This article originally appeared in the Fall 2019 edition of The Missouri Times Magazine.
After zip-zapping through rows of cubicles — a guide is necessary for newcomers — at the Howerton State Office Building, there is an office with a whiteboard that looks more suited for an episode of “The Big Bang Theory” than a state bureaucrat.
Kirk Mathews — who is a fan of the decade-long sitcom — uses the dry erase board in his relatively new office to work out problems in Missouri’s Medicaid program. The former lawmaker is the head of the newly created Medicaid Office of Transformation.
“I could not be more excited about the job. I really do love the work,” Mathews said. “I get to marry my career passions with an opportunity to help the state.”
As the chief transformation officer, the Pacific native is tasked with making improvements to the multi-billion dollar state health care program, MO HealthNet. The Office of Transformation operates outside, but parallel to, the state Medicaid office, and Mathews answered directly to MO HealthNet Director Todd Richardson.
When Richardson — who was Speaker of the House when Mathews served in the lower chamber — was appointed to lead Missouri’s Medicaid program, Mathews said he sent him a congratulatory text. He also asked Richardson to let him know if he could help him.
“He simply texted me back saying be careful what I asked for,” Mathews said. “I’m glad I asked.”
“It is really exciting work,” he continued. “Everything we do is shaped by the vision [Richardson] has cast, which is a commitment to being a best-in-class Medicaid program that provides services to Missouri’s most vulnerable citizens in a way that is financially sustainable.”
Mathews added that Richardson’s desire is to put Medicaid on a sustainable path forward and change the course of MO HealthNet for the next 40 or 50 years. That task, according to Mathews, is monumental — which he says he didn’t comprehend until he got into his new position and started working.
The biggest overhaul he wants to make to the program will also be the most difficult and long-term project.
“I think the hallmark of our efforts will be bringing value-based payment methodology to the program. Health care across the country is shifting to paying for value, not volume. We still have some payment methodologies that are not only kind of archaic, but incredibly complicated. We want to put a payment mechanism that really provides incentive to add value to the health care equation,” said Mathews.
Even with decades in the health care field, Mathews said he has a steep learning curve but is loving the work and is excited “to make some positive changes for our state. I think we have a good opportunity here.”
After working for a company that recruited health care executives, Mathews branched out on his own. In 1997, he started a management company focused on hospitalists — physicians that only care for the hospitalized patient. He grew that company to employ physicians in 19 states before selling it in 2011.
He has also authored a book on recruiting hospitalists and served on the Public Policy Committee of the Society of Hospital Medicine.
Mathews noted he “kind of fell” into the health care industry.
Attending Northwest Missouri State on a football scholarship — he was named to an all-American team as a quarterback and resides in his university’s Hall of Fame — he originally majored in engineering. After eight hours of physics and another eight of calculus, he knew he didn’t want to be an engineer. So, he changed his major to accounting.
“When I graduated, the one thing I knew for certain was that I didn’t want to be an accountant either. So, I stuck around and got my master’s degree in business administration,” he said.
While in graduate school, Mathews got married and welcomed the birth of his first child. The couple would go on to have four total.
After spending some time working in financial planning — a position he did not enjoy — he switched to recruiting health care executives on the advice of a high school friend.
“My career and owning that company did a couple of things: It got me interested in changing the status quo, and it got me interested in public policy,” Mathews said.
First elected to the Missouri House in 2014, he served two consecutive terms but opted not to run for a third in 2018. His wife became the primary caregiver for her father — who has since passed away — who was diagnosed with Lewy body dementia. With her in Iowa, he stepped away from the legislature. The whole experience was “eye-opening.”
Now, he is back to splitting his time between Jefferson City and Pacific, Missouri. Though, unlike as a lawmaker, the commute doesn’t end with session.
“This is also not a permanently budgeted position. This is longer than a one year job, but it is not a life-time job. This is a couple or three years, trying to make the changes and put them in place,” said Mathews.