Arkansas Hospital Association's Bo Ryall on the New Health Care Law

Bo Ryall joined the Arkansas Hospital Association in 2005 and has been its president since 2010.

He has served as chief lobbyist on the state level for Arkansas hospitals and was previously executive director of the HomeCare Association of Arkansas.

Ryall holds a bachelor’s degree from the University of Arkansas at Fayetteville and a master’s degree in public administration from the University of Arkansas at Little Rock.

Q: What are your thoughts on the new health care law, now that it’s actually starting to take effect? How are some of AHA’s members reacting?

A: The positive for hospitals is having more people insured. In 2011, the uncompensated care (charity care and bad debt) costs for all hospitals in Arkansas totaled $346 million. These costs rise at more than a 6 percent rate yearly. The federal Affordable Care Act and the state Health Care Independence Act (private option) give hospitals a chance to reduce the cost of the uninsured on the health care system. Hospitals are engaging in the enrollment process by training staff as certified application counselors and coordinating with navigators to ensure that the uninsured have an opportunity to enroll in a health insurance product.

Do you see an easy way for hospitals to cut costs?

Congress has enacted more than $2.5 billion in cuts to Arkansas hospitals during the next 10 years, and more cuts are on the list for consideration as the budget and debt ceiling talks continue on the federal level. The largest expense for a hospital is personnel, and any reduction in personnel ultimately has the potential to affect quality of care. Quite simply, there is nothing left to cut.

Some hospitals have asked town residents to pass taxes to support the hospital in the community. What do you think of this practice?

In this time of declining reimbursements from government and commercial insurance, all hospitals are struggling to survive, especially small rural hospitals. In many communities, the local hospital is the top employer in the county, or among the top two or three employers. So when hospitals have presented the ramifications of hospital service reductions, layoffs or closure to communities, people overwhelmingly have recognized that access to local health care, combined with the economic impact, is vital to a community. Support from the community is crucial to keeping the doors open for these hospitals.

Are members of the AHA seeing increases in the numbers of people comparison shopping for procedures?

During the economic slowdown, we have seen more patients delaying their health care and any elective procedures they may need. When seeking health care, an overwhelming percentage of people are not in a position to shop for their procedures. It does happen, but in instances where people can shop, they typically take the advice of their physician and elect to have their procedures done at the physician’s preference.

Where does the AHA stand on making hospital and other health care costs more transparent?

Hospitals want to be as transparent as we can be, but we also want to make sure that we follow all of the rules and regulations for protecting a patient’s privacy. Our website at shows a range of prices for the top 20 procedures in any given hospital. Hospitals are working to make their bills more patient-friendly. Simply listing what hospitals charge rarely reflects what hospitals are actually paid, and it is even more difficult to be able to tell patients what their out-of-pocket responsibility will be for any given procedure.