The County Line
The county line is a place traditionally known for being vague, ambiguous, and frequently visited by people who are intrigued by the prospect of viewing life from an unconventional perspective. Episodes include conversations led by host, Lee Carl, and a wide ranging cast of characters. Come join us for genuine hospitality and entertainment on the outskirts of life!
The County Line
#126 - Quentin Whitwell
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...
Listen on: Apple Podcasts Spotify
County Line congregation. I would like all of you to welcome Mr Quinton Whitwell with Progressive Health out of North Mississippi. Y'all are located in Oxford, Is that correct, Quinton? That's correct.
Speaker 2:Oxford is home. Of course. I spent 15 years in Jackson, but we've been back in Oxford almost 10 years now.
Speaker 1:I went to Oxford for the LSU weekend and that's the first time I'd been back up there in probably five or six years, and the level of growth is amazing.
Speaker 2:It's really crazy. When I lived in Jackson, you have your nice white tablecloth restaurants and clients coming in and all this I was always wondering would Oxford be a problem? People get into it and have an international airport, et cetera. Nobody's ever complained about coming to Oxford. We're actually in the middle of building out our headquarters here so that we have all the C-suite level people that are working with us now, as we've grown to make Oxford our headquarters, right here on the historic downtown square. It makes for a great place to work and it makes for a great place to come visit. We enjoy the benefits of Oxford and, of course, just enjoy living here in my hometown and contributing back.
Speaker 1:Yeah, and it's got a ripe environment for the industry that you find yourself in the way of talent and work, finding people to finding good people. I wouldn't imagine it's a difficult task for you being in Oxford and how it's uniquely located, with a very strong and growing medical community and obviously, the college there.
Speaker 2:Yeah. So Nashville is kind of considered the epicenter of the south for healthcare and a lot of people think everything has to be done out of Nashville. I think there are a lot of people very interested and curious about the fact of what we're doing in Mississippi. For me, obviously, we're passionate about rural healthcare. We're passionate about rural places, not just what we do inside the four walls of a hospital, but also why those communities are stagnant or losing population, how we can contribute to their overall success. And so you know, oxford obviously is a robust small town, but we just like being committed to being in a small town.
Speaker 1:So, leading into what progressive health does and the mission of progressive health group, can you shed some light on that for us?
Speaker 2:Yeah, so you know, I graduated from Ole Miss Law School back in 98. I started practicing law and ultimately ended up building up a lobbying firm and use that level of political interaction. And, you know, legislation changes, policy changes to my advantage, for clients. And ultimately, when I was asked by Dr Kenneth Williams to help him in his small rural hospital in Holly Springs, mississippi, I found something I could be passionate about and that's what motivates me every day.
Speaker 2:And we went from, you know, trying to make sure we made it as successful as we could, to then buying PANOLA in Batesville and then reopening the hospital in Marks, mississippi, which is a critical access, and then taking over the clinics for Tunica County and then engaging with Jefferson County over in Fayette in their hospital, and then expanding into Alabama, in Thomasville, alabama, and then into Georgia, in Ossilla, georgia, at the Irwin County Hospital. And now we've got purchase and sale agreements out there for hospitals in Arkansas, tennessee Moore in Alabama and in Texas. So we're just growing. We're growing because we think that we understand the landscape of rural health care, we know how to do things more efficiently, better. We believe that our leadership model and the culture that we create is what makes us different. And then the brand new designation of rural emergency hospital with a federal subsidy and a higher reimbursement for outpatient services has proven that we understand a unique nature and we've got the right people around us to be able to grow, so we're really excited about it.
Speaker 1:So it sounds to me like y'all have a model in mind that y'all implement when y'all go into these rural hospitals, these rural areas, into these hospitals, and it sounds to me like what y'all task yourselves with doing is ensuring that the operations and the management of those hospitals are done in a way that becomes profitable for that hospital. Is that accurate to say? Is that y'all's mission?
Speaker 2:Absolutely Obviously. You can't continue to run a hospital if you can't get it to profitability. There's always charitable components that are a part of health care and taking care of your community and your population. I like to say that we're the Chick-fil-A of health care. It's my pleasure, it's how can I help you? We bring a whole new set of service to this industry. When I go into a building and start engaging with our employees, that become under our banner. We talk about the fact that you need to be heads up as you're walking through the halls. Anybody that you're in contact with within six feet that you greet, whether they're a patient, a visitor or a co-worker. Get your eyes off your cell phone while you're walking through the halls. Be engaged and just demonstrate a level of care that people have gotten to not expecting it longer. When you do that, people will talk about that. They will be glad to come back.
Speaker 2:Rural hospitals often are cleaner, safer, better for service than the big ones A lot of these big ones. I like to say you could roll a bowling ball down the hallway and not hit anybody. As far as staff goes, because they're so understaffed. In a rural, smaller hospital you obviously have to have a certain level of FTEs or full-time employees. There, I personally think that there's an environment where rules can survive and thrive. I think also a lot of that is in the way that we bring outpatient services to the public. In the future, as we grow, we are developing national groups that will come in in a plug-and-play format and bring things like orthopedics or wellness or physical therapy or mental health evaluations or wound care or pain management. All of these things are things that we can do and we have partners in place to perform and to provide for.
Speaker 1:There's a lot of talk about Medicaid expansion, particularly in Mississippi and other red states. Tate Reeves, our governor, has stated that he's against Medicaid expansion. In his words, he basically calls it welfare. His stance is he doesn't believe in bringing more people of Mississippi onto the welfare roles at the crux of the issue when it comes to rural hospitals. What would you say if you had to assess the scenario and provide a reasoning for why so many of these rural hospitals are struggling financially? If there was one issue, or a couple of issues that are contributing most to that happening, what would you attribute that to?
Speaker 2:Well, first of all, let me say I supported Tate Reeves in 2003 when he had three people in a primary running against him for state treasure. When you are one of the first people to support somebody, you make sure you stay in good stead. I'm a supporter of the governor on a personal level and I also have found him to be thoughtful about a lot of things and to the extent that I think there are some changes that need to be made at this point, I think we're going to get a new dynamic with a new speaker of the House, with Governor Hoesman being reelected, I personally believe it is time for the state of Mississippi to act. I also think that our Mississippi Economic Council needs to get involved and they need to let the state of Mississippi legislature understand that the business community cannot thrive in a town like Houston, mississippi, for example, that doesn't even have an emergency room open and, at the same time, has a thriving manufacturing department. So how are we going to not have a working hospital and still be able to grow in those communities? I personally think that some of the windows of Medicaid expansion have already been missed. The states that early adopted got a lot of disproportionate share money early on.
Speaker 2:I am not necessarily optimistic that this enhancement formula that the governor has laid out is actually going to be approved or if it will actually bring the amount of revenues that are projected, but certainly we would like to try and see. I hope that that submission has already been made. I don't know that. I do know that the state Medicaid department has been talking to a lot of us about getting ready for the enhancement portion and what all that's going to entail, so that's a good sign. The state funding that was passed last year was not done in the right way. It was tied to ARPA funds that we had already been reimbursed for, so the legislature is going to have to fix that next year.
Speaker 2:I believe the state of Alabama is going for Medicaid expansion. I think their business community is all forward. I think they're going to call it some other name, maybe even do it in a block grant format. But I'm very curious what Alabama is going to do. I think Georgia is putting their toe in the water. Of course Arkansas has already done it, louisiana has done it. You can see the proof right there they have less hospitals that are closing.
Speaker 1:So the reluctance to me seems mostly for political reasons, as opposed to thinking it's best for the patients and the access to health care in these rural communities. When I read not being an expert, not even close, in health care and or legislation, but when I read press releases and articles trying to decipher and determine what Medicaid expansion means, the pros and the cons of it, it's a very convoluted conversation for the average person, in my view. What does Medicaid expansion entail? What does that phrase mean to you?
Speaker 2:Yeah. So, first of all, I have said for years, if I was in the oil and gas business and I walked into any governor's office and said, governor, we're going as a group to put a dollar out there and the federal government is going to give us $5 back, they would be like where did I sign? Give me a pen right now. So why, in the world, when we're dealing with healthcare, which is playing with people's lives and they're literally whether they're healthy and safe or not, why are we rejecting that? And unfortunately, you are correct.
Speaker 2:Politics is to blame, because it started off as the Affordable Care Act under President Obama. It's just like any piece of legislation. There are parts of it that were not palatable and that a lot of people did not like, and they thought that it was essentially pushing us toward what you call a one-payer system, which has not really been the net effect, by the way. And so then you get the House Republicans. Every single ad for the last 10 years has been I'm voting to repeal Obamacare. Well, guess what? We've already been through a Republican president. Since then, we've got a different president. Now, who knows who our president is going to be in two years from now? Let's quit talking about the Obamacare component and let's just talk about the policy of where we're at, and let's be realistic.
Speaker 2:Basically, what it is, lee, is the industry puts up a certain amount of money and the federal government reimburses that back at $4 to $5 for every dollar they put in. And we already have a formula called MAP, the Hospital Assessment Program, where this is already being done. Now the other side of Medicaid expansion is also for the patient, and this is the part where we get into these conversations about welfare and this and the other, and this is where I just disagree with my opponents on this. If I don't care who you are, if you live in Mississippi, you deserve access to health care, at least at some level, and you're already going to show up in the ER anyway, whether you have some form of insurance or not. So why in the world will we not put these people on some sort of program that the people that are treating them are going to be reimbursed for the services they're providing? They're coming anyway.
Speaker 1:Yes, and that's a question that I have in regards to these rural hospitals.
Speaker 1:I get why, on a basic level, why they're struggling financially, because in rural areas, for the most part, you're dealing with an impoverished population and they don't have the means, as the citizens in a more affluent area may, to have insurance because of lack of access to jobs that provide benefits, so forth and so on.
Speaker 1:There are a multitude of different reasons that contribute to these people being poor, but, as you mentioned, that doesn't mean that they shouldn't have the access to the health care because they are going to go to the ER when an emergency happens and then that hospital is on the hook for that uncompensated care, and that's just counterintuitive to the way one becomes profitable. So it sounds to me like the federal government's willing to match a certain amount of dollars, or more than match a certain amount of dollars put up by. My one question is who puts that money up? You mentioned the industry puts the money up, but then, number two after whoever puts the money up, and then we don't accept the dollars from the federal government. What happens to that money if it's not used by us in the way of Medicaid expansion? Does it just burn off?
Speaker 2:Yeah, so yeah, each hospital is assessed a tax. They write their check to Medicaid 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, but it's just the way it works you have to put in before you get back. So that's the way this program would work at a little bit of a higher level.
Speaker 2:Now to your point about where does the money go. I mean, look, do I agree that we should have an $18 trillion federal deficit? No, I do not. But at the same time, if California and New York and Washington State and Louisiana are taking full advantage of a federal program to get money that is supplied into their population to prop up their rural health care and we're not, we're just being hardheaded, to make a point. I mean, I don't know anybody in Mississippi that wants to stand on a proposition of, hey, we didn't spend as much federal dollars as California did, and the reality of it is our rural hospitals cratered because we didn't have the ability to keep them open, while, as everybody else, took full advantage of it and everybody else is fine and thriving. And what I don't understand is why rural areas, which are the most important to the heartbeat of America, would be the ones that we would pick on. I mean, I understand that most people live in Jackson or on the Gulf Coast or near the Memphis metro area. I get that and I've lived in some of those places actually all of those places myself at some point in my life or career.
Speaker 2:But Greenwood, mississippi, to not be able to deliver babies any longer. Do you know how far people have to drive to deliver a baby in the Mississippi Delta right now? You got Clarksdale and Greenville and then you got, of course, your lower Delta, like Vicksburg, natchez. All those other people, I mean they're either going to Jackson, maybe Oxford. I mean you know we're talking two and a half, three hour drives for these people to deliver a child and what's happening is a lot of them are being delivered in the ERs, which is not exactly safe and scary and it's uncalled for and you know so.
Speaker 2:You know we put in a bid for the Greenwood LaFleur Hospital. We're hoping that we're gonna get it. You know that hospital had tens and tens of millions of dollars in the bank just not even too long ago. I can't help but think a lot of it has been based on leadership, but also just, the times have changed and we're good at operating under the 2023 world as opposed to the, you know, 1984 model, and so that's where we can make a difference and I'm hoping we're gonna be able to do it. And I also think that we need to look outside the box at things like I mean, maybe even I've offered to set up a birthing center in the Delta, wanted to do it in Belzona, mississippi. I had some people that were interested there. You know that would be a much better, safer way to deliver babies than you know, than what's going on right now.
Speaker 1:Yeah, I think we're dealing with a couple of different components in these rural areas. It's no secret that typically, rural areas experience decreasing population over time. I think that's one of the major contributing factors, in addition to there just not being any jobs in these rural areas. But there are still people there and all people matter and, as you have said, all Mississippians deserve equitable access to health care. When you go into these rural places, quentin, what do you see as being the outside from the decreasing population and the poverty? What do you see as being the biggest contributing factor to these hospitals from an operational standpoint not being adequate?
Speaker 2:Well, I do believe there has to be a level of trust with the community. A lot of times they don't even know what services are provided inside their own small town rural hospital. They just assumed that they need to drive, you know, an hour and a half to some bigger facility to get something done, Even things as simple as, like you know, blood work or lab work. So there's a level of explaining and marketing to the public and outlining that there's. Also, just at the end of the day, just to be really candid, there are a lot of hospitals that are not doing things the way they need to be done to engage the public. So when we come in with a different model and a different attitude, it's kind of like the old adage of you know the restaurant's not doing very well and put up a sign that says under new management, you know we bring this refreshing new life there, but if we don't, take full advantage of it.
Speaker 2:You know there may not be the excitement that needs to be generated, so you know.
Speaker 2:But this is what I would say at the end of the day, rural areas are the backbone of our community and, yes, people are migrating to a lot of bigger areas, but I think a lot of people are migrating back to the rural areas. You know that they can work at home a lot of times now. They don't mind traveling a little bit further to work if they're going to go home and be peaceful out on. You know they may not be their back 40, but they're back. You know, couple acres or whatever. And so you know you need to have good school systems, you need to have at least some kind of financial component, like banking or industry, and you got to have healthcare and you got to have a hospital. And with this new rural emergency hospital methodology that we are bringing into play, I think we are making a big impact and I'm very pleased with the fact that we're digging into these areas and helping save jobs in those places and give people an excuse to want to come back.
Speaker 1:Yeah, and another component of the potential of Medicaid expansion that I really like is number one if you make something profitable, you're going to spur growth. If you spur growth, you're going to need more people to work. More people to work is going to mean more jobs. So I mean, I think, just on its face, if the federal government is going to allot this money, I think by not taking advantage of it, that we are disallowing a lot of people that need healthcare and access to it from getting it. These rural hospitals, for example. I'm in Philadelphia, mississippi. We have a general hospital. I think it's a pretty good hospital. I think it could be better, but there's always room for improvement, right, but for a small town, it does what we need it to do. A place like Neshoba General who owns a hospital like that? Like, is that a private, for example, neshoba General Is that a private entity? Is that a public entity For most of these small rural hospitals, are they private, public? Who owns them?
Speaker 2:It's a good question. I had somebody say to me I've never met an individual that actually owns a hospital. It's a little unique. So basically and I don't know about Neshoba General I mean to be honest with you, I know where. I mean I've been to Philadelphia, obviously Mississippi, but it's never really. I guess that's a good thing. You don't really hear about it. So there's no drama. That's positive.
Speaker 2:My guess is it probably has some sort of county-owned component A lot of these smaller hospitals have. Usually what happens is they set up like a healthcare board and that healthcare board is actually established from the county board of supervisors. So, like in Jefferson County and Fayette, mississippi that we are working with, the board of supervisors puts all of the board members of the hospital on and then they operate independently, but it's a county-owned facility. Over time, because of whatever people, there's a lot of reason why county facilities don't work right. First of all, you're probably hiring people because of political purposes. A lot of times, unfortunately, you also have people that don't really know about hospital business that are running it. So a lot of times some of these will become distressed assets and then they'll end up on the market for sale. So that's one way they end up in private hands.
Speaker 2:Okay, sometimes they operate in a not-for-profit scenario, sometimes they operate in a for-profit scenario. We've worked in both models over time and it just really depends on where we are and why it would be better for one than the other. But you know, and then you get your big systems and like, if you go into states like South Carolina and North Carolina, almost every hospital that's still alive has been affiliated with by some larger system and it's a part of a hub-and-spoke model and there's very few independents that are left. So that's kind of. I mean, honestly, we as an individual group go in and identify these hospitals that are for purchase, but they are few and far between and then some of them we manage. I mean, several of the ones we manage are county-owned and we just are the ones that make sure it's profitable.
Speaker 1:I see, I see, yeah, it's an interesting discussion when talking about access to healthcare, because we look at the public services that our country has traditionally provided, particularly public education. And then you, you know, when I first, when I was going to college, I started asking myself in my early 20s, really started diving into how our country has determined what is a utility and what is a and what is not. You know what? What is the government responsible for providing? What are they not responsible for? For providing? What should taxpayer dollars be used for? What shouldn't taxpayer dollars be used for? And, just like education, I think that there is room for the public and private sectors to be involved in healthcare. Now, having said that is, do you think there's a misconception on the part of just average people when they hear the term Medicaid expansion and they automatically associate that with socialized medicine? Is Medicaid expansion, in your mind, a form of socialized medicine or is it just simply a financial gift from the government?
Speaker 2:I don't think it's either one. I think I think that no one is perfect in terms of how they put policy forth right, but I think we are in an era of wedge driving that if if you say the sky is blue, I'm going to say the sky is purple, and it's just absolutely ridiculous. We, the, the, the United States of America is not going to be a one payer system. That's not going to happen and anybody's scared. Anybody to make that, to make them think it's going to happen, is wrong. However, on the flip side, the actual payers are voluntarily following Medicare fee schedules to basically look just like Medicare themselves, because it makes them more profitable. You know used to if Medicare reimbursed for a service at $100. An insurance, private insurance company might reimburse 250. Now if Medicare says it's $100, they're gonna say it's $100 for 110, 120, whatever, maybe some little minimal additional thing, even though people are paying in.
Speaker 2:So, to the extent that our multi-tier payer system is crumbling, it's the insurance industry's own decisions to do that, and so to punish your average Joe Q Public for something that is happening in terms of that big pharma and big insurance and these major multi-billion dollar corporations are in the middle of doing to themselves doesn't make any sense to me, and the problem is the public is not educated. They hear a sound bite and they just think, oh, that's a bad thing, and they don't understand. And it's our job to let people know that. Hey, let's put it like this If I'm an average person in small town America and my dollar can go toward my local hospital or it could go toward a major insurance company out of this international or whatever, where do you want that dollar to go to? Certainly you want it to go back at the local level, I mean there was a bill last year there was.
Speaker 2:I mean, don't give me name and names, Lee, but because of all the prior authorizations that are required. Now it's like they're slapping these doctors' hands, like. I mean, like a doctor's gonna write an order that isn't needed? Give me a break. It's just a way to deny 200 or more million dollars a year in claims on a technicality for some paperwork, and that's the kind of stuff that we're dealing with in the industry and I guarantee you this. The small town rural hospital is not the culprit. No, absolutely not.
Speaker 1:So like what is the proposition for people that are adamantly opposed to implementing Medicaid expansion? Like what is the option to? You mentioned that y'all have a model, that y'all can improve rural hospitals without the influx of Medicaid expansion money. So what did those propositions look like? To improve these rural hospitals without the influx of the Medicaid expansion money?
Speaker 2:Well, you know, this is where my law and policy background comes in handy, and now that I'm a hospital operator, we literally look at every single breadcrumb that is out there. The way I describe it when asked publicly or privately to anyone is that we're using the Hansel and Gretel model. Okay, and what I mean by that is the federal government went out there and put some broad, sweeping initiatives in place that basically hurt the rural hospitals the way it's tied to your cost-based index, the way that you're required to qualify to get a patient in the bed, the fact that they want more outpatient services and less inpatient. But then they pass a series of breadcrumbs. You know rural health clinic reimbursements, 340B program. You know chronic care management program, remote patient monitoring program, this new rural emergency hospital program, et cetera, et cetera, et cetera. And if you stack those up and follow them, then you can get back to the house, and that's what we've done better than most people.
Speaker 2:I think most people in rural healthcare end up lost in the wilderness and we follow the breadcrumbs back to the house. And so, you know, what I'm suggesting is is that between a combination of knowing those factors, being more nimble and leader-like in our culture, we're able to be successful enough to survive, but we still believe that Medicaid expansion or whatever you want to call it, I mean my gosh, we'll call it the Ronald Reagan healthcare plan, I don't care what you call it, Just give the hospitals opportunity to buy into a program that will pay them back and will allow the patients that they serve to have some damn insurance?
Speaker 1:Yeah, because it's perpetual. When you talk about impoverished places, like you said early on, people are gonna go to the emergency room. They're going to do what they have to do to try to take care of themselves, regardless if they have insurance or funding or not. So I mean, I think it makes perfect sense. Also, you mentioned something in describing y'all's model that I find very interesting. It sounds like y'all take the legislation that has been passed for, however many years as it pertains to rural hospitals and, to use your terms, y'all stack them on top of one another, basically decipher them and ensure that you can maximize the benefit of that legislation for the rural hospitals and use them in tandem to gain as much funding or maximize the amount of benefits that you can get from that legislation as possible. Is that accurate?
Speaker 2:That's exactly right, I would imagine that's.
Speaker 1:Is that labor intensive?
Speaker 2:Well there are a lot of people that work for me that think I'm crazy, because they say when do?
Speaker 1:you sleep?
Speaker 2:You know I'm emailing you at one o'clock in the morning, I'm emailing you at six o'clock in the morning. It's like, you know, I've got a good team around me. Now at this point we've built out a good set of folks that I can rely upon. But yeah, I mean I had this vision of how this thing could be done and I've put myself around enough people that we can make it happen. As we grow to scale. I mean we're in seven hospitals right now in three states. We're about to expand into two to three more states. Well, probably four more states we're looking at probably being, you know, 15 to 20 hospitals by the end of the first quarter of next year.
Speaker 2:So it does make it difficult, but what we're working on is developing this model that you know it's not a one-size-fits-all-e, because every community has their own special needs.
Speaker 2:But we've got the model that literally like, let's just say, there's an apparatus of 12 potential tools that we might apply. We might apply six of them to one another, six to another or some combination to another, but we at least have the whole thing built out and I call it my one, two, three plan. I literally know how to begin the changes that need to be made and then to implement to get to success. And then the third piece is kind of that three to five year strap plan of growth. And so that's how we do it and yeah, I mean it takes a lot of work, it's time intensive, it takes a lot of brain power, but I thank the good Lord that my mother was a chemistry physics teacher, so maybe I never thought with that side of my brain I didn't think. But maybe some of these brain cells are finally getting into my head so how long have you been CEO of Progressive Health?
Speaker 2:So we started out simply just like buying a hospital here there, and so I set as the CEO. Well, first I was a COO at Alliance Health Systems in Holly Springs for six years and then I became CEO at Panola Medical Center for three years and then, when we started growing and adding these all in, I made sure that we had administrators in all those sites and I became the CEO of the whole health system. So CEO of Progressive Health has been two years.
Speaker 1:So y'all do actually purchase hospitals and or put in management to oversee operations. Y'all go either way.
Speaker 2:That's correct. We have apparatuses to do both and from my perspective, I like to own them. I like to have full control so that I know that what we're doing will work. But they're just a certain circumstances. Certain county-owned entities, for example, that are not going to sell but they need to be helped and we have a great team of people to do that. So we send out. I mean, there's a hospital in Tennessee we did a RFP for. We kind of did a hybrid model in that one where we basically want to have the operations but the county is still in the building and we lease it back from them. So we think outside the box and we're open to those conversations and we're willing to engage in those conversations.
Speaker 1:Let's backtrack a little bit to COVID. There's a lot of that's also a very convoluted conversation as it pertains to how hospitals interacted with the federal government throughout that whole process and, the way I understand it is, the federal government was compensating hospitals based on a number of COVID cases and a number of COVID cases they reported and that a lot of COVID cases became COVID cases that weren't say it was a broken arm, but the person also had COVID. It was reported as a COVID positive or whatever a COVID case. How convoluted was that entire process and is what I'm describing. Does it have any validity?
Speaker 2:All right, you're taking me back here. Hopefully, I want to have PTSD on this conversation. When this occurred literally, I mean it was crazy, because at first I was hearing about this from just random sources, like a Steve Bannon podcast or something, where it's like you thought it was all a conspiracy theory. Then all of a sudden it becomes real. Then it gets so really scary. This is something that none of us have ever seen in our lifetime.
Speaker 2:I had two feelings, and they were mixed feelings. On one hand, I felt like we needed, locally and as hospital operators, to maintain some sense of stability and normalcy as odd as that may sound to continuity of care. I think that our federal government way overdramatized the situation to the point that if you broke your arm, you couldn't even have a surgery performed because, unless it was COVID related, you just couldn't see a doctor. There was a breakdown in the system, and there are people that did not get care for cancer, for cardiac problems, whatever they may be, for this period of one year. I think it ended up, of course, being detrimental to the overall population. You got to be able to walk and chew gum I don't know how else to put it. I think we failed in that regard as an overall system.
Speaker 2:I will say this and I'm going to give it out to CMS I'm going to assume that the Trump administration had something to do with it.
Speaker 2:I don't know how another administration would have doled this out, but however it was done and whoever did it and I know some of them are just the bureaucrats that have been there for ages, but they created a formula. That formula, the main initial part, was just based on beds and objective data. In some degree there were what's called safety net hospitals that essentially have been designated by the federal government since whatever the 50s or whatever, when we were looking at nuclear bomb type scenarios. They doled out the money and they doled it out in block grant format and very quickly, and it saved all of us from collapse. The irony is, if you look at the dollar amount, especially in the rural amounts I just wish they do it that way Forget Medicaid expansion For a pittance of amount of money, almost all these rural hospitals they're losing a million and a half to $3 million a year maximum. If you just think about that, you throw a couple million dollars at a rural hospital to save it If that's what it takes to keep a hospital open.
Speaker 2:But COVID, what we did and I thought was if there's anything I'll pat myself on the back on is the mastermind of the way we created our COVID clinics and we did the drive-thru clinics. We were one of the first ones to do that. It was a one-stop shop. We also jumped into the fray on the antibodies. Everything that was positive we jumped on, and then the things that we were a little skittish about we tried to push back. All being sensible, I don't know of any money that we got. That was like because there never was any kind of conspiracy in my offices of like, oh if we document this COVID, then we get more money, or anything like that.
Speaker 2:The main money we got was all in block grant format early on and it was devised before all of that. Now, after the fact, what you had to do is you had to actually document what all you did, and if you had not performed all of that, they would actually take back the money they had given you and do a clawback, which I thought was not fair. Now, in some of these bigger systems some of the things that you've heard about ways that they may have been eligible to get hundreds and hundreds of millions of dollars that may be true. That did not happen in the rural environments.
Speaker 1: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 of data have you seen on that, progressing farther away from the actual pandemic itself? Have you seen numbers on vaccines go up? Do you have that off the top of your head?
Speaker 2:Let me just put it to you like this we're probably giving 20 flu shot vaccines to every one COVID vaccine right now. From my perspective, when COVID was rampantly out there all across the world and we didn't know what the devastating effect was, someone with an mRNA shot concept 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 at least not going with it at this point has migrated to a position of just more common cold issues. Other things I had COVID back about a month ago. I was shocked that I got it. It was very real. It took me out for several days but I wasn't hospitalized or anything. That nature just needed to rest and just get well again.
Speaker 1:It's so difficult, regardless of what issue we're talking about, for the everyday person to discern what's real, what's not, what information can be trusted, what can't. I'm following the Israel conflict right now. It's a dawning task just to try to determine who's telling us the semblance of the truth maybe not even the whole truth, but a little bit. The thing with COVID was just exacerbated and overdramatized, as you mentioned, by the media, the federal government. It sounds like the federal government just over-prioritized COVID as opposed to anything else. Maybe it was a knee-jerk reaction, but that's what it sounds like. It doesn't sound like what you're describing is something nefarious and intent in the way of doling out money based on COVID cases as much as it was. They were just trying to prioritize COVID treatment over any other types of treatment during that time period.
Speaker 2:Yeah, Look, I'm a big fan of the county line and I think you'd like to shoot things straight, but you also look into every angle and every possibility and you're willing to call bullshit on people that are going to not shoot you straight. I hope I'm not making for a boring podcast by trying to throw a little water on some of these conspiracy theories, because I certainly believe that there was a lot of things that occurred that were wrong. There were some power moves by specific individuals here, and there there became this whole culture of pushing people. You're either the facts or the un-vacs.
Speaker 2:But, quentin Whitwell, all I'm telling you is that I'm a person that loves everybody. I love all of God's people. Sometimes that puts me in a weird position, because they can't figure out if I'm right or I'm left or what, and I like to be that way because I'm not anything other than trying to be just level-headed and be a leader that makes a difference where I have a lane to run in, and so it wasn't my job to know what the World Health Organization's policy decisions, how it impacted whatever I mean, that's not my job.
Speaker 2:My job was I was supposed to be taking care of people in Batesville, mississippi, or Marx, mississippi, or Holly Springs, mississippi, and these people were scared and they were concerned and they had legitimate issues and they were being told to stay away from their healthcare facilities and they're all staying at home and they're all holed up and they're you know, and they got no social interaction. And they come out of this thing and their mind is screwed up and they're mad as hell and they took these shots and they don't know what it did to them and you know, somebody's got to just be like, hey, we're here, we're here to help, you know, and that's what we've been trying to do and that's why we do what we do and we're passionate about it. But yeah, all these things are real and we're dealing with it. But from a just like purely economic standpoint, I've never seen the federal government act so fast. We, literally we would show up to the office to check the bank account and have, you know, a payment dropped, and we wouldn't.
Speaker 2:I mean, you know, we didn't even know what their formula was at the time. We were kind of going through the head and going through the math and trying to figure out like, okay, what were they anticipating? We learned more about these formulas as time went on and some of them were good, some of them were bad. Some of them you know some people, I think probably got more money than needed. Some probably didn't get enough, but at least they did disseminate money fast. What I didn't like I saw a couple of places take, like COVID money and then go like buy two or three more failing hospitals and then they screwed up their own system, you know. And so there were, there were times when people didn't do it right, but you know, we felt like we managed it well and we think that being entrusted and showing that we were trustworthy is going to pay off for the long haul for us as we grow the system.
Speaker 1:Well, I think it's important for people like you and I to have public conversations, and when I say people like you, and I mean everyday 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 for people that hold positions similar to yours to allow, be allowed to speak unfettered, in the way you know, in a long form conversation such as this and to put water on fiery conspiracy theories, because people don't know what to believe, but they're more likely to trust somebody that sounds like them. That's from where they're from more so than the Washington Post with a liberal agenda or, you name, you know, the daily wire with a conservative agenda. I think it's very important for us to have these conversations, and I commend you for doing so. How in the world did you find yourself with this passion? Is the passion for rural healthcare? Is that something that's always been ignited and inside of you, or did you happen upon that spontaneously throughout your life?
Speaker 2:Well, it's funny. I don't know the full psychological answer for that, but you know I can take you back to when I first got my first car and I went to governor's school and had friends all of a sudden from all over the state and they were from all these small towns. And you know, you're rolling to a city like Forest, Mississippi, and visit with a guy named Ryan Simmons who's now a medical doctor in Jackson and you know, and he introduces me, this cute little blonde who ended up becoming my wife. So you know, I mean.
Speaker 2:I just, I like these small towns and I've always liked going into them and I've always been fascinated. They all have their own story, you know, I mean. And so I mean, like I went into Wayne County, tennessee, two days ago and I mean they had this restaurant that took up like a whole side of their square and it had like all these like outdoor seated areas and they had music blaring and I mean it's just really cool, like, and I've never heard this place before my life and a car pulls up with a Massachusetts tag and I'm like, what are you doing here? And they're like, you know, I mean, and so you almost don't even understand, like you know. And then you go into a town like Helena, arkansas. They've got a $2 billion port project 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.
Speaker 2:I went down there and I everybody said it'd be really nice. And you know, I googled them and it turns out it was like a famous murder had happened there or whatever. And I'm like, oh, you know what's going on and you know, but they're wonderful people there and it just, you know, you just. But I love small towns. Small towns are great to go in, they have their own uniqueness. I mean, just like you said, you're from Philadelphia but you know good and well. I mean you know the people in Louisville, you know the people in Knoxville, you know the people in Foresh and people in Carthage. You know they're all 45 minutes away from each other, but they all have you. You'd be like oh, that's a person, oh, yeah, no, no.
Speaker 2:I mean you can literally just like pick it right, and so I think that's what makes America awesome, and so I enjoy it. I enjoy the back roads. I enjoy, you know, going to these places, meeting these people, hearing their stories. And you know you mentioned a word early on and before we get off I wanted to follow up on it and it's our term health equity. And health equity can mean a lot of things to a lot of people and kind of like you know we've already discussed, I'm not here. I'm here to call things straight. I'm not here to be one way or another on the political spectrum. I've been there, done that, I'm old enough now that I can just call it like I see it.
Speaker 2:But I don't care who you are. If you're, if you're a working class white person, working class African American person, if you know, if you're a no class anybody, you know I don't care who you are. If you're a person, you deserve to be treated and you know you deserve to be taken care of and in your health is all you got. Hopefully you got family behind that, but you know I can't be your family, but I could be there to provide you a healthy life, and we can. Also. You know, I think once people start embracing not only healthy lives but a healthy lifestyle, then you can really create a movement. I mean, you know, my wife has gotten into yoga over the years and that's something she teaches and she's, you know, she's she's so much healthier than you know I'll ever be.
Speaker 2:But you know, those are the kind of things that when you, when you start committing yourself to you, start recognizing there's a better way, and bringing that to rural places is what is, what is my passion and that's how I developed it. And you know why that happened. I can't really tell you, but you know, I mean I, I had the opportunity to serve as the city councilman for in Jackson, mississippi, award one, northeast Jackson we used to call it FNEJ, fashionable Northeast Jackson. You know and you know. But you know, to me it doesn't matter where you're from or who you represent, it's just a matter of whether you actually, you know, care and you're trying to make a difference, and that's what we do.
Speaker 1:Well, I appreciate what what the mission is at progressive health and what y'all are doing. We we need better healthcare access in our rural areas and y'all are addressing that in Mississippi and I think I was speaking with Greta Kemp Martin yesterday. She's on the Democratic ticket for attorney general and we were talking about the state of Mississippi and I said I think our best days are ahead of us in the not too distant future, and I think companies like progressive health doing the things that y'all are doing, will only get us there quicker. So, quinton, again I appreciate you coming on the county line and I hope that this will not be the last time that the county line congregation gets to hear from you.
Speaker 2:Well, it's my pleasure, I appreciate it. Lee, you've done a great job of your podcast and I, you know, I think everyone out there notices just how hard you're working at it and you've actually, you know, you've been committed to some good content and and talking about things that everybody wants to hear about. I mean, you know people are people want to hear about healthcare, they want to hear about the you know what's going on politically. They want to know about their you know sports. They want to know about the medical marijuana industry. I mean, I've listened to you on a lot of these different subjects. They want to know about international affairs and that's no easy feat to to, you know, bone up on.
Speaker 2:So I applaud you for what you're doing and, you know, thankful that we had a mutual contact to get to know you and and appreciate the fact that you brought me on and you know I, I, I now I've got your email, your phone number, so you know we won't be strangers and I think there will be some things that will come down the pike. And I would just say this as we wrap it up let's watch this legislative session. I think, with the new speaker and Jason White, I think, I think we will get some movement for rural hospitals and for our hospital industry in general, and I think, after we get past this political season, here in the next few weeks, we're going to see some, some action. So let's, let's, let's stay on top of that.
Speaker 1:We'll leave it right there, mr Whitwell, once again, I appreciate it. Countyline congregation. Thank you all so much and until next time, peace.