QualChoice CEO Sees Admin Center, More Jobs For Arkansas With Buyout

by Roby Brock ([email protected]) 178 views 

QualChoice CEO Mike Stock said his company’s buyout by Catholic Health Initiatives (CHI) should result in expansion opportunities in Arkansas.

Last week, CHI announced it would acquire the Little Rock-based health maintenance organization. Stock, who appeared on this week’s edition of Talk Business & Politics with State Sen. David Sanders (R-Little Rock), said the move could grow scores, if not hundreds, of white-collar jobs in state.

“CHI – Catholic Health Initiatives, is one of the largest providers of health care in the country. They’re in 18 states. They have a plan to expand their footprint in financing health care and they want to use QualChoice as the administrative center for doing that by running all their administrative operations through this,” Stock said. “That’s the plan down the road. I think there will be expansion here.”

Sanders, who has been a chief driver of health care policy changes in Arkansas – particularly the private option framework – said the CHI-QualChoice move is indicative of major market changes underway in the health care arena.

“This is an indication of what’s to come, not only here in Arkansas but I think nationally,” Sanders said.

He warned that with the market changes underway, it would be important for lawmakers and policy leaders to adapt accordingly and to be prepared to conduct business “not as usual.”

“I think it’s a net positive, so long as what we try not to do is not move with the market changes,” he said. “We have a tendency as policy makers and regulators to hold fast and hold true to how things were organized. This world of health care is changing before our very eyes.”

WHAT’S AT WORK, WHAT’S TO COME?
Stock and Sanders centered their discussion on cost-containment efforts being made at the state and national level, as well as a growing “consumerism” that will place more responsibility for health care choices in users’ control.

Arkansas has been a laboratory for experimentation in health care delivery in the last year or so. The state has embarked on a Payment Improvement Initiative aimed at controlling costs. The plan has included pilot projects and new payment delivery methods that involve patient-centered medical homes and episodic care management.

Additionally, Arkansas’ adaptation of Medicaid expansion under the Affordable Care Act – the private option – has altered the health care insurance system in state. According to the latest figures, more than 106,000 have been enrolled for insurance coverage under the private option.

Stock said it is still very early in the process to gauge the overall effectiveness of all of these efforts, but there are glimpses of positive results.

“The amount of data that we have now is still very small and still very immature,” he said. “In terms of controlling costs and bringing down the costs of health care, one thing that you have to remember is that insurance companies don’t drive the cost of health care. We are financiers of the cost of health care. The government finances health care. The actual cost of health care is determined at the point of origin where it is delivered by the providers. That’s where the cost is. What insurance companies try and do is work with those providers to make sure at that point of care delivery, the delivery is as efficient and cost-effective as possible.”

Some Arkansas hospitals are seeing reduced emergency room visits, a signal that there may be less uninsured patients coming through the system as well as smarter direction of patients to providers who can give more efficient health care.

“There is still more need for transparency in terms of quality and price in health care system,” Sanders said. “Those are sort of the missing components and what lies ahead on the horizon where we have to go from a policy standpoint.”

Sanders said he will remain focused on fine-tuning or overhauling health care policy in the months and years to come.

“I’m an equal opportunity skeptic. When an insurance lobbyist comes at me, a doctor lobbyist comes at me, or a hospital lobbyist or a government bureaucrat even – we have to look at everyone with guarded skepticism because what has to happen is we can’t operate in silos and do what is in our best interest. We have to move the ball down the field operating in the best interest of the consumer and the taxpayer,” he said.

Stock and Sanders continued their conversation in our online web extra discussing shortcomings in the Affordable Care Act that they said should be addressed to promote more consumer decision-making and competition in the marketplace. Watch their full interview below.