Before he joined Washington Regional Medical System, J. Larry Shackelford was the CEO at Medical Associates of Northwest Arkansas, a multispecialty physician group practice. After graduating from the University of Arkansas in 1986 with a bachelor’s in business administration, Shackelford worked for the accounting firm Baird Kurtz & Dobson for six years. He is a CPA and fellow in the American College of Medical Practice Executives.
Shackelford is a state delegate to the Regional Policy Board of the American Hospital Association, board member of the Arkansas Hospital Association and Dean’s Executive Advisory Board member of the Walton School of Business at the University of Arkansas. He was named Washington Regional Medical System president and CEO in 2017 after serving as senior vice president of Strategy & Outreach Services since 2010.
Do you think we’ll ever get to the point where hospitals will give patients their total price of care before they are treated? Do you think that would help lower the cost of health care?
I do believe that we will continue to see initiatives related to price transparency. Patients aren’t able to make informed decisions and become frustrated when they don’t know the cost of care on the front end.
Currently, most of our hospital care is reimbursed as a single lump sum based upon the diagnosis and complexity of the condition of the patient. This amount typically does not vary with the length of stay in the hospital or with the amount of resources consumed. However, it is often the back end of the episode of care before the diagnosis and complexity are fully known.
I believe the financial model is changing and opportunities to provide cost information on the front end will continue to move toward transparency.
Do you think the Affordable Care Act has been a success? How would you like to see it changed?
I believe the ACA has been a success in improving access to care for many Arkansans who previously had limited access. There are aspects of the ACA that focus on comprehensive primary care and emphasize prevention and wellness that allow serious medical issues to be identified earlier and treated more effectively with fewer resources. For our hospital, much of this care was historically delivered in the emergency department later in the disease process at a higher cost.
However, the ACA has not really addressed the financing of health care. In some ways, we have limited effectiveness of access by not addressing the capacity of the health system. There are not a lot of incentives or accountabilities for each of us individually to manage our own health and wellness, and in many respects, we remain a “sick care” vs. a “health” care system. Everyone needs skin in the game, and the rate of growth for the cost of health care is not sustainable.
What area of growth are you going to focus on at Washington Regional over the next two years?
Over the next year, we will become a comprehensive stroke center. We will continue to be a leader in bringing specialty providers to our market and will continue to see growth in our joint replacement and cardiovascular services, neurosciences and Women & Infants Center. We will continue to focus on recruitment and retention of physicians, advanced practice providers, nurses and other members of our care team. We will also focus on workforce development for all team members, because every team member is critical to the delivery of quality care and a quality patient experience.
Additionally, our $77 million construction project will be completed next year, bringing additional inpatient capacity, expanded operating rooms, an expanded clinical laboratory and additional overall infrastructure.
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