Tennessee health care modernization task force's proposals won't include 'Band-Aid fixes or political talking points'

Stuart McWhorter

NASHVILLE - With Republican Gov. Bill Lee on Tuesday expected to announce members of his long-awaited "Healthcare Modernization Task Force," his finance commissioner, Stuart McWhorter, says not to expect the group's eventual recommendations to involve "Band-Aid fixes or political talking points.

"We worked to understand some of the root issues preventing us from being a healthier, more prosperous state," McWhorter said in an opinion piece about the months of closed-door meetings with health insurers, providers and various groups to identify issues and themes for task force members to tackle.

That goal, McWhorter said, "was to listen and have candid conversations with Tennesseans who are the closest to the most complex issues in our health care system."

As a result, task force members will be expected to spend considerable time, perhaps years in some cases, as they look at making recommendations to address problems, some of which may be achievable in the short term but others only over the long haul, sometimes taking years.

McWhorter cautioned that "as we have a public discussion about these issues that are connected to this $3.5 trillion national industry, it is important to note, there is no silver bullet that will immediately solve all of the issues we face."

During the administration's "listening tour" phase, officials held four closed-door meetings across the state with insurers, providers and other groups. The list of participants has included Chattanooga-based Erlanger Healthy Services and BlueCross BlueShield of Tennessee. Meetings included a session in Cleveland.

photo Stuart McWhorter

At another meeting in August at the state Capitol, reporters from the Times Free Press and Tennessean were told they couldn't attend.

Gov. Lee announced during his first State of the State address in March that he would form the task force. Commissioners and staff from eight state agencies facilitated discussions alongside private sector experts to explore improving rural health, reducing chronic conditions, improving transparency and helping foster innovation.

McWhorter, who has a master's degree in hospital administration, later worked in the hospital industry as well as for a Nashville-based orthopedic group before joining with his father, Clayton McWhorter, to launch Clayton Associates, a successful Nashville-based healthcare and technology venture capital fund.

In his opinion piece, McWhorter said that as a result of the listening tour, the administration identified a number of key areas surrounding health and health care in Tennessee. They include:

* Transportation: It's a "significant barrier" to care and it's keeping some Tennesseans from having access to a primary care physician or out-patient services, McWhorter writes. That "inevitably leads to medical problems becoming unmanageable."

* Technology, including telehealth, is an "underutilized tool." It could have an impact in issues including mental health, McWhorter says.

* Rural areas: An emphasis of Lee's, residents of rural parts of Tennessee "are hit harder by these issues than other parts of the state," especially when it comes to the lack of medical professionals, McWhorter says.

* Addressing "social determinants of health" such as education and healthy behaviors.

* Medical billing: McWhorter says the issue "is complex and includes some of the largest facets of our health care system. There is no quick solution for this issue, but it is one our state will need to have a detailed conversation about in the months and years ahead."

The naming of the task force comes as Lee, under the direction of fellow Republicans in the General Assembly, seeks a federal waiver of Medicaid rules from the Trump administration. The governor says it will free the state from many restrictions and, critics charge, important safeguards, in how the state operates its $12.1 billion TennCare program for low income children, pregnant women, children's caretakers, seniors and the disabled.

Lee specifically is seeking to convert some $7.9 billion in federal funding in a hybrid block grant from Medicaid.

Critics, including the Tennessee Justice Center, say the state and up to 300,000 low-income adult, working-age Tennesseans would be better served if state officials would expand the existing Medicaid program under the federal Affordable Care Act. Providers, including hospitals, have their own questions.

They argue it would provide an influx of new funds that would help not just rural residents but assist rural hospitals in a state which has seen one of the highest numbers of small-town hospital closures in the nation.

In his successful bid for governor, Lee said he didn't favor Medicaid expansion.

In an interview with the Times Free Press back in August, McWhorter pointed to Ballad Health, an integrated healthcare system serving 29 counties of Northeast Tennessee, Southwest Virginia, Northwest North Carolina and Southeast Kentucky, as having several focuses and initiatives that have caught his eye.

"They don't talk about the fact that they have some rural hospitals in their system that aren't making money. They know they're critical to their system. What they're talking about is how do you educate a population around chronic illnesses, which means you're trying to educate them in awareness of healthy eating habits and exercise."

He also said during the August interview that he sees "an opportunity for larger hospitals to partner with rural hospitals or other health care facilities or providers.

"If you're just a stand-alone hospital, and you don't have any affiliate agreement or you're not part of some larger system, if you're just looking at it as a business, it's a tough business to make money and stay afloat," McWhorter said.

Contact Andy Sher at asher@timesfreepress.com or 615-255-0550. Follow on Twitter @AndySher1.