State of the State: Addressing health care challenges to continue in 2025

The rising cost of health care, lack of access in many rural areas around the state, and the highest maternal mortality rate in the country are big challenges that advocates, stakeholders, and providers are working to address in 2025.

Work is ongoing with Northwest Arkansas Council, Heartland Whole Health Institute, University of Arkansas for Medical Sciences (UAMS), state officials, and medical providers to address access, funding, and affordability for all Arkansans.

Northwest Arkansas Council has made health care a top priority, including expanding the medical workforce, lobbying for higher reimbursement rates for treatment, transition to value-based care, and addressing the shortage of medical specialties.

Maternity health is a major concern that has drawn attention around the state. Arkansas Surgeon General Dr. Kay Chandler said the task force established by Gov. Sarah Sanders met 20 times during 2024 to devise a plan to improve access to prenatal care through community outreach. Part of that includes the state’s health departments offering prenatal care and training for emergency room staff in rural hospitals that often have to deliver babies of mothers with no prenatal care.

Sanders on Feb. 6 unveiled a much anticipated maternal health care package aimed at improving Arkansas’ low national ranking.

Chandler, a practicing OBGYN, said there are about 35,000 pregnancies in Arkansas annually, and about 10,000 of the expectant moms don’t seek care until after the first trimester, and 1,000 don’t see a doctor until they go into labor. She said changes to Medicaid coverage for expectant mothers known as “preemptive eligibility” will allow coverage for testing that could detect health risks earlier in the pregnancy.

Using community health care workers like doulas and midwives is another way to provide access. UAMS has secured funding for a new midwifery program to begin in 2026. Additional fellowships in family medicine through the University of Arkansas at Monticello will start this summer, allowing two years of more complex obstetrics training like cesarean sections, Chandler said.

Chandler said work also includes resources for expectant mothers suffering from substance abuse and the months following delivery with postpartum depression.

“We are leaving no stone unturned as we work to improve maternal health outcomes for all women around the state,” Chandler said.

Pearl McElfish, director of research at UAMS-Northwest, said 45.3% of Arkansas counties are maternity health care deserts. There is one doctor in Helena and one in Forest City who delivers babies, and travel time to appointments is burdensome and costly.

“We have to go to the people, and we are doing that with mobile health units, a program launched in mid-2024 and being expanded this year,” McElfish said. “We have units in El Dorado, Jonesboro, Helena, and Northwest Arkansas. We plan to add two more this year in Fort Smith or Texarkana and in Pine Bluff.”

The mobile units provide prenatal care, primary care and chronic care for conditions like diabetes. She said the units work with churches and businesses in communities setting up in their parking lots to meet the people where they are. She said UAMS will also train between 60 and 100 doulas in 2025 to work in communities where they are needed.

“We received 150 applications for the program in the first two weeks. Some of the funding came from a Blue & You grant, but a more sustainable funding source is needed to make the program sustainable,” she added.

UAMS is working with Walmart on a program that provides benefit cards to 3,000 pregnant women to purchase healthier foods. The program will study the impact healthier eating has on stress levels and health outcomes.

McElfish said work is ongoing with pharmacies in small towns to certify them to provide diabetes self-management education, which is another problem in Arkansas.

Chandler said that in 2023 Arkansas had an adult obesity rate of 40%, the third highest in the nation, and 24% of Arkansas public school children are obese. She said 30% of the population is pre-diabetic and most have no idea. Chandler said community health departments and the Hunger Alliance offer education on how to shop for and prepare fresh food on a budget.

McElfish said telemedicine can bridge the care gap in rural areas. She said UAMS is working to get bluetooth-enabled medical tech out to patients who are at risk. For instance, there are smart blood pressure cuffs, blood glucose monitors, and thermometers patients can use at home. She said multiple funding sources for this program include a grant from the U.S. Centers for Disease Control and Prevention. The funding sources are temporary while data is being gathered and a more sustainable funding model will emerge.

Chandler and McElfish said they continue to work with the Heartland Whole Health Institute in Bentonville. Walter Harris, president of health transformation at the institute, said transforming the cost structure and creating a value-based care model is at the center of the work. He said the institute seeks solutions to provide better access to specialty care while also tackling reimbursement inequities in a system that is more than 60 years old.

“We believe that transparent, wellness-oriented care is nonnegotiable,” Harris said. “Providers and patients alike benefit when the traditional approach to care and physician reimbursement is abandoned for a model that prioritizes keeping patients healthy and costs down. This is just the beginning of what we will accomplish together.”

Editor’s note: The State of the State series provides reports twice a year on Arkansas’ key economic sectors. The series publishes stories to begin a year and around mid-year to provide an update on the state’s economy. Link here for the State of the State page and previous stories.