November 1, 2023 • 64 mins
Are the bigger hospitals always the best providers of healthcare? Quentin Whitwell, CEO of Progressive Health, turns this idea on its head as we delve deeply into the world of rural healthcare. Quentin's insightful conversation reveals a landscape rich with potential, highlighting the unique advantages small hospitals bring to the table - from a better staff-to-patient ratio to a more personalized level of patient care.
We take an enlightening journey through the complex maze of federal funding, discussing how the government's matching program can be a game-changer for rural healthcare. Quentin supplies a fresh perspective on the concept of Medicaid expansion, debunking common misconceptions and laying bare the true potential it holds for improving patient care. He also sheds light on the challenges of scaling an organization across multiple states and reveals how Progressive Health has employed a unique hybrid model to manage and purchase hospitals.
Finally, we wrap up our conversation by immersing ourselves in the unique stories and character of small towns. Quentin shares his thoughts on promoting health equity, underscoring the importance of fostering healthy lifestyles and creating a movement towards better health. You won't want to miss this intriguing and insightful conversation with Quentin Whitwell, where we unearth the hidden potential of rural healthcare.
QUENTIN WHITWELL: https://www.quentinwhitwell.one/about
QUENTIN WHITWELL INSTAGRAM: https://www.instagram.com/qwhitwell/
PROGRESSIVE HEALTH: https://www.phghealth.com/
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(0:18) Progressive Health in Rural Hospital
(15:47) Issues and Solutions for Rural Hospitals
(29:43) Medicaid Expansion and Rural Hospitals
(38:14) Hospital Expansion and COVID Funding
(50:50) Rural Healthcare and Public Conversations
(56:21) Explore Towns, Promote Health Equity
Modern-day politics discussion and analysis. Conservative Political Commentator Ryan...
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:18):
County Line congregation.
I would like all of you towelcome Mr Quinton Whitwell with
Progressive Health out of NorthMississippi.
Y'all are located in Oxford, Isthat correct, Quinton?
That's correct.
Speaker 2 (00:33):
Oxford is home.
Of course.
I spent 15 years in Jackson,but we've been back in Oxford
almost 10 years now.
Speaker 1 (00:40):
I went to Oxford for the LSU weekend and that's the
first time I'd been back upthere in probably five or six
years, and the level of growthis amazing.
Speaker 2 (00:54):
It's really crazy.
When I lived in Jackson, youhave your nice white tablecloth
restaurants and clients comingin and all this I was always
wondering would Oxford be aproblem?
People get into it and have aninternational airport, et cetera
.
Nobody's ever complained aboutcoming to Oxford.
(01:15):
We're actually in the middle ofbuilding out our headquarters
here so that we have all theC-suite level people that are
working with us now, as we'vegrown to make Oxford our
headquarters, right here on thehistoric downtown square.
It makes for a great place towork and it makes for a great
place to come visit.
We enjoy the benefits of Oxfordand, of course, just enjoy
(01:40):
living here in my hometown andcontributing back.
Speaker 1 (01:44):
Yeah, and it's got a ripe environment for the
industry that you find yourselfin the way of talent and work,
finding people to finding goodpeople.
I wouldn't imagine it's adifficult task for you being in
Oxford and how it's uniquelylocated, with a very strong and
growing medical community andobviously, the college there.
Speaker 2 (02:07):
Yeah.
So Nashville is kind ofconsidered the epicenter of the
south for healthcare and a lotof people think everything has
to be done out of Nashville.
I think there are a lot ofpeople very interested and
curious about the fact of whatwe're doing in Mississippi.
For me, obviously, we'repassionate about rural
(02:27):
healthcare.
We're passionate about ruralplaces, not just what we do
inside the four walls of ahospital, but also why those
communities are stagnant orlosing population, how we can
contribute to their overallsuccess.
And so you know, oxfordobviously is a robust small town
(02:48):
, but we just like beingcommitted to being in a small
town.
Speaker 1 (02:53):
So, leading into what progressive health does and the
mission of progressive healthgroup, can you shed some light
on that for us?
Speaker 2 (03:06):
Yeah, so you know, I graduated from Ole Miss Law
School back in 98.
I started practicing law andultimately ended up building up
a lobbying firm and use thatlevel of political interaction.
And, you know, legislationchanges, policy changes to my
advantage, for clients.
And ultimately, when I wasasked by Dr Kenneth Williams to
(03:30):
help him in his small ruralhospital in Holly Springs,
mississippi, I found something Icould be passionate about and
that's what motivates me everyday.
And we went from, you know,trying to make sure we made it
as successful as we could, tothen buying PANOLA in Batesville
(03:52):
and then reopening the hospitalin Marks, mississippi, which is
a critical access, and thentaking over the clinics for
Tunica County and then engagingwith Jefferson County over in
Fayette in their hospital, andthen expanding into Alabama, in
Thomasville, alabama, and theninto Georgia, in Ossilla,
(04:14):
georgia, at the Irwin CountyHospital.
And now we've got purchase andsale agreements out there for
hospitals in Arkansas, tennesseeMoore in Alabama and in Texas.
So we're just growing.
We're growing because we thinkthat we understand the landscape
(04:38):
of rural health care, we knowhow to do things more
efficiently, better.
We believe that our leadershipmodel and the culture that we
create is what makes usdifferent.
And then the brand newdesignation of rural emergency
hospital with a federal subsidyand a higher reimbursement for
outpatient services has proventhat we understand a unique
(05:03):
nature and we've got the rightpeople around us to be able to
grow, so we're really excitedabout it.
Speaker 1 (05:09):
So it sounds to me like y'all have a model in mind
that y'all implement when y'allgo into these rural hospitals,
these rural areas, into thesehospitals, and it sounds to me
like what y'all task yourselveswith doing is ensuring that the
operations and the management ofthose hospitals are done in a
(05:29):
way that becomes profitable forthat hospital.
Is that accurate to say?
Is that y'all's mission?
Speaker 2 (05:38):
Absolutely Obviously.
You can't continue to run ahospital if you can't get it to
profitability.
There's always charitablecomponents that are a part of
health care and taking care ofyour community and your
population.
I like to say that we're theChick-fil-A of health care.
(05:58):
It's my pleasure, it's how canI help you?
We bring a whole new set ofservice to this industry.
When I go into a building andstart engaging with our
employees, that become under ourbanner.
We talk about the fact that youneed to be heads up as you're
(06:20):
walking through the halls.
Anybody that you're in contactwith within six feet that you
greet, whether they're a patient, a visitor or a co-worker.
Get your eyes off your cellphone while you're walking
through the halls.
Be engaged and just demonstratea level of care that people
have gotten to not expecting itlonger.
(06:42):
When you do that, people willtalk about that.
They will be glad to come back.
Rural hospitals often arecleaner, safer, better for
service than the big ones A lotof these big ones.
I like to say you could roll abowling ball down the hallway
(07:05):
and not hit anybody.
As far as staff goes, becausethey're so understaffed.
In a rural, smaller hospitalyou obviously have to have a
certain level of FTEs orfull-time employees.
There, I personally think thatthere's an environment where
rules can survive and thrive.
(07:27):
I think also a lot of that isin the way that we bring
outpatient services to thepublic.
In the future, as we grow, weare developing national groups
that will come in in aplug-and-play format and bring
things like orthopedics orwellness or physical therapy or
(07:49):
mental health evaluations orwound care or pain management.
All of these things are thingsthat we can do and we have
partners in place to perform andto provide for.
Speaker 1 (08:04):
There's a lot of talk about Medicaid expansion,
particularly in Mississippi andother red states.
Tate Reeves, our governor, hasstated that he's against
Medicaid expansion.
In his words, he basicallycalls it welfare.
His stance is he doesn'tbelieve in bringing more people
of Mississippi onto the welfareroles at the crux of the issue
(08:29):
when it comes to rural hospitals.
What would you say if you hadto assess the scenario and
provide a reasoning for why somany of these rural hospitals
are struggling financially?
If there was one issue, or acouple of issues that are
contributing most to thathappening, what would you
(08:52):
attribute that to?
Speaker 2 (08:55):
Well, first of all, let me say I supported Tate
Reeves in 2003 when he had threepeople in a primary running
against him for state treasure.
When you are one of the firstpeople to support somebody, you
make sure you stay in good stead.
(09:16):
I'm a supporter of the governoron a personal level and I also
have found him to be thoughtfulabout a lot of things and to the
extent that I think there aresome changes that need to be
made at this point, I thinkwe're going to get a new dynamic
(09:36):
with a new speaker of the House, with Governor Hoesman being
reelected, I personally believeit is time for the state of
Mississippi to act.
I also think that ourMississippi Economic Council
needs to get involved and theyneed to let the state of
(09:57):
Mississippi legislatureunderstand that the business
community cannot thrive in atown like Houston, mississippi,
for example, that doesn't evenhave an emergency room open and,
at the same time, has athriving manufacturing
(10:19):
department.
So how are we going to not havea working hospital and still be
able to grow in thosecommunities?
I personally think that some ofthe windows of Medicaid
expansion have already beenmissed.
The states that early adoptedgot a lot of disproportionate
(10:42):
share money early on.
I am not necessarily optimisticthat this enhancement formula
that the governor has laid outis actually going to be approved
or if it will actually bringthe amount of revenues that are
projected, but certainly wewould like to try and see.
I hope that that submission hasalready been made.
(11:02):
I don't know that.
I do know that the stateMedicaid department has been
talking to a lot of us aboutgetting ready for the
enhancement portion and what allthat's going to entail, so
that's a good sign.
The state funding that waspassed last year was not done in
(11:23):
the right way.
It was tied to ARPA funds thatwe had already been reimbursed
for, so the legislature is goingto have to fix that next year.
I believe the state of Alabamais going for Medicaid expansion.
I think their businesscommunity is all forward.
I think they're going to callit some other name, maybe even
(11:44):
do it in a block grant format.
But I'm very curious whatAlabama is going to do.
I think Georgia is puttingtheir toe in the water.
Of course Arkansas has alreadydone it, louisiana has done it.
You can see the proof rightthere they have less hospitals
that are closing.
Speaker 1 (12:02):
So the reluctance to me seems mostly for political
reasons, as opposed to thinkingit's best for the patients and
the access to health care inthese rural communities.
When I read not being an expert, not even close, in health care
and or legislation, but when Iread press releases and articles
(12:25):
trying to decipher anddetermine what Medicaid
expansion means, the pros andthe cons of it, it's a very
convoluted conversation for theaverage person, in my view.
What does Medicaid expansionentail?
What does that phrase mean toyou?
Speaker 2 (12:48):
Yeah.
So, first of all, I have saidfor years, if I was in the oil
and gas business and I walkedinto any governor's office and
said, governor, we're going as agroup to put a dollar out there
and the federal government isgoing to give us $5 back, they
(13:09):
would be like where did I sign?
Give me a pen right now.
So why, in the world, whenwe're dealing with healthcare,
which is playing with people'slives and they're literally
whether they're healthy and safeor not, why are we rejecting
that?
And unfortunately, you arecorrect.
(13:30):
Politics is to blame, because itstarted off as the Affordable
Care Act under President Obama.
It's just like any piece oflegislation.
There are parts of it that werenot palatable and that a lot of
people did not like, and theythought that it was essentially
pushing us toward what you calla one-payer system, which has
(13:55):
not really been the net effect,by the way.
And so then you get the HouseRepublicans.
Every single ad for the last 10years has been I'm voting to
repeal Obamacare.
Well, guess what?
We've already been through aRepublican president.
(14:17):
Since then, we've got adifferent president.
Now, who knows who ourpresident is going to be in two
years from now?
Let's quit talking about theObamacare component and let's
just talk about the policy ofwhere we're at, and let's be
realistic.
(14:38):
Basically, what it is, lee, isthe industry puts up a certain
amount of money and the federalgovernment reimburses that back
at $4 to $5 for every dollarthey put in.
And we already have a formulacalled MAP, the Hospital
Assessment Program, where thisis already being done.
Now the other side of Medicaidexpansion is also for the
(15:05):
patient, and this is the partwhere we get into these
conversations about welfare andthis and the other, and this is
where I just disagree with myopponents on this.
If I don't care who you are, ifyou live in Mississippi, you
deserve access to health care,at least at some level, and
(15:27):
you're already going to show upin the ER anyway, whether you
have some form of insurance ornot.
So why in the world will we notput these people on some sort
of program that the people thatare treating them are going to
be reimbursed for the servicesthey're providing?
They're coming anyway.
Speaker 1 (15:47):
Yes, and that's a question that I have in regards
to these rural hospitals.
I get why, on a basic level, whythey're struggling financially,
because in rural areas, for themost part, you're dealing with
an impoverished population andthey don't have the means, as
(16:10):
the citizens in a more affluentarea may, to have insurance
because of lack of access tojobs that provide benefits, so
forth and so on.
There are a multitude ofdifferent reasons that
contribute to these people beingpoor, but, as you mentioned,
that doesn't mean that theyshouldn't have the access to the
health care because they aregoing to go to the ER when an
(16:34):
emergency happens and then thathospital is on the hook for that
uncompensated care, and that'sjust counterintuitive to the way
one becomes profitable.
So it sounds to me like thefederal government's willing to
match a certain amount ofdollars, or more than match a
(16:56):
certain amount of dollars put upby.
My one question is who putsthat money up?
You mentioned the industry putsthe money up, but then, number
two after whoever puts the moneyup, and then we don't accept
the dollars from the federalgovernment.
What happens to that money ifit's not used by us in the way
(17:16):
of Medicaid expansion?
Does it just burn off?
Speaker 2 (17:22):
Yeah, so yeah, each hospital is assessed a tax.
They write their check toMedicaid and then Medicaid turns
around and reimburses them.
So we may have to put in$200,000 to turn around and get
a $450,000 check back.
It sounds a little crazy, butit's just the way it works you
(17:44):
have to put in before you getback.
So that's the way this programwould work at a little bit of a
higher level.
Now to your point about wheredoes the money go.
I mean, look, do I agree thatwe should have an $18 trillion
federal deficit?
No, I do not.
But at the same time, ifCalifornia and New York and
(18:13):
Washington State and Louisianaare taking full advantage of a
federal program to get moneythat is supplied into their
population to prop up theirrural health care and we're not,
we're just being hardheaded, tomake a point.
I mean, I don't know anybody inMississippi that wants to stand
(18:40):
on a proposition of, hey, wedidn't spend as much federal
dollars as California did, andthe reality of it is our rural
hospitals cratered because wedidn't have the ability to keep
them open, while, as everybodyelse, took full advantage of it
(19:00):
and everybody else is fine andthriving.
And what I don't understand iswhy rural areas, which are the
most important to the heartbeatof America, would be the ones
that we would pick on.
I mean, I understand that mostpeople live in Jackson or on the
Gulf Coast or near the Memphismetro area.
(19:21):
I get that and I've lived insome of those places actually
all of those places myself atsome point in my life or career.
But Greenwood, mississippi, tonot be able to deliver babies
any longer.
Do you know how far people haveto drive to deliver a baby in
(19:44):
the Mississippi Delta right now?
You got Clarksdale andGreenville and then you got, of
course, your lower Delta, likeVicksburg, natchez.
All those other people, I meanthey're either going to Jackson,
maybe Oxford.
I mean you know we're talkingtwo and a half, three hour
(20:06):
drives for these people todeliver a child and what's
happening is a lot of them arebeing delivered in the ERs,
which is not exactly safe andscary and it's uncalled for and
you know so.
You know we put in a bid for theGreenwood LaFleur Hospital.
(20:27):
We're hoping that we're gonnaget it.
You know that hospital had tensand tens of millions of dollars
in the bank just not even toolong ago.
I can't help but think a lot ofit has been based on leadership
, but also just, the times havechanged and we're good at
(20:51):
operating under the 2023 worldas opposed to the, you know,
1984 model, and so that's wherewe can make a difference and I'm
hoping we're gonna be able todo it.
And I also think that we needto look outside the box at
things like I mean, maybe evenI've offered to set up a
birthing center in the Delta,wanted to do it in Belzona,
(21:15):
mississippi.
I had some people that wereinterested there.
You know that would be a muchbetter, safer way to deliver
babies than you know, thanwhat's going on right now.
Speaker 1 (21:30):
Yeah, I think we're dealing with a couple of
different components in theserural areas.
It's no secret that typically,rural areas experience
decreasing population over time.
I think that's one of the majorcontributing factors, in
addition to there just not beingany jobs in these rural areas.
(21:50):
But there are still peoplethere and all people matter and,
as you have said, allMississippians deserve equitable
access to health care.
When you go into these ruralplaces, quentin, what do you see
as being the outside from thedecreasing population and the
(22:11):
poverty?
What do you see as being thebiggest contributing factor to
these hospitals from anoperational standpoint not being
adequate?
Speaker 2 (22:25):
Well, I do believe there has to be a level of trust
with the community.
A lot of times they don't evenknow what services are provided
inside their own small townrural hospital.
They just assumed that theyneed to drive, you know, an hour
and a half to some biggerfacility to get something done,
Even things as simple as, likeyou know, blood work or lab work
(22:46):
.
So there's a level ofexplaining and marketing to the
public and outlining thatthere's.
Also, just at the end of theday, just to be really candid,
there are a lot of hospitalsthat are not doing things the
(23:07):
way they need to be done toengage the public.
So when we come in with adifferent model and a different
attitude, it's kind of like theold adage of you know the
restaurant's not doing very welland put up a sign that says
under new management, you knowwe bring this refreshing new
life there, but if we don't,take full advantage of it.
(23:30):
You know there may not be theexcitement that needs to be
generated, so you know.
But this is what I would say atthe end of the day, rural areas
are the backbone of ourcommunity and, yes, people are
(23:50):
migrating to a lot of biggerareas, but I think a lot of
people are migrating back to therural areas.
You know that they can work athome a lot of times now.
They don't mind traveling alittle bit further to work if
they're going to go home and bepeaceful out on.
You know they may not be theirback 40, but they're back.
(24:12):
You know, couple acres orwhatever.
And so you know you need tohave good school systems, you
need to have at least some kindof financial component, like
banking or industry, and you gotto have healthcare and you got
to have a hospital.
And with this new ruralemergency hospital methodology
that we are bringing into play,I think we are making a big
(24:34):
impact and I'm very pleased withthe fact that we're digging
into these areas and helpingsave jobs in those places and
give people an excuse to want tocome back.
Speaker 1 (24:46):
Yeah, and another component of the potential of
Medicaid expansion that I reallylike is number one if you make
something profitable, you'regoing to spur growth.
If you spur growth, you'regoing to need more people to
work.
More people to work is going tomean more jobs.
So I mean, I think, just on itsface, if the federal government
(25:07):
is going to allot this money, Ithink by not taking advantage
of it, that we are disallowing alot of people that need
healthcare and access to it fromgetting it.
These rural hospitals, forexample.
I'm in Philadelphia,mississippi.
(25:27):
We have a general hospital.
I think it's a pretty goodhospital.
I think it could be better, butthere's always room for
improvement, right, but for asmall town, it does what we need
it to do.
A place like Neshoba Generalwho owns a hospital like that?
Like, is that a private, forexample, neshoba General Is that
(25:49):
a private entity?
Is that a public entity Formost of these small rural
hospitals, are they private,public?
Who owns them?
Speaker 2 (25:59):
It's a good question.
I had somebody say to me I'venever met an individual that
actually owns a hospital.
It's a little unique.
So basically and I don't knowabout Neshoba General I mean to
be honest with you, I know where.
I mean I've been toPhiladelphia, obviously
Mississippi, but it's neverreally.
(26:22):
I guess that's a good thing.
You don't really hear about it.
So there's no drama.
That's positive.
My guess is it probably has somesort of county-owned component
A lot of these smaller hospitalshave.
Usually what happens is theyset up like a healthcare board
and that healthcare board isactually established from the
(26:45):
county board of supervisors.
So, like in Jefferson Countyand Fayette, mississippi that we
are working with, the board ofsupervisors puts all of the
board members of the hospital onand then they operate
independently, but it's acounty-owned facility.
Over time, because of whateverpeople, there's a lot of reason
(27:14):
why county facilities don't workright.
First of all, you're probablyhiring people because of
political purposes.
A lot of times, unfortunately,you also have people that don't
really know about hospitalbusiness that are running it.
So a lot of times some of thesewill become distressed assets
(27:34):
and then they'll end up on themarket for sale.
So that's one way they end upin private hands.
Okay, sometimes they operate ina not-for-profit scenario,
sometimes they operate in afor-profit scenario.
We've worked in both modelsover time and it just really
(27:55):
depends on where we are and whyit would be better for one than
the other.
But you know, and then you getyour big systems and like, if
you go into states like SouthCarolina and North Carolina,
almost every hospital that'sstill alive has been affiliated
with by some larger system andit's a part of a hub-and-spoke
(28:17):
model and there's very fewindependents that are left.
So that's kind of.
I mean, honestly, we as anindividual group go in and
identify these hospitals thatare for purchase, but they are
few and far between and thensome of them we manage.
(28:38):
I mean, several of the ones wemanage are county-owned and we
just are the ones that make sureit's profitable.
Speaker 1 (28:46):
I see, I see, yeah, it's an interesting discussion
when talking about access tohealthcare, because we look at
the public services that ourcountry has traditionally
provided, particularly publiceducation.
And then you, you know, when Ifirst, when I was going to
college, I started asking myselfin my early 20s, really started
(29:09):
diving into how our country hasdetermined what is a utility
and what is a and what is not.
You know what?
What is the governmentresponsible for providing?
What are they not responsiblefor?
For providing?
What should taxpayer dollars beused for?
What shouldn't taxpayer dollarsbe used for?
(29:30):
And, just like education, Ithink that there is room for the
public and private sectors tobe involved in healthcare.
Now, having said that is, doyou think there's a
misconception on the part ofjust average people when they
hear the term Medicaid expansionand they automatically
(29:53):
associate that with socializedmedicine?
Is Medicaid expansion, in yourmind, a form of socialized
medicine or is it just simply afinancial gift from the
government?
Speaker 2 (30:12):
I don't think it's either one.
I think I think that no one isperfect in terms of how they put
policy forth right, but I thinkwe are in an era of wedge
driving that if if you say thesky is blue, I'm going to say
(30:32):
the sky is purple, and it's justabsolutely ridiculous.
We, the, the, the United Statesof America is not going to be a
one payer system.
That's not going to happen andanybody's scared.
Anybody to make that, to makethem think it's going to happen,
is wrong.
However, on the flip side, theactual payers are voluntarily
(30:59):
following Medicare fee schedulesto basically look just like
Medicare themselves, because itmakes them more profitable.
You know used to if Medicarereimbursed for a service at $100
.
An insurance, private insurancecompany might reimburse 250.
Now if Medicare says it's $100,they're gonna say it's $100 for
(31:23):
110, 120, whatever, maybe somelittle minimal additional thing,
even though people are payingin.
So, to the extent that ourmulti-tier payer system is
crumbling, it's the insuranceindustry's own decisions to do
that, and so to punish youraverage Joe Q Public for
(31:48):
something that is happening interms of that big pharma and big
insurance and these majormulti-billion dollar
corporations are in the middleof doing to themselves doesn't
make any sense to me, and theproblem is the public is not
educated.
They hear a sound bite and theyjust think, oh, that's a bad
(32:13):
thing, and they don't understand.
And it's our job to let peopleknow that.
Hey, let's put it like this IfI'm an average person in small
town America and my dollar cango toward my local hospital or
(32:38):
it could go toward a majorinsurance company out of this
international or whatever, wheredo you want that dollar to go
to?
Certainly you want it to goback at the local level, I mean
there was a bill last year therewas.
I mean, don't give me name andnames, Lee, but because of all
(33:04):
the prior authorizations thatare required.
Now it's like they're slappingthese doctors' hands, like.
I mean, like a doctor's gonnawrite an order that isn't needed
?
Give me a break.
It's just a way to deny 200 ormore million dollars a year in
claims on a technicality forsome paperwork, and that's the
(33:27):
kind of stuff that we're dealingwith in the industry and I
guarantee you this.
The small town rural hospitalis not the culprit.
No, absolutely not.
Speaker 1 (33:40):
So like what is the proposition for people that are
adamantly opposed toimplementing Medicaid expansion?
Like what is the option to?
You mentioned that y'all have amodel, that y'all can improve
rural hospitals without theinflux of Medicaid expansion
(34:01):
money.
So what did those propositionslook like?
To improve these ruralhospitals without the influx of
the Medicaid expansion money?
Speaker 2 (34:11):
Well, you know, this is where my law and policy
background comes in handy, andnow that I'm a hospital operator
, we literally look at everysingle breadcrumb that is out
there.
The way I describe it whenasked publicly or privately to
anyone is that we're using theHansel and Gretel model.
(34:36):
Okay, and what I mean by thatis the federal government went
out there and put some broad,sweeping initiatives in place
that basically hurt the ruralhospitals the way it's tied to
your cost-based index, the waythat you're required to qualify
(34:57):
to get a patient in the bed, thefact that they want more
outpatient services and lessinpatient.
But then they pass a series ofbreadcrumbs.
You know rural health clinicreimbursements, 340B program.
You know chronic caremanagement program, remote
patient monitoring program, thisnew rural emergency hospital
(35:21):
program, et cetera, et cetera,et cetera.
And if you stack those up andfollow them, then you can get
back to the house, and that'swhat we've done better than most
people.
I think most people in ruralhealthcare end up lost in the
wilderness and we follow thebreadcrumbs back to the house.
And so, you know, what I'msuggesting is is that between a
(35:44):
combination of knowing thosefactors, being more nimble and
leader-like in our culture,we're able to be successful
enough to survive, but we stillbelieve that Medicaid expansion
or whatever you want to call it,I mean my gosh, we'll call it
the Ronald Reagan healthcareplan, I don't care what you call
(36:08):
it, Just give the hospitalsopportunity to buy into a
program that will pay them backand will allow the patients that
they serve to have some damninsurance?
Speaker 1 (36:24):
Yeah, because it's perpetual.
When you talk aboutimpoverished places, like you
said early on, people are gonnago to the emergency room.
They're going to do what theyhave to do to try to take care
of themselves, regardless ifthey have insurance or funding
or not.
So I mean, I think it makesperfect sense.
Also, you mentioned somethingin describing y'all's model that
(36:48):
I find very interesting.
It sounds like y'all take thelegislation that has been passed
for, however many years as itpertains to rural hospitals and,
to use your terms, y'all stackthem on top of one another,
basically decipher them andensure that you can maximize the
(37:12):
benefit of that legislation forthe rural hospitals and use
them in tandem to gain as muchfunding or maximize the amount
of benefits that you can getfrom that legislation as
possible.
Is that accurate?
Speaker 2 (37:29):
That's exactly right, I would imagine that's.
Speaker 1 (37:33):
Is that labor intensive?
Speaker 2 (37:37):
Well there are a lot of people that work for me that
think I'm crazy, because theysay when do?
Speaker 1 (37:44):
you sleep?
Speaker 2 (37:45):
You know I'm emailing you at one o'clock in the
morning, I'm emailing you at sixo'clock in the morning.
It's like, you know, I've got agood team around me.
Now at this point we've builtout a good set of folks that I
can rely upon.
But yeah, I mean I had thisvision of how this thing could
(38:08):
be done and I've put myselfaround enough people that we can
make it happen.
As we grow to scale.
I mean we're in seven hospitalsright now in three states.
We're about to expand into twoto three more states.
Well, probably four more stateswe're looking at probably being
, you know, 15 to 20 hospitalsby the end of the first quarter
(38:30):
of next year.
So it does make it difficult,but what we're working on is
developing this model that youknow it's not a
one-size-fits-all-e, becauseevery community has their own
special needs.
But we've got the model thatliterally like, let's just say,
(38:56):
there's an apparatus of 12potential tools that we might
apply.
We might apply six of them toone another, six to another or
some combination to another, butwe at least have the whole
thing built out and I call it myone, two, three plan.
I literally know how to beginthe changes that need to be made
(39:18):
and then to implement to get tosuccess.
And then the third piece iskind of that three to five year
strap plan of growth.
And so that's how we do it andyeah, I mean it takes a lot of
work, it's time intensive, ittakes a lot of brain power, but
I thank the good Lord that mymother was a chemistry physics
(39:42):
teacher, so maybe I neverthought with that side of my
brain I didn't think.
But maybe some of these braincells are finally getting into
my head so how long have youbeen CEO of Progressive Health?
So we started out simply justlike buying a hospital here
(40:05):
there, and so I set as the CEO.
Well, first I was a COO atAlliance Health Systems in Holly
Springs for six years and thenI became CEO at Panola Medical
Center for three years and then,when we started growing and
adding these all in, I made surethat we had administrators in
(40:27):
all those sites and I became theCEO of the whole health system.
So CEO of Progressive Healthhas been two years.
Speaker 1 (40:37):
So y'all do actually purchase hospitals and or put in
management to overseeoperations.
Y'all go either way.
Speaker 2 (40:47):
That's correct.
We have apparatuses to do bothand from my perspective, I like
to own them.
I like to have full control sothat I know that what we're
doing will work.
But they're just a certaincircumstances.
(41:09):
Certain county-owned entities,for example, that are not going
to sell but they need to behelped and we have a great team
of people to do that.
So we send out.
I mean, there's a hospital inTennessee we did a RFP for.
We kind of did a hybrid modelin that one where we basically
(41:32):
want to have the operations butthe county is still in the
building and we lease it backfrom them.
So we think outside the box andwe're open to those
conversations and we're willingto engage in those conversations
.
Speaker 1 (41:50):
Let's backtrack a little bit to COVID.
There's a lot of that's also avery convoluted conversation as
it pertains to how hospitalsinteracted with the federal
government throughout that wholeprocess and, the way I
understand it is, the federalgovernment was compensating
hospitals based on a number ofCOVID cases and a number of
(42:13):
COVID cases they reported andthat a lot of COVID cases became
COVID cases that weren't say itwas a broken arm, but the
person also had COVID.
It was reported as a COVIDpositive or whatever a COVID
case.
How convoluted was that entireprocess and is what I'm
(42:38):
describing.
Does it have any validity?
Speaker 2 (42:43):
All right, you're taking me back here.
Hopefully, I want to have PTSDon this conversation.
When this occurred literally, Imean it was crazy, because at
first I was hearing about thisfrom just random sources, like a
(43:08):
Steve Bannon podcast orsomething, where it's like you
thought it was all a conspiracytheory.
Then all of a sudden it becomesreal.
Then it gets so really scary.
This is something that none ofus have ever seen in our
lifetime.
(43:31):
I had two feelings, and theywere mixed feelings.
On one hand, I felt like weneeded, locally and as hospital
operators, to maintain somesense of stability and normalcy
as odd as that may sound tocontinuity of care.
I think that our federalgovernment way overdramatized
(43:57):
the situation to the point thatif you broke your arm, you
couldn't even have a surgeryperformed because, unless it was
COVID related, you justcouldn't see a doctor.
There was a breakdown in thesystem, and there are people
(44:17):
that did not get care for cancer, for cardiac problems, whatever
they may be, for this period ofone year.
I think it ended up, of course,being detrimental to the
overall population.
You got to be able to walk andchew gum I don't know how else
(44:41):
to put it.
I think we failed in thatregard as an overall system.
I will say this and I'm going togive it out to CMS I'm going to
assume that the Trumpadministration had something to
do with it.
I don't know how anotheradministration would have doled
(45:02):
this out, but however it wasdone and whoever did it and I
know some of them are just thebureaucrats that have been there
for ages, but they created aformula.
That formula, the main initialpart, was just based on beds and
objective data.
(45:23):
In some degree there werewhat's called safety net
hospitals that essentially havebeen designated by the federal
government since whatever the50s or whatever, when we were
looking at nuclear bomb typescenarios.
They doled out the money andthey doled it out in block grant
(45:43):
format and very quickly, and itsaved all of us from collapse.
The irony is, if you look atthe dollar amount, especially in
the rural amounts I just wishthey do it that way Forget
Medicaid expansion For apittance of amount of money,
(46:05):
almost all these rural hospitalsthey're losing a million and a
half to $3 million a yearmaximum.
If you just think about that,you throw a couple million
dollars at a rural hospital tosave it If that's what it takes
to keep a hospital open.
(46:28):
But COVID, what we did and Ithought was if there's anything
I'll pat myself on the back onis the mastermind of the way we
created our COVID clinics and wedid the drive-thru clinics.
We were one of the first onesto do that.
It was a one-stop shop.
We also jumped into the fray onthe antibodies.
(46:50):
Everything that was positive wejumped on, and then the things
that we were a little skittishabout we tried to push back.
All being sensible, I don'tknow of any money that we got.
That was like because therenever was any kind of conspiracy
(47:14):
in my offices of like, oh if wedocument this COVID, then we
get more money, or anything likethat.
The main money we got was all inblock grant format early on and
it was devised before all ofthat.
Now, after the fact, what youhad to do is you had to actually
document what all you did, andif you had not performed all of
(47:35):
that, they would actually takeback the money they had given
you and do a clawback, which Ithought was not fair.
Now, in some of these biggersystems some of the things that
you've heard about ways thatthey may have been eligible to
get hundreds and hundreds ofmillions of dollars that may be
true.
That did not happen in therural environments.
Speaker 1 (47:58):
Did y'all and do y'all continue, I assume, to
administer the vaccines?
We do.
Have y'all seen it?
What kind of numbers, kind ofdata have you seen on that,
progressing farther away fromthe actual pandemic itself?
Have you seen numbers onvaccines go up?
Do you have that off the top ofyour head?
Speaker 2 (48:20):
Let me just put it to you like this we're probably
giving 20 flu shot vaccines toevery one COVID vaccine right
now.
From my perspective, when COVIDwas rampantly out there all
(48:40):
across the world and we didn'tknow what the devastating effect
was, someone with an mRNA shotconcept to try to help save that
off, why not try it Right now,unless you have some kind of
susceptibility?
It seems like this thing atleast not going with it at this
(49:06):
point has migrated to a positionof just more common cold issues
.
Other things I had COVID backabout a month ago.
I was shocked that I got it.
It was very real.
It took me out for several daysbut I wasn't hospitalized or
(49:33):
anything.
That nature just needed to restand just get well again.
Speaker 1 (49:40):
It's so difficult, regardless of what issue we're
talking about, for the everydayperson to discern what's real,
what's not, what information canbe trusted, what can't.
I'm following the Israelconflict right now.
It's a dawning task just to tryto determine who's telling us
(50:06):
the semblance of the truth maybenot even the whole truth, but a
little bit.
The thing with COVID was justexacerbated and overdramatized,
as you mentioned, by the media,the federal government.
It sounds like the federalgovernment just over-prioritized
(50:26):
COVID as opposed to anythingelse.
Maybe it was a knee-jerkreaction, but that's what it
sounds like.
It doesn't sound like whatyou're describing is something
nefarious and intent in the wayof doling out money based on
COVID cases as much as it was.
They were just trying toprioritize COVID treatment over
(50:48):
any other types of treatmentduring that time period.
Speaker 2 (50:50):
Yeah, Look, I'm a big fan of the county line and I
think you'd like to shoot thingsstraight, but you also look
into every angle and everypossibility and you're willing
to call bullshit on people thatare going to not shoot you
straight.
I hope I'm not making for aboring podcast by trying to
(51:12):
throw a little water on some ofthese conspiracy theories,
because I certainly believe thatthere was a lot of things that
occurred that were wrong.
There were some power moves byspecific individuals here, and
there there became this wholeculture of pushing people.
(51:34):
You're either the facts or theun-vacs.
But, quentin Whitwell, all I'mtelling you is that I'm a person
that loves everybody.
I love all of God's people.
Sometimes that puts me in aweird position, because they
can't figure out if I'm right orI'm left or what, and I like to
(51:55):
be that way because I'm notanything other than trying to be
just level-headed and be aleader that makes a difference
where I have a lane to run in,and so it wasn't my job to know
what the World HealthOrganization's policy decisions,
(52:16):
how it impacted whatever I mean, that's not my job.
My job was I was supposed to betaking care of people in
Batesville, mississippi, or Marx, mississippi, or Holly Springs,
mississippi, and these peoplewere scared and they were
concerned and they hadlegitimate issues and they were
being told to stay away fromtheir healthcare facilities and
(52:36):
they're all staying at home andthey're all holed up and they're
you know, and they got nosocial interaction.
And they come out of this thingand their mind is screwed up
and they're mad as hell and theytook these shots and they don't
know what it did to them andyou know, somebody's got to just
be like, hey, we're here, we'rehere to help, you know, and
(53:01):
that's what we've been trying todo and that's why we do what we
do and we're passionate aboutit.
But yeah, all these things arereal and we're dealing with it.
But from a just like purelyeconomic standpoint, I've never
seen the federal government actso fast.
We, literally we would show upto the office to check the bank
account and have, you know, apayment dropped, and we wouldn't
(53:23):
.
I mean, you know, we didn't evenknow what their formula was at
the time.
We were kind of going throughthe head and going through the
math and trying to figure outlike, okay, what were they
anticipating?
We learned more about theseformulas as time went on and
some of them were good, some ofthem were bad.
Some of them you know somepeople, I think probably got
more money than needed.
(53:44):
Some probably didn't get enough, but at least they did
disseminate money fast.
What I didn't like I saw acouple of places take, like
COVID money and then go like buytwo or three more failing
hospitals and then they screwedup their own system, you know.
And so there were, there weretimes when people didn't do it
(54:11):
right, but you know, we feltlike we managed it well and we
think that being entrusted andshowing that we were trustworthy
is going to pay off for thelong haul for us as we grow the
system.
Speaker 1 (54:26):
Well, I think it's important for people like you
and I to have publicconversations, and when I say
people like you, and I meaneveryday people, boots on the
ground.
You're in the healthcare system, you have been experiencing
this entire process firsthand,and I think it's uber important
(54:48):
for people that hold positionssimilar to yours to allow, be
allowed to speak unfettered, inthe way you know, in a long form
conversation such as this andto put water on fiery conspiracy
theories, because people don'tknow what to believe, but
they're more likely to trustsomebody that sounds like them.
(55:12):
That's from where they're frommore so than the Washington Post
with a liberal agenda or, youname, you know, the daily wire
with a conservative agenda.
I think it's very important forus to have these conversations,
and I commend you for doing so.
How in the world did you findyourself with this passion?
(55:32):
Is the passion for ruralhealthcare?
Is that something that's alwaysbeen ignited and inside of you,
or did you happen upon thatspontaneously throughout your
life?
Speaker 2 (55:44):
Well, it's funny.
I don't know the fullpsychological answer for that,
but you know I can take you backto when I first got my first
car and I went to governor'sschool and had friends all of a
sudden from all over the stateand they were from all these
small towns.
(56:04):
And you know, you're rolling toa city like Forest, Mississippi
, and visit with a guy namedRyan Simmons who's now a medical
doctor in Jackson and you know,and he introduces me, this cute
little blonde who ended upbecoming my wife.
So you know, I mean.
I just, I like these small townsand I've always liked going
(56:24):
into them and I've always beenfascinated.
They all have their own story,you know, I mean.
And so I mean, like I went intoWayne County, tennessee, two
days ago and I mean they hadthis restaurant that took up
like a whole side of theirsquare and it had like all these
(56:49):
like outdoor seated areas andthey had music blaring and I
mean it's just really cool, like, and I've never heard this
place before my life and a carpulls up with a Massachusetts
tag and I'm like, what are youdoing here?
And they're like, you know, Imean, and so you almost don't
even understand, like you know.
And then you go into a townlike Helena, arkansas.
(57:12):
They've got a $2 billion portproject going on right now.
If they don't have a hospital,that whole thing is going to
collapse.
You know, and you know, I mean,like some of them have kind of
some crazy stories too.
I have one hospital.
(57:33):
I went down there and Ieverybody said it'd be really
nice.
And you know, I googled themand it turns out it was like a
famous murder had happened thereor whatever.
And I'm like, oh, you knowwhat's going on and you know,
but they're wonderful peoplethere and it just, you know, you
just.
But I love small towns.
Small towns are great to go in,they have their own uniqueness.
(57:57):
I mean, just like you said,you're from Philadelphia but you
know good and well.
I mean you know the people inLouisville, you know the people
in Knoxville, you know thepeople in Foresh and people in
Carthage.
You know they're all 45 minutesaway from each other, but they
all have you.
You'd be like oh, that's aperson, oh, yeah, no, no.
I mean you can literally justlike pick it right, and so I
(58:21):
think that's what makes Americaawesome, and so I enjoy it.
I enjoy the back roads.
I enjoy, you know, going tothese places, meeting these
people, hearing their stories.
And you know you mentioned aword early on and before we get
off I wanted to follow up on itand it's our term health equity.
(58:43):
And health equity can mean alot of things to a lot of people
and kind of like you know we'vealready discussed, I'm not here
.
I'm here to call thingsstraight.
I'm not here to be one way oranother on the political
spectrum.
I've been there, done that, I'mold enough now that I can just
call it like I see it.
But I don't care who you are.
If you're, if you're a workingclass white person, working
(59:07):
class African American person,if you know, if you're a no
class anybody, you know I don'tcare who you are.
If you're a person, you deserveto be treated and you know you
deserve to be taken care of andin your health is all you got.
Hopefully you got family behindthat, but you know I can't be
(59:28):
your family, but I could bethere to provide you a healthy
life, and we can.
Also.
You know, I think once peoplestart embracing not only healthy
lives but a healthy lifestyle,then you can really create a
movement.
I mean, you know, my wife hasgotten into yoga over the years
and that's something she teachesand she's, you know, she's
(59:51):
she's so much healthier than youknow I'll ever be.
But you know, those are the kindof things that when you, when
you start committing yourself toyou, start recognizing there's
a better way, and bringing thatto rural places is what is, what
is my passion and that's how Ideveloped it.
(01:00:11):
And you know why that happened.
I can't really tell you, butyou know, I mean I, I had the
opportunity to serve as the citycouncilman for in Jackson,
mississippi, award one,northeast Jackson we used to
call it FNEJ, fashionableNortheast Jackson.
You know and you know.
(01:00:31):
But you know, to me it doesn'tmatter where you're from or who
you represent, it's just amatter of whether you actually,
you know, care and you're tryingto make a difference, and
that's what we do.
Speaker 1 (01:00:44):
Well, I appreciate what what the mission is at
progressive health and whaty'all are doing.
We we need better healthcareaccess in our rural areas and
y'all are addressing that inMississippi and I think I was
speaking with Greta Kemp Martinyesterday.
She's on the Democratic ticketfor attorney general and we were
(01:01:06):
talking about the state ofMississippi and I said I think
our best days are ahead of us inthe not too distant future, and
I think companies likeprogressive health doing the
things that y'all are doing,will only get us there quicker.
So, quinton, again I appreciateyou coming on the county line
and I hope that this will not bethe last time that the county
line congregation gets to hearfrom you.
Speaker 2 (01:01:29):
Well, it's my pleasure, I appreciate it.
Lee, you've done a great job ofyour podcast and I, you know, I
think everyone out therenotices just how hard you're
working at it and you'veactually, you know, you've been
committed to some good contentand and talking about things
that everybody wants to hearabout.
I mean, you know people arepeople want to hear about
(01:01:51):
healthcare, they want to hearabout the you know what's going
on politically.
They want to know about theiryou know sports.
They want to know about themedical marijuana industry.
I mean, I've listened to you ona lot of these different
subjects.
They want to know aboutinternational affairs and that's
no easy feat to to, you know,bone up on.
So I applaud you for what you'redoing and, you know, thankful
(01:02:14):
that we had a mutual contact toget to know you and and
appreciate the fact that youbrought me on and you know I, I,
I now I've got your email, yourphone number, so you know we
won't be strangers and I thinkthere will be some things that
will come down the pike.
And I would just say this as wewrap it up let's watch this
legislative session.
(01:02:34):
I think, with the new speakerand Jason White, I think, I
think we will get some movementfor rural hospitals and for our
hospital industry in general,and I think, after we get past
this political season, here inthe next few weeks, we're going
to see some, some action.
So let's, let's, let's stay ontop of that.
Speaker 1 (01:02:58):
We'll leave it right there, mr Whitwell, once again,
I appreciate it.
Countyline congregation.
Thank you all so much and untilnext time, peace.
County Line congregation.
I would like all of you towelcome Mr Quinton Whitwell with
Progressive Health out of NorthMississippi.
Y'all are located in Oxford, Isthat correct, Quinton?
That's correct.
Speaker 2 (00:33):
Oxford is home.
Of course.
I spent 15 years in Jackson,but we've been back in Oxford
almost 10 years now.
Speaker 1 (00:40):
I went to Oxford for the LSU weekend and that's the
first time I'd been back upthere in probably five or six
years, and the level of growthis amazing.
Speaker 2 (00:54):
It's really crazy.
When I lived in Jackson, youhave your nice white tablecloth
restaurants and clients comingin and all this I was always
wondering would Oxford be aproblem?
People get into it and have aninternational airport, et cetera
.
Nobody's ever complained aboutcoming to Oxford.
(01:15):
We're actually in the middle ofbuilding out our headquarters
here so that we have all theC-suite level people that are
working with us now, as we'vegrown to make Oxford our
headquarters, right here on thehistoric downtown square.
It makes for a great place towork and it makes for a great
place to come visit.
We enjoy the benefits of Oxfordand, of course, just enjoy
(01:40):
living here in my hometown andcontributing back.
Speaker 1 (01:44):
Yeah, and it's got a ripe environment for the
industry that you find yourselfin the way of talent and work,
finding people to finding goodpeople.
I wouldn't imagine it's adifficult task for you being in
Oxford and how it's uniquelylocated, with a very strong and
growing medical community andobviously, the college there.
Speaker 2 (02:07):
Yeah.
So Nashville is kind ofconsidered the epicenter of the
south for healthcare and a lotof people think everything has
to be done out of Nashville.
I think there are a lot ofpeople very interested and
curious about the fact of whatwe're doing in Mississippi.
For me, obviously, we'repassionate about rural
(02:27):
healthcare.
We're passionate about ruralplaces, not just what we do
inside the four walls of ahospital, but also why those
communities are stagnant orlosing population, how we can
contribute to their overallsuccess.
And so you know, oxfordobviously is a robust small town
(02:48):
, but we just like beingcommitted to being in a small
town.
Speaker 1 (02:53):
So, leading into what progressive health does and the
mission of progressive healthgroup, can you shed some light
on that for us?
Speaker 2 (03:06):
Yeah, so you know, I graduated from Ole Miss Law
School back in 98.
I started practicing law andultimately ended up building up
a lobbying firm and use thatlevel of political interaction.
And, you know, legislationchanges, policy changes to my
advantage, for clients.
And ultimately, when I wasasked by Dr Kenneth Williams to
(03:30):
help him in his small ruralhospital in Holly Springs,
mississippi, I found something Icould be passionate about and
that's what motivates me everyday.
And we went from, you know,trying to make sure we made it
as successful as we could, tothen buying PANOLA in Batesville
(03:52):
and then reopening the hospitalin Marks, mississippi, which is
a critical access, and thentaking over the clinics for
Tunica County and then engagingwith Jefferson County over in
Fayette in their hospital, andthen expanding into Alabama, in
Thomasville, alabama, and theninto Georgia, in Ossilla,
(04:14):
georgia, at the Irwin CountyHospital.
And now we've got purchase andsale agreements out there for
hospitals in Arkansas, tennesseeMoore in Alabama and in Texas.
So we're just growing.
We're growing because we thinkthat we understand the landscape
(04:38):
of rural health care, we knowhow to do things more
efficiently, better.
We believe that our leadershipmodel and the culture that we
create is what makes usdifferent.
And then the brand newdesignation of rural emergency
hospital with a federal subsidyand a higher reimbursement for
outpatient services has proventhat we understand a unique
(05:03):
nature and we've got the rightpeople around us to be able to
grow, so we're really excitedabout it.
Speaker 1 (05:09):
So it sounds to me like y'all have a model in mind
that y'all implement when y'allgo into these rural hospitals,
these rural areas, into thesehospitals, and it sounds to me
like what y'all task yourselveswith doing is ensuring that the
operations and the management ofthose hospitals are done in a
(05:29):
way that becomes profitable forthat hospital.
Is that accurate to say?
Is that y'all's mission?
Speaker 2 (05:38):
Absolutely Obviously.
You can't continue to run ahospital if you can't get it to
profitability.
There's always charitablecomponents that are a part of
health care and taking care ofyour community and your
population.
I like to say that we're theChick-fil-A of health care.
(05:58):
It's my pleasure, it's how canI help you?
We bring a whole new set ofservice to this industry.
When I go into a building andstart engaging with our
employees, that become under ourbanner.
We talk about the fact that youneed to be heads up as you're
(06:20):
walking through the halls.
Anybody that you're in contactwith within six feet that you
greet, whether they're a patient, a visitor or a co-worker.
Get your eyes off your cellphone while you're walking
through the halls.
Be engaged and just demonstratea level of care that people
have gotten to not expecting itlonger.
(06:42):
When you do that, people willtalk about that.
They will be glad to come back.
Rural hospitals often arecleaner, safer, better for
service than the big ones A lotof these big ones.
I like to say you could roll abowling ball down the hallway
(07:05):
and not hit anybody.
As far as staff goes, becausethey're so understaffed.
In a rural, smaller hospitalyou obviously have to have a
certain level of FTEs orfull-time employees.
There, I personally think thatthere's an environment where
rules can survive and thrive.
(07:27):
I think also a lot of that isin the way that we bring
outpatient services to thepublic.
In the future, as we grow, weare developing national groups
that will come in in aplug-and-play format and bring
things like orthopedics orwellness or physical therapy or
(07:49):
mental health evaluations orwound care or pain management.
All of these things are thingsthat we can do and we have
partners in place to perform andto provide for.
Speaker 1 (08:04):
There's a lot of talk about Medicaid expansion,
particularly in Mississippi andother red states.
Tate Reeves, our governor, hasstated that he's against
Medicaid expansion.
In his words, he basicallycalls it welfare.
His stance is he doesn'tbelieve in bringing more people
of Mississippi onto the welfareroles at the crux of the issue
(08:29):
when it comes to rural hospitals.
What would you say if you hadto assess the scenario and
provide a reasoning for why somany of these rural hospitals
are struggling financially?
If there was one issue, or acouple of issues that are
contributing most to thathappening, what would you
(08:52):
attribute that to?
Speaker 2 (08:55):
Well, first of all, let me say I supported Tate
Reeves in 2003 when he had threepeople in a primary running
against him for state treasure.
When you are one of the firstpeople to support somebody, you
make sure you stay in good stead.
(09:16):
I'm a supporter of the governoron a personal level and I also
have found him to be thoughtfulabout a lot of things and to the
extent that I think there aresome changes that need to be
made at this point, I thinkwe're going to get a new dynamic
(09:36):
with a new speaker of the House, with Governor Hoesman being
reelected, I personally believeit is time for the state of
Mississippi to act.
I also think that ourMississippi Economic Council
needs to get involved and theyneed to let the state of
(09:57):
Mississippi legislatureunderstand that the business
community cannot thrive in atown like Houston, mississippi,
for example, that doesn't evenhave an emergency room open and,
at the same time, has athriving manufacturing
(10:19):
department.
So how are we going to not havea working hospital and still be
able to grow in thosecommunities?
I personally think that some ofthe windows of Medicaid
expansion have already beenmissed.
The states that early adoptedgot a lot of disproportionate
(10:42):
share money early on.
I am not necessarily optimisticthat this enhancement formula
that the governor has laid outis actually going to be approved
or if it will actually bringthe amount of revenues that are
projected, but certainly wewould like to try and see.
I hope that that submission hasalready been made.
(11:02):
I don't know that.
I do know that the stateMedicaid department has been
talking to a lot of us aboutgetting ready for the
enhancement portion and what allthat's going to entail, so
that's a good sign.
The state funding that waspassed last year was not done in
(11:23):
the right way.
It was tied to ARPA funds thatwe had already been reimbursed
for, so the legislature is goingto have to fix that next year.
I believe the state of Alabamais going for Medicaid expansion.
I think their businesscommunity is all forward.
I think they're going to callit some other name, maybe even
(11:44):
do it in a block grant format.
But I'm very curious whatAlabama is going to do.
I think Georgia is puttingtheir toe in the water.
Of course Arkansas has alreadydone it, louisiana has done it.
You can see the proof rightthere they have less hospitals
that are closing.
Speaker 1 (12:02):
So the reluctance to me seems mostly for political
reasons, as opposed to thinkingit's best for the patients and
the access to health care inthese rural communities.
When I read not being an expert, not even close, in health care
and or legislation, but when Iread press releases and articles
(12:25):
trying to decipher anddetermine what Medicaid
expansion means, the pros andthe cons of it, it's a very
convoluted conversation for theaverage person, in my view.
What does Medicaid expansionentail?
What does that phrase mean toyou?
Speaker 2 (12:48):
Yeah.
So, first of all, I have saidfor years, if I was in the oil
and gas business and I walkedinto any governor's office and
said, governor, we're going as agroup to put a dollar out there
and the federal government isgoing to give us $5 back, they
(13:09):
would be like where did I sign?
Give me a pen right now.
So why, in the world, whenwe're dealing with healthcare,
which is playing with people'slives and they're literally
whether they're healthy and safeor not, why are we rejecting
that?
And unfortunately, you arecorrect.
(13:30):
Politics is to blame, because itstarted off as the Affordable
Care Act under President Obama.
It's just like any piece oflegislation.
There are parts of it that werenot palatable and that a lot of
people did not like, and theythought that it was essentially
pushing us toward what you calla one-payer system, which has
(13:55):
not really been the net effect,by the way.
And so then you get the HouseRepublicans.
Every single ad for the last 10years has been I'm voting to
repeal Obamacare.
Well, guess what?
We've already been through aRepublican president.
(14:17):
Since then, we've got adifferent president.
Now, who knows who ourpresident is going to be in two
years from now?
Let's quit talking about theObamacare component and let's
just talk about the policy ofwhere we're at, and let's be
realistic.
(14:38):
Basically, what it is, lee, isthe industry puts up a certain
amount of money and the federalgovernment reimburses that back
at $4 to $5 for every dollarthey put in.
And we already have a formulacalled MAP, the Hospital
Assessment Program, where thisis already being done.
Now the other side of Medicaidexpansion is also for the
(15:05):
patient, and this is the partwhere we get into these
conversations about welfare andthis and the other, and this is
where I just disagree with myopponents on this.
If I don't care who you are, ifyou live in Mississippi, you
deserve access to health care,at least at some level, and
(15:27):
you're already going to show upin the ER anyway, whether you
have some form of insurance ornot.
So why in the world will we notput these people on some sort
of program that the people thatare treating them are going to
be reimbursed for the servicesthey're providing?
They're coming anyway.
Speaker 1 (15:47):
Yes, and that's a question that I have in regards
to these rural hospitals.
I get why, on a basic level, whythey're struggling financially,
because in rural areas, for themost part, you're dealing with
an impoverished population andthey don't have the means, as
(16:10):
the citizens in a more affluentarea may, to have insurance
because of lack of access tojobs that provide benefits, so
forth and so on.
There are a multitude ofdifferent reasons that
contribute to these people beingpoor, but, as you mentioned,
that doesn't mean that theyshouldn't have the access to the
health care because they aregoing to go to the ER when an
(16:34):
emergency happens and then thathospital is on the hook for that
uncompensated care, and that'sjust counterintuitive to the way
one becomes profitable.
So it sounds to me like thefederal government's willing to
match a certain amount ofdollars, or more than match a
(16:56):
certain amount of dollars put upby.
My one question is who putsthat money up?
You mentioned the industry putsthe money up, but then, number
two after whoever puts the moneyup, and then we don't accept
the dollars from the federalgovernment.
What happens to that money ifit's not used by us in the way
(17:16):
of Medicaid expansion?
Does it just burn off?
Speaker 2 (17:22):
Yeah, so yeah, each hospital is assessed a tax.
They write their check toMedicaid and then Medicaid turns
around and reimburses them.
So we may have to put in$200,000 to turn around and get
a $450,000 check back.
It sounds a little crazy, butit's just the way it works you
(17:44):
have to put in before you getback.
So that's the way this programwould work at a little bit of a
higher level.
Now to your point about wheredoes the money go.
I mean, look, do I agree thatwe should have an $18 trillion
federal deficit?
No, I do not.
But at the same time, ifCalifornia and New York and
(18:13):
Washington State and Louisianaare taking full advantage of a
federal program to get moneythat is supplied into their
population to prop up theirrural health care and we're not,
we're just being hardheaded, tomake a point.
I mean, I don't know anybody inMississippi that wants to stand
(18:40):
on a proposition of, hey, wedidn't spend as much federal
dollars as California did, andthe reality of it is our rural
hospitals cratered because wedidn't have the ability to keep
them open, while, as everybodyelse, took full advantage of it
(19:00):
and everybody else is fine andthriving.
And what I don't understand iswhy rural areas, which are the
most important to the heartbeatof America, would be the ones
that we would pick on.
I mean, I understand that mostpeople live in Jackson or on the
Gulf Coast or near the Memphismetro area.
(19:21):
I get that and I've lived insome of those places actually
all of those places myself atsome point in my life or career.
But Greenwood, mississippi, tonot be able to deliver babies
any longer.
Do you know how far people haveto drive to deliver a baby in
(19:44):
the Mississippi Delta right now?
You got Clarksdale andGreenville and then you got, of
course, your lower Delta, likeVicksburg, natchez.
All those other people, I meanthey're either going to Jackson,
maybe Oxford.
I mean you know we're talkingtwo and a half, three hour
(20:06):
drives for these people todeliver a child and what's
happening is a lot of them arebeing delivered in the ERs,
which is not exactly safe andscary and it's uncalled for and
you know so.
You know we put in a bid for theGreenwood LaFleur Hospital.
(20:27):
We're hoping that we're gonnaget it.
You know that hospital had tensand tens of millions of dollars
in the bank just not even toolong ago.
I can't help but think a lot ofit has been based on leadership
, but also just, the times havechanged and we're good at
(20:51):
operating under the 2023 worldas opposed to the, you know,
1984 model, and so that's wherewe can make a difference and I'm
hoping we're gonna be able todo it.
And I also think that we needto look outside the box at
things like I mean, maybe evenI've offered to set up a
birthing center in the Delta,wanted to do it in Belzona,
(21:15):
mississippi.
I had some people that wereinterested there.
You know that would be a muchbetter, safer way to deliver
babies than you know, thanwhat's going on right now.
Speaker 1 (21:30):
Yeah, I think we're dealing with a couple of
different components in theserural areas.
It's no secret that typically,rural areas experience
decreasing population over time.
I think that's one of the majorcontributing factors, in
addition to there just not beingany jobs in these rural areas.
(21:50):
But there are still peoplethere and all people matter and,
as you have said, allMississippians deserve equitable
access to health care.
When you go into these ruralplaces, quentin, what do you see
as being the outside from thedecreasing population and the
(22:11):
poverty?
What do you see as being thebiggest contributing factor to
these hospitals from anoperational standpoint not being
adequate?
Speaker 2 (22:25):
Well, I do believe there has to be a level of trust
with the community.
A lot of times they don't evenknow what services are provided
inside their own small townrural hospital.
They just assumed that theyneed to drive, you know, an hour
and a half to some biggerfacility to get something done,
Even things as simple as, likeyou know, blood work or lab work
(22:46):
.
So there's a level ofexplaining and marketing to the
public and outlining thatthere's.
Also, just at the end of theday, just to be really candid,
there are a lot of hospitalsthat are not doing things the
(23:07):
way they need to be done toengage the public.
So when we come in with adifferent model and a different
attitude, it's kind of like theold adage of you know the
restaurant's not doing very welland put up a sign that says
under new management, you knowwe bring this refreshing new
life there, but if we don't,take full advantage of it.
(23:30):
You know there may not be theexcitement that needs to be
generated, so you know.
But this is what I would say atthe end of the day, rural areas
are the backbone of ourcommunity and, yes, people are
(23:50):
migrating to a lot of biggerareas, but I think a lot of
people are migrating back to therural areas.
You know that they can work athome a lot of times now.
They don't mind traveling alittle bit further to work if
they're going to go home and bepeaceful out on.
You know they may not be theirback 40, but they're back.
(24:12):
You know, couple acres orwhatever.
And so you know you need tohave good school systems, you
need to have at least some kindof financial component, like
banking or industry, and you gotto have healthcare and you got
to have a hospital.
And with this new ruralemergency hospital methodology
that we are bringing into play,I think we are making a big
(24:34):
impact and I'm very pleased withthe fact that we're digging
into these areas and helpingsave jobs in those places and
give people an excuse to want tocome back.
Speaker 1 (24:46):
Yeah, and another component of the potential of
Medicaid expansion that I reallylike is number one if you make
something profitable, you'regoing to spur growth.
If you spur growth, you'regoing to need more people to
work.
More people to work is going tomean more jobs.
So I mean, I think, just on itsface, if the federal government
(25:07):
is going to allot this money, Ithink by not taking advantage
of it, that we are disallowing alot of people that need
healthcare and access to it fromgetting it.
These rural hospitals, forexample.
I'm in Philadelphia,mississippi.
(25:27):
We have a general hospital.
I think it's a pretty goodhospital.
I think it could be better, butthere's always room for
improvement, right, but for asmall town, it does what we need
it to do.
A place like Neshoba Generalwho owns a hospital like that?
Like, is that a private, forexample, neshoba General Is that
(25:49):
a private entity?
Is that a public entity Formost of these small rural
hospitals, are they private,public?
Who owns them?
Speaker 2 (25:59):
It's a good question.
I had somebody say to me I'venever met an individual that
actually owns a hospital.
It's a little unique.
So basically and I don't knowabout Neshoba General I mean to
be honest with you, I know where.
I mean I've been toPhiladelphia, obviously
Mississippi, but it's neverreally.
(26:22):
I guess that's a good thing.
You don't really hear about it.
So there's no drama.
That's positive.
My guess is it probably has somesort of county-owned component
A lot of these smaller hospitalshave.
Usually what happens is theyset up like a healthcare board
and that healthcare board isactually established from the
(26:45):
county board of supervisors.
So, like in Jefferson Countyand Fayette, mississippi that we
are working with, the board ofsupervisors puts all of the
board members of the hospital onand then they operate
independently, but it's acounty-owned facility.
Over time, because of whateverpeople, there's a lot of reason
(27:14):
why county facilities don't workright.
First of all, you're probablyhiring people because of
political purposes.
A lot of times, unfortunately,you also have people that don't
really know about hospitalbusiness that are running it.
So a lot of times some of thesewill become distressed assets
(27:34):
and then they'll end up on themarket for sale.
So that's one way they end upin private hands.
Okay, sometimes they operate ina not-for-profit scenario,
sometimes they operate in afor-profit scenario.
We've worked in both modelsover time and it just really
(27:55):
depends on where we are and whyit would be better for one than
the other.
But you know, and then you getyour big systems and like, if
you go into states like SouthCarolina and North Carolina,
almost every hospital that'sstill alive has been affiliated
with by some larger system andit's a part of a hub-and-spoke
(28:17):
model and there's very fewindependents that are left.
So that's kind of.
I mean, honestly, we as anindividual group go in and
identify these hospitals thatare for purchase, but they are
few and far between and thensome of them we manage.
(28:38):
I mean, several of the ones wemanage are county-owned and we
just are the ones that make sureit's profitable.
Speaker 1 (28:46):
I see, I see, yeah, it's an interesting discussion
when talking about access tohealthcare, because we look at
the public services that ourcountry has traditionally
provided, particularly publiceducation.
And then you, you know, when Ifirst, when I was going to
college, I started asking myselfin my early 20s, really started
(29:09):
diving into how our country hasdetermined what is a utility
and what is a and what is not.
You know what?
What is the governmentresponsible for providing?
What are they not responsiblefor?
For providing?
What should taxpayer dollars beused for?
What shouldn't taxpayer dollarsbe used for?
(29:30):
And, just like education, Ithink that there is room for the
public and private sectors tobe involved in healthcare.
Now, having said that is, doyou think there's a
misconception on the part ofjust average people when they
hear the term Medicaid expansionand they automatically
(29:53):
associate that with socializedmedicine?
Is Medicaid expansion, in yourmind, a form of socialized
medicine or is it just simply afinancial gift from the
government?
Speaker 2 (30:12):
I don't think it's either one.
I think I think that no one isperfect in terms of how they put
policy forth right, but I thinkwe are in an era of wedge
driving that if if you say thesky is blue, I'm going to say
(30:32):
the sky is purple, and it's justabsolutely ridiculous.
We, the, the, the United Statesof America is not going to be a
one payer system.
That's not going to happen andanybody's scared.
Anybody to make that, to makethem think it's going to happen,
is wrong.
However, on the flip side, theactual payers are voluntarily
(30:59):
following Medicare fee schedulesto basically look just like
Medicare themselves, because itmakes them more profitable.
You know used to if Medicarereimbursed for a service at $100
.
An insurance, private insurancecompany might reimburse 250.
Now if Medicare says it's $100,they're gonna say it's $100 for
(31:23):
110, 120, whatever, maybe somelittle minimal additional thing,
even though people are payingin.
So, to the extent that ourmulti-tier payer system is
crumbling, it's the insuranceindustry's own decisions to do
that, and so to punish youraverage Joe Q Public for
(31:48):
something that is happening interms of that big pharma and big
insurance and these majormulti-billion dollar
corporations are in the middleof doing to themselves doesn't
make any sense to me, and theproblem is the public is not
educated.
They hear a sound bite and theyjust think, oh, that's a bad
(32:13):
thing, and they don't understand.
And it's our job to let peopleknow that.
Hey, let's put it like this IfI'm an average person in small
town America and my dollar cango toward my local hospital or
(32:38):
it could go toward a majorinsurance company out of this
international or whatever, wheredo you want that dollar to go
to?
Certainly you want it to goback at the local level, I mean
there was a bill last year therewas.
I mean, don't give me name andnames, Lee, but because of all
(33:04):
the prior authorizations thatare required.
Now it's like they're slappingthese doctors' hands, like.
I mean, like a doctor's gonnawrite an order that isn't needed
?
Give me a break.
It's just a way to deny 200 ormore million dollars a year in
claims on a technicality forsome paperwork, and that's the
(33:27):
kind of stuff that we're dealingwith in the industry and I
guarantee you this.
The small town rural hospitalis not the culprit.
No, absolutely not.
Speaker 1 (33:40):
So like what is the proposition for people that are
adamantly opposed toimplementing Medicaid expansion?
Like what is the option to?
You mentioned that y'all have amodel, that y'all can improve
rural hospitals without theinflux of Medicaid expansion
(34:01):
money.
So what did those propositionslook like?
To improve these ruralhospitals without the influx of
the Medicaid expansion money?
Speaker 2 (34:11):
Well, you know, this is where my law and policy
background comes in handy, andnow that I'm a hospital operator
, we literally look at everysingle breadcrumb that is out
there.
The way I describe it whenasked publicly or privately to
anyone is that we're using theHansel and Gretel model.
(34:36):
Okay, and what I mean by thatis the federal government went
out there and put some broad,sweeping initiatives in place
that basically hurt the ruralhospitals the way it's tied to
your cost-based index, the waythat you're required to qualify
(34:57):
to get a patient in the bed, thefact that they want more
outpatient services and lessinpatient.
But then they pass a series ofbreadcrumbs.
You know rural health clinicreimbursements, 340B program.
You know chronic caremanagement program, remote
patient monitoring program, thisnew rural emergency hospital
(35:21):
program, et cetera, et cetera,et cetera.
And if you stack those up andfollow them, then you can get
back to the house, and that'swhat we've done better than most
people.
I think most people in ruralhealthcare end up lost in the
wilderness and we follow thebreadcrumbs back to the house.
And so, you know, what I'msuggesting is is that between a
(35:44):
combination of knowing thosefactors, being more nimble and
leader-like in our culture,we're able to be successful
enough to survive, but we stillbelieve that Medicaid expansion
or whatever you want to call it,I mean my gosh, we'll call it
the Ronald Reagan healthcareplan, I don't care what you call
(36:08):
it, Just give the hospitalsopportunity to buy into a
program that will pay them backand will allow the patients that
they serve to have some damninsurance?
Speaker 1 (36:24):
Yeah, because it's perpetual.
When you talk aboutimpoverished places, like you
said early on, people are gonnago to the emergency room.
They're going to do what theyhave to do to try to take care
of themselves, regardless ifthey have insurance or funding
or not.
So I mean, I think it makesperfect sense.
Also, you mentioned somethingin describing y'all's model that
(36:48):
I find very interesting.
It sounds like y'all take thelegislation that has been passed
for, however many years as itpertains to rural hospitals and,
to use your terms, y'all stackthem on top of one another,
basically decipher them andensure that you can maximize the
(37:12):
benefit of that legislation forthe rural hospitals and use
them in tandem to gain as muchfunding or maximize the amount
of benefits that you can getfrom that legislation as
possible.
Is that accurate?
Speaker 2 (37:29):
That's exactly right, I would imagine that's.
Speaker 1 (37:33):
Is that labor intensive?
Speaker 2 (37:37):
Well there are a lot of people that work for me that
think I'm crazy, because theysay when do?
Speaker 1 (37:44):
you sleep?
Speaker 2 (37:45):
You know I'm emailing you at one o'clock in the
morning, I'm emailing you at sixo'clock in the morning.
It's like, you know, I've got agood team around me.
Now at this point we've builtout a good set of folks that I
can rely upon.
But yeah, I mean I had thisvision of how this thing could
(38:08):
be done and I've put myselfaround enough people that we can
make it happen.
As we grow to scale.
I mean we're in seven hospitalsright now in three states.
We're about to expand into twoto three more states.
Well, probably four more stateswe're looking at probably being
, you know, 15 to 20 hospitalsby the end of the first quarter
(38:30):
of next year.
So it does make it difficult,but what we're working on is
developing this model that youknow it's not a
one-size-fits-all-e, becauseevery community has their own
special needs.
But we've got the model thatliterally like, let's just say,
(38:56):
there's an apparatus of 12potential tools that we might
apply.
We might apply six of them toone another, six to another or
some combination to another, butwe at least have the whole
thing built out and I call it myone, two, three plan.
I literally know how to beginthe changes that need to be made
(39:18):
and then to implement to get tosuccess.
And then the third piece iskind of that three to five year
strap plan of growth.
And so that's how we do it andyeah, I mean it takes a lot of
work, it's time intensive, ittakes a lot of brain power, but
I thank the good Lord that mymother was a chemistry physics
(39:42):
teacher, so maybe I neverthought with that side of my
brain I didn't think.
But maybe some of these braincells are finally getting into
my head so how long have youbeen CEO of Progressive Health?
So we started out simply justlike buying a hospital here
(40:05):
there, and so I set as the CEO.
Well, first I was a COO atAlliance Health Systems in Holly
Springs for six years and thenI became CEO at Panola Medical
Center for three years and then,when we started growing and
adding these all in, I made surethat we had administrators in
(40:27):
all those sites and I became theCEO of the whole health system.
So CEO of Progressive Healthhas been two years.
Speaker 1 (40:37):
So y'all do actually purchase hospitals and or put in
management to overseeoperations.
Y'all go either way.
Speaker 2 (40:47):
That's correct.
We have apparatuses to do bothand from my perspective, I like
to own them.
I like to have full control sothat I know that what we're
doing will work.
But they're just a certaincircumstances.
(41:09):
Certain county-owned entities,for example, that are not going
to sell but they need to behelped and we have a great team
of people to do that.
So we send out.
I mean, there's a hospital inTennessee we did a RFP for.
We kind of did a hybrid modelin that one where we basically
(41:32):
want to have the operations butthe county is still in the
building and we lease it backfrom them.
So we think outside the box andwe're open to those
conversations and we're willingto engage in those conversations
.
Speaker 1 (41:50):
Let's backtrack a little bit to COVID.
There's a lot of that's also avery convoluted conversation as
it pertains to how hospitalsinteracted with the federal
government throughout that wholeprocess and, the way I
understand it is, the federalgovernment was compensating
hospitals based on a number ofCOVID cases and a number of
(42:13):
COVID cases they reported andthat a lot of COVID cases became
COVID cases that weren't say itwas a broken arm, but the
person also had COVID.
It was reported as a COVIDpositive or whatever a COVID
case.
How convoluted was that entireprocess and is what I'm
(42:38):
describing.
Does it have any validity?
Speaker 2 (42:43):
All right, you're taking me back here.
Hopefully, I want to have PTSDon this conversation.
When this occurred literally, Imean it was crazy, because at
first I was hearing about thisfrom just random sources, like a
(43:08):
Steve Bannon podcast orsomething, where it's like you
thought it was all a conspiracytheory.
Then all of a sudden it becomesreal.
Then it gets so really scary.
This is something that none ofus have ever seen in our
lifetime.
(43:31):
I had two feelings, and theywere mixed feelings.
On one hand, I felt like weneeded, locally and as hospital
operators, to maintain somesense of stability and normalcy
as odd as that may sound tocontinuity of care.
I think that our federalgovernment way overdramatized
(43:57):
the situation to the point thatif you broke your arm, you
couldn't even have a surgeryperformed because, unless it was
COVID related, you justcouldn't see a doctor.
There was a breakdown in thesystem, and there are people
(44:17):
that did not get care for cancer, for cardiac problems, whatever
they may be, for this period ofone year.
I think it ended up, of course,being detrimental to the
overall population.
You got to be able to walk andchew gum I don't know how else
(44:41):
to put it.
I think we failed in thatregard as an overall system.
I will say this and I'm going togive it out to CMS I'm going to
assume that the Trumpadministration had something to
do with it.
I don't know how anotheradministration would have doled
(45:02):
this out, but however it wasdone and whoever did it and I
know some of them are just thebureaucrats that have been there
for ages, but they created aformula.
That formula, the main initialpart, was just based on beds and
objective data.
(45:23):
In some degree there werewhat's called safety net
hospitals that essentially havebeen designated by the federal
government since whatever the50s or whatever, when we were
looking at nuclear bomb typescenarios.
They doled out the money andthey doled it out in block grant
(45:43):
format and very quickly, and itsaved all of us from collapse.
The irony is, if you look atthe dollar amount, especially in
the rural amounts I just wishthey do it that way Forget
Medicaid expansion For apittance of amount of money,
(46:05):
almost all these rural hospitalsthey're losing a million and a
half to $3 million a yearmaximum.
If you just think about that,you throw a couple million
dollars at a rural hospital tosave it If that's what it takes
to keep a hospital open.
(46:28):
But COVID, what we did and Ithought was if there's anything
I'll pat myself on the back onis the mastermind of the way we
created our COVID clinics and wedid the drive-thru clinics.
We were one of the first onesto do that.
It was a one-stop shop.
We also jumped into the fray onthe antibodies.
(46:50):
Everything that was positive wejumped on, and then the things
that we were a little skittishabout we tried to push back.
All being sensible, I don'tknow of any money that we got.
That was like because therenever was any kind of conspiracy
(47:14):
in my offices of like, oh if wedocument this COVID, then we
get more money, or anything likethat.
The main money we got was all inblock grant format early on and
it was devised before all ofthat.
Now, after the fact, what youhad to do is you had to actually
document what all you did, andif you had not performed all of
(47:35):
that, they would actually takeback the money they had given
you and do a clawback, which Ithought was not fair.
Now, in some of these biggersystems some of the things that
you've heard about ways thatthey may have been eligible to
get hundreds and hundreds ofmillions of dollars that may be
true.
That did not happen in therural environments.
Speaker 1 (47:58):
Did y'all and do y'all continue, I assume, to
administer the vaccines?
We do.
Have y'all seen it?
What kind of numbers, kind ofdata have you seen on that,
progressing farther away fromthe actual pandemic itself?
Have you seen numbers onvaccines go up?
Do you have that off the top ofyour head?
Speaker 2 (48:20):
Let me just put it to you like this we're probably
giving 20 flu shot vaccines toevery one COVID vaccine right
now.
From my perspective, when COVIDwas rampantly out there all
(48:40):
across the world and we didn'tknow what the devastating effect
was, someone with an mRNA shotconcept to try to help save that
off, why not try it Right now,unless you have some kind of
susceptibility?
It seems like this thing atleast not going with it at this
(49:06):
point has migrated to a positionof just more common cold issues
.
Other things I had COVID backabout a month ago.
I was shocked that I got it.
It was very real.
It took me out for several daysbut I wasn't hospitalized or
(49:33):
anything.
That nature just needed to restand just get well again.
Speaker 1 (49:40):
It's so difficult, regardless of what issue we're
talking about, for the everydayperson to discern what's real,
what's not, what information canbe trusted, what can't.
I'm following the Israelconflict right now.
It's a dawning task just to tryto determine who's telling us
(50:06):
the semblance of the truth maybenot even the whole truth, but a
little bit.
The thing with COVID was justexacerbated and overdramatized,
as you mentioned, by the media,the federal government.
It sounds like the federalgovernment just over-prioritized
(50:26):
COVID as opposed to anythingelse.
Maybe it was a knee-jerkreaction, but that's what it
sounds like.
It doesn't sound like whatyou're describing is something
nefarious and intent in the wayof doling out money based on
COVID cases as much as it was.
They were just trying toprioritize COVID treatment over
(50:48):
any other types of treatmentduring that time period.
Speaker 2 (50:50):
Yeah, Look, I'm a big fan of the county line and I
think you'd like to shoot thingsstraight, but you also look
into every angle and everypossibility and you're willing
to call bullshit on people thatare going to not shoot you
straight.
I hope I'm not making for aboring podcast by trying to
(51:12):
throw a little water on some ofthese conspiracy theories,
because I certainly believe thatthere was a lot of things that
occurred that were wrong.
There were some power moves byspecific individuals here, and
there there became this wholeculture of pushing people.
(51:34):
You're either the facts or theun-vacs.
But, quentin Whitwell, all I'mtelling you is that I'm a person
that loves everybody.
I love all of God's people.
Sometimes that puts me in aweird position, because they
can't figure out if I'm right orI'm left or what, and I like to
(51:55):
be that way because I'm notanything other than trying to be
just level-headed and be aleader that makes a difference
where I have a lane to run in,and so it wasn't my job to know
what the World HealthOrganization's policy decisions,
(52:16):
how it impacted whatever I mean, that's not my job.
My job was I was supposed to betaking care of people in
Batesville, mississippi, or Marx, mississippi, or Holly Springs,
mississippi, and these peoplewere scared and they were
concerned and they hadlegitimate issues and they were
being told to stay away fromtheir healthcare facilities and
(52:36):
they're all staying at home andthey're all holed up and they're
you know, and they got nosocial interaction.
And they come out of this thingand their mind is screwed up
and they're mad as hell and theytook these shots and they don't
know what it did to them andyou know, somebody's got to just
be like, hey, we're here, we'rehere to help, you know, and
(53:01):
that's what we've been trying todo and that's why we do what we
do and we're passionate aboutit.
But yeah, all these things arereal and we're dealing with it.
But from a just like purelyeconomic standpoint, I've never
seen the federal government actso fast.
We, literally we would show upto the office to check the bank
account and have, you know, apayment dropped, and we wouldn't
(53:23):
.
I mean, you know, we didn't evenknow what their formula was at
the time.
We were kind of going throughthe head and going through the
math and trying to figure outlike, okay, what were they
anticipating?
We learned more about theseformulas as time went on and
some of them were good, some ofthem were bad.
Some of them you know somepeople, I think probably got
more money than needed.
(53:44):
Some probably didn't get enough, but at least they did
disseminate money fast.
What I didn't like I saw acouple of places take, like
COVID money and then go like buytwo or three more failing
hospitals and then they screwedup their own system, you know.
And so there were, there weretimes when people didn't do it
(54:11):
right, but you know, we feltlike we managed it well and we
think that being entrusted andshowing that we were trustworthy
is going to pay off for thelong haul for us as we grow the
system.
Speaker 1 (54:26):
Well, I think it's important for people like you
and I to have publicconversations, and when I say
people like you, and I meaneveryday people, boots on the
ground.
You're in the healthcare system, you have been experiencing
this entire process firsthand,and I think it's uber important
(54:48):
for people that hold positionssimilar to yours to allow, be
allowed to speak unfettered, inthe way you know, in a long form
conversation such as this andto put water on fiery conspiracy
theories, because people don'tknow what to believe, but
they're more likely to trustsomebody that sounds like them.
(55:12):
That's from where they're frommore so than the Washington Post
with a liberal agenda or, youname, you know, the daily wire
with a conservative agenda.
I think it's very important forus to have these conversations,
and I commend you for doing so.
How in the world did you findyourself with this passion?
(55:32):
Is the passion for ruralhealthcare?
Is that something that's alwaysbeen ignited and inside of you,
or did you happen upon thatspontaneously throughout your
life?
Speaker 2 (55:44):
Well, it's funny.
I don't know the fullpsychological answer for that,
but you know I can take you backto when I first got my first
car and I went to governor'sschool and had friends all of a
sudden from all over the stateand they were from all these
small towns.
(56:04):
And you know, you're rolling toa city like Forest, Mississippi
, and visit with a guy namedRyan Simmons who's now a medical
doctor in Jackson and you know,and he introduces me, this cute
little blonde who ended upbecoming my wife.
So you know, I mean.
I just, I like these small townsand I've always liked going
(56:24):
into them and I've always beenfascinated.
They all have their own story,you know, I mean.
And so I mean, like I went intoWayne County, tennessee, two
days ago and I mean they hadthis restaurant that took up
like a whole side of theirsquare and it had like all these
(56:49):
like outdoor seated areas andthey had music blaring and I
mean it's just really cool, like, and I've never heard this
place before my life and a carpulls up with a Massachusetts
tag and I'm like, what are youdoing here?
And they're like, you know, Imean, and so you almost don't
even understand, like you know.
And then you go into a townlike Helena, arkansas.
(57:12):
They've got a $2 billion portproject going on right now.
If they don't have a hospital,that whole thing is going to
collapse.
You know, and you know, I mean,like some of them have kind of
some crazy stories too.
I have one hospital.
(57:33):
I went down there and Ieverybody said it'd be really
nice.
And you know, I googled themand it turns out it was like a
famous murder had happened thereor whatever.
And I'm like, oh, you knowwhat's going on and you know,
but they're wonderful peoplethere and it just, you know, you
just.
But I love small towns.
Small towns are great to go in,they have their own uniqueness.
(57:57):
I mean, just like you said,you're from Philadelphia but you
know good and well.
I mean you know the people inLouisville, you know the people
in Knoxville, you know thepeople in Foresh and people in
Carthage.
You know they're all 45 minutesaway from each other, but they
all have you.
You'd be like oh, that's aperson, oh, yeah, no, no.
I mean you can literally justlike pick it right, and so I
(58:21):
think that's what makes Americaawesome, and so I enjoy it.
I enjoy the back roads.
I enjoy, you know, going tothese places, meeting these
people, hearing their stories.
And you know you mentioned aword early on and before we get
off I wanted to follow up on itand it's our term health equity.
(58:43):
And health equity can mean alot of things to a lot of people
and kind of like you know we'vealready discussed, I'm not here
.
I'm here to call thingsstraight.
I'm not here to be one way oranother on the political
spectrum.
I've been there, done that, I'mold enough now that I can just
call it like I see it.
But I don't care who you are.
If you're, if you're a workingclass white person, working
(59:07):
class African American person,if you know, if you're a no
class anybody, you know I don'tcare who you are.
If you're a person, you deserveto be treated and you know you
deserve to be taken care of andin your health is all you got.
Hopefully you got family behindthat, but you know I can't be
(59:28):
your family, but I could bethere to provide you a healthy
life, and we can.
Also.
You know, I think once peoplestart embracing not only healthy
lives but a healthy lifestyle,then you can really create a
movement.
I mean, you know, my wife hasgotten into yoga over the years
and that's something she teachesand she's, you know, she's
(59:51):
she's so much healthier than youknow I'll ever be.
But you know, those are the kindof things that when you, when
you start committing yourself toyou, start recognizing there's
a better way, and bringing thatto rural places is what is, what
is my passion and that's how Ideveloped it.
(01:00:11):
And you know why that happened.
I can't really tell you, butyou know, I mean I, I had the
opportunity to serve as the citycouncilman for in Jackson,
mississippi, award one,northeast Jackson we used to
call it FNEJ, fashionableNortheast Jackson.
You know and you know.
(01:00:31):
But you know, to me it doesn'tmatter where you're from or who
you represent, it's just amatter of whether you actually,
you know, care and you're tryingto make a difference, and
that's what we do.
Speaker 1 (01:00:44):
Well, I appreciate what what the mission is at
progressive health and whaty'all are doing.
We we need better healthcareaccess in our rural areas and
y'all are addressing that inMississippi and I think I was
speaking with Greta Kemp Martinyesterday.
She's on the Democratic ticketfor attorney general and we were
(01:01:06):
talking about the state ofMississippi and I said I think
our best days are ahead of us inthe not too distant future, and
I think companies likeprogressive health doing the
things that y'all are doing,will only get us there quicker.
So, quinton, again I appreciateyou coming on the county line
and I hope that this will not bethe last time that the county
line congregation gets to hearfrom you.
Speaker 2 (01:01:29):
Well, it's my pleasure, I appreciate it.
Lee, you've done a great job ofyour podcast and I, you know, I
think everyone out therenotices just how hard you're
working at it and you'veactually, you know, you've been
committed to some good contentand and talking about things
that everybody wants to hearabout.
I mean, you know people arepeople want to hear about
(01:01:51):
healthcare, they want to hearabout the you know what's going
on politically.
They want to know about theiryou know sports.
They want to know about themedical marijuana industry.
I mean, I've listened to you ona lot of these different
subjects.
They want to know aboutinternational affairs and that's
no easy feat to to, you know,bone up on.
So I applaud you for what you'redoing and, you know, thankful
(01:02:14):
that we had a mutual contact toget to know you and and
appreciate the fact that youbrought me on and you know I, I,
I now I've got your email, yourphone number, so you know we
won't be strangers and I thinkthere will be some things that
will come down the pike.
And I would just say this as wewrap it up let's watch this
legislative session.
(01:02:34):
I think, with the new speakerand Jason White, I think, I
think we will get some movementfor rural hospitals and for our
hospital industry in general,and I think, after we get past
this political season, here inthe next few weeks, we're going
to see some, some action.
So let's, let's, let's stay ontop of that.
Speaker 1 (01:02:58):
We'll leave it right there, mr Whitwell, once again,
I appreciate it.
Countyline congregation.
Thank you all so much and untilnext time, peace.
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