Officials talk about Northwest Arkansas healthcare system challenges

The effort to make Northwest Arkansas a healthcare destination is a long game, but work has already begun, and the progress made is noteworthy, according to Paul Umbach, a consultant at Trip Umbach who worked with the region to create a five-year game plan.

Umbach took part in an Onward Ozarks webinar on Monday (Dec. 16) that included Stefanie Pawluk, recently named the executive director of the Northwest Arkansas Council’s healthcare transformation division, and John Findley, chief medical officer at the Heartland Whole Health Institute.

The conversation centered around the recent healthcare transformation report released by the Council at its annual meeting in November. Key areas discussed included progress made on the out-migration of healthcare dollars over the past five years. Umbach reported that in 2019 $950 million was lost annually because of healthcare migration outside the region. Between 2019 and 2021 the figure improved by $250 million, which is a good start, he said.

Umbach said there’s also been a 35% increase in graduate medical education slots with the work of Mercy and Washington Regional expanding residency slots to train more specialty doctors. He said while fewer people are having to leave the region for care, the in-flow of patients to Northwest Arkansas remains low. The exception is at Arkansas Children’s Northwest which opened in Springdale 2018 and kept more patients at home and saw an influx of patients from surrounding areas.

Umbach said he does this work in 50 regions and over time Spokane, Wash., was able to see more patients coming into the region for care than exiting. He said Evansville, Ind., is keeping more patients than they lose because of efforts to expand specialty care. Umbach said the region could achieve parity by 2040 with programs already in place.

Pawluk said work continues to have a Level 1 trauma center. Washington Regional is the only Level 2 trauma center in the region and the closest Level 1 center is 130 miles away in Springfield, Mo. She said with the region home to hundreds of miles of mountain biking trails, the lack of a Level 1 trauma center could slow the growth of this economic catalyst.

Washington Regional is working on becoming a Level 1 trauma center over the next few years. The gap analysis of the region’s trauma care infrastructure should be complete by June, followed by a strategy to secure funding and support within two years. Stakeholders believe that by 2030, the region will have a Level 1 trauma care which could also be a magnet for specialized clinicians and researchers.

The biggest hurdle for the region becoming a healthcare destination is money. Pawluk said care reimbursement formulas and workforce challenges make it difficult to recruit and retain doctors and specialists when pay is lower than in a neighboring state.

Findley said the Heartland Whole Health Institute works with all the players in the region to facilitate conversations and partnerships with respected institutions like the Cleveland Clinic for cardiac care. He said the Alice Walton School of Medicine will train doctors with a unique curriculum that looks at holistic models as well as traditional care.

Findley said the new partnership between Mercy and the Cleveland Clinic will also be key in training doctors in specialty cardiac care protocol. Findley said other partnerships are possible to elevate the training of local doctors in the region and also recruit and retain specialty care physicians.

Umbach warned that even if the region can train and retain more doctors and specialty care, that would be futile unless the number of nurses and other healthcare positions also grows.

“I am reminded of a situation I was recently in trying to catch a flight. I saw several pilots standing near the gate, but the flight was delayed. When I asked why, they said they didn’t have a flight crew,” Umbach said.

He said without the operating room techs and nurses, the surgery won’t happen even if with best surgeon. Umbach said growing the healthcare workforce among college students in the region is a challenge because of high-paying technology jobs that allow them to work from home. He said the region has graduated fewer healthcare workers each year since the pandemic and that needs to change. He said creating a pipeline through junior high and high school curricula is one way to begin addressing the problem.

Umbach said bigger is not the answer because the billions spent on healthcare are not creating healthier patients.

“We are all ready for a new model where health care can lead with health, not a model that compensates only for treating the sick,” he said. “We need to build a cheetah who can survive in any climate, not stay with the dinosaur we have now.”