Payment reforms have helped to reduce costs and improve care efficiency at the same time the state’s Medicaid growth rate has slowed from about 6% to between 2-3%, according to the Arkansas Center for Health Improvement’s Statewide Tracking Report.
The report is the first of three studies meant to describe the effects of the Arkansas Health Care Payment Improvement Initiative (AHCPII).
The initiative involves two strategies: a patient-centered medical home model that emphasizes care coordinated through a primary care physician; and an episode of care model where a single provider manages care throughout the entirety of a particular health issue, such as pregnancies and upper respiratory infections. Episode of care Medicaid physicians who keep costs below a certain level receive payments, while those whose costs are unacceptable are responsible for reimbursing part of the cost.
As many as 73% of Medicaid health care providers and 60% of Arkansas Blue Cross and Blue Shield principal accountable providers involved with those episodes have improved or contained costs so far, the study found. Pregnancy screening rates have improved, and there was a 17% reduction in unnecessary antibiotic prescriptions for non-specific upper respiratory infections.
The report also found that 73% of the state’s primary care providers caring for 80% of eligible Medicaid beneficiaries were participating in the patient-centered medical home model through 2014. Those totals exceeded expectations, according to a news release from ACHI, which is a nonpartisan policy center supported by UAMS, the Arkansas Department of Health, Arkansas Blue Cross and Blue Shield, Arkansas Children’s Hospital and Delta Dental of Arkansas.
The Payment Improvement Initiative involves the Arkansas Medicaid program, Arkansas Blue Cross and Blue Shield, QualChoice of Arkansas, and several large self-insured employer plans serving Baptist Health, Wal-Mart, state, school and federal employees, and others.
Dr. Joe Thompson, ACHI director and former Arkansas surgeon general, said the report provides the first indication of the Payment Improvement Initiative’s progress.
“Stakeholders at all levels have worked together to create a bold initiative to provide Arkansans with a solution to many of the health system challenges experienced throughout the country,” Thompson said. “The AHCPII is the first statewide, multi-payer initiative of its kind in the nation. It’s big and it’s new. As such, there are bound to be things that work well and some that need adjustment. The Statewide Tracking Report allows us the broad view needed to identify both.”