After 25 years of practicing internal medicine, Lafayette native Dr. Ronald James Ritchey was ready for a change. He consulted with the Louisiana Medical Mutual Insurance Company (LAMMICO), then traveled throughout the country with Amedysis. He even received an MBA at the University of Louisiana at Lafayette. Five years ago, his life changed when he was introduced to Louisiana Health Care Review (LHCR), a healthcare quality improvement organization working under contract with Medicare and Medicaid.
For about 20 years, LHCR has been under a Medicare contract to do quality oversight for its Louisiana beneficiaries in Louisiana. In Mississippi and Illinois, the organization is under contract to Medicaid to perform quality oversight and utilization review for those states’ Medicaid organizations.
During his tenure at LHCR, Ritchey worked in various capacities before being dubbed medical director for corporate affairs last year. The organization has two other medical directors – one working specifically with review of cases, medical quality issues, and beneficiary complaints; another interacting more directly with providers in the northern part of the state. Ritchey’s responsibilities are concentrated in the corporate office, dealing with issues such as business development and design of quality improvement plans.
Before becoming medical director, Ritchey was a consultant, helping LHCR develop a program for disease management. Eventually, he designed new business opportunities, wrote grants for Medicare and Medicaid, and worked with new business proposals, such as developing disease management for diabetes or heart failure. As medical director, Ritchey splits his travel between Baton Rouge and Lafayette during the week. Occasionally, he visits the Jackson, Miss. and Springfield, Ill. offices for contract-related issues, including negotiating contract extensions and designing quality improvement programs for new contracts.
Ritchey has found a good fit with LHCR. “LHCR’s focus, as the name implies, is healthcare quality,” he said. “They are very passionate about quality, which is something I am quite interested in, and I have an opportunity to impact. Instead of one patient at a time, you get a chance to impact a larger number of patients and, hopefully, improve their outcomes.”