where health care facilities are located. When you think about the research you all do or aspire to do in the future, how do you see workforce development or educational elements playing a role?
Wilson: One of the first projects that I worked on when I came to the Arkansas Center for Health Improvement was a workforce analysis. Revisiting some of those analyses a decade down the line, I recognize how little data we had to work with. Now we have so much more robust information, and I see the shortcomings in what we did more than a decade ago.
We’re able to do some things in terms of assessing our workforce by looking at claims information to see levels of activity of different types of physicians and where they’re actually practicing — information that often isn’t captured in licensure or survey information. We’ve been able to do analyses that are far above and beyond what even some national groups have done.
Workforce is going to be a critical component I think of making sure we have particularly rural access here in Arkansas. One of the things that’s going to have to underpin that is systematic and modernized data collection of our health care professionals — from physicians to medical assistants to nurses to psychologists. So that underpinning is going to be really important. So I’m hopeful that the state will begin to move in that direction to be able to see what investments they’re making are having a difference on our workforce, as well as access out in the field.
Moore: As someone who is an attorney, you think a lot about how you have to read very dense, hard-to-understand things — parse them out for an average person to understand — but also articulate it in a legal matter, in front of a judge or peers. In a parallel way, the work that ACHI does, you’re delivering information in a more jargon-heavy way to policymakers, but you’re also partially responsible for making sure everyday Arkansans can understand it, too. How do you make sure that both of those things are happening — that you can articulate in enough detail to policymakers to change things, but also make it understandable for any and every Arkansan to help improve themselves?
Wilson: I think part of it is making sure that the data are contextualized in a way that’s relatable — a situation that is relatable to a policymaker, from an individual in their own family up to a governmental policymaker. So first, making it relatable. But I think we also need to recognize that the poor health outcomes — and good health outcomes, for that matter — that we may see in the data, there’s a part about the experience from a patient standpoint and from a provider standpoint that we’re going to have to begin to capture better, because that can often lead you to policy solutions that you can’t see in the empirical data.
So really, making it relatable and observing the experience in a way that can contextualize the empirical data that you have — I think that’s going to be critical as we move forward.
Moore: Humanizing the data.
Wilson: Exactly. That’s part of why I started the podcast that I’ve got here at the Arkansas Center for Health Improvement at the beginning of the pandemic. Part of the reason that I did that was to humanize the health care workers and public health workers who were really on the front lines. So I really think that humanizing and connecting people in ways that they haven’t ever thought they may be connected — that’s going to be critical in moving people toward solid policy solutions.
Moore: Craig, is there anything I missed — anything to make sure we touch on here?
Wilson: I just want to say, through the Healthcare Transparency Initiative, which we manage on behalf of the insurance department, we’ve got now 12 years of really rich claims data, vital records, disease registry information all linked together. Probably only one or two other states have that rich of a data set to be able to look at their residents of their state and their experience with health care over time and across different sectors.
So really making sure that we are utilizing that data in a prolific way to make sure we are informing decision-makers, as well as facilitating access to it for others to do research and innovation. Sometimes that takes a little bit of a longer effort, but doing that collaboratively, I think, is going to be a goal of mine — working with other institutions to advance their research aims that are aligned with our mission.
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