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Medicaid Who’s Who Interview: Jim McInnis

Jim McInnis is Experienced Chief Executive, CAO, CFO, VP, and Builder of Mission Driven Companies & Relationships. Check out his LinkedIn profile HERE.

1.     Which segment of the industry are you currently involved?

I work with states and MCOs to manage long term care and support services and a variety of waiver programs.

2.     How many years have you been in the Medicaid industry?

Over 20 years, including my consulting and operations leadership roles.  Given how fast things move, the time feels a lot shorter.  It’s terrific!

3.     What is your focus/passion? (Industry related or not)

Having influence and impact in the community.  I often dabble in town politics.  I also like to see people I’ve recruited get promoted and make an impact.

4.     What is the top item on your “bucket list?”

Playing for the Boston Bruins, but that time has well past.  I’d like to do a tour of baseball stadiums with my sons and convince my wife and daughter to attend a couple games too.

5.     What do you enjoy doing most with your personal time?

I’m a gardener.  I could spend hours at a landscape nursery.

6.     Who is your favorite historical figure and why?

The Wright Brothers because despite the competition and failures they remained enthusiastic and committed to achieving.  They put their money and reputations on the line and subjected their work to hundreds of public trials.  Their character outlasted their business ventures.

7.     What is your favorite junk food?

Brownie edges.  Moist, cake-like brownies are over-rated – chewy and crunchy are the best.

8.     Of what accomplishment are you most proud?

After we had triplets, the support from our family that permitted us some sleep and allowed me to wrap-up my MBA.

9.     For what one thing do you wish you could get a mulligan?

My first month driving a car.  Not good when the insurance agent asks, ’you again?’

10.  What are the top 1-3 issues that you think will be important in Medicaid during the next 6 months?

Watching how states will move managed long-term care services to MCOs and how the MCOs will adapt their capabilities to serve consumer direction programs.  Until recently, these programs were untouched by managed care.  States grew the programs and established rules to encourage recruitment and retention of direct care workers.  Under new contracts, MCOs will need to sort out data integrity, provider network and fraud prevention challenges in a politically charged and disruptive environment.  Wage increases and union efforts to organize direct care workers will influence quality.  If you can’t find and keep a good direct care worker, then overall costs go up.  MCOs also will need to test and deploy new electronic visit verification (EVV) fraud tools that states delayed doing this year.