Improving the Arkansas Health Care System

by Dr. Joe Thompson  on Monday, Sep. 10, 2012 12:00 am  

Dr. Joe ThompsonArkansas Surgeon GeneralDirector, Arkansas Center for Health Improvement

Arkansas Medicaid has partnered with the two largest private insurance companies — Arkansas Blue Cross and Blue Shield and QualChoice of Arkansas — to change how the state and insurance companies pay for medical care. This promising approach will for the first time “assign” responsibility to a “clinical coordinator” on the “care team” and align financial incentives with outcomes patients expect. Financial incentives are included for providers who achieve quality outcomes for their patients, helping promote coordination among those who provide care. In July, providers began receiving reports outlining how well they met established thresholds for specific episodes of care, such as congestive heart failure, pregnancy, hip and knee replacement and others. Also, Arkansas received a federal Medicare program buy-in when the state was selected to participate in the Comprehensive Primary Care Initiative, which will provide monthly per-patient funding to selected primary care practices to cover the cost of expanded care coordination. For more information, visit here.

Workforce Strategic Planning

For the first time, a strategic plan addresses the growing challenges faced by the health workforce in the immediate and long-term future. The Arkansas Health Workforce Strategic Plan delivered to Governor Mike Beebe in April 2012 is the first step in a larger commitment to ensure that Arkansas’s health workforce will meet the state’s needs. The plan is a roadmap to change that includes specific recommendations to improve navigation and coordination of team-based care, expand the availability and use of technology, increase the supply of and address the mal-distribution of available providers, and adjust the payment system to support these changes. The plan is available here.

Health Information Technology

The backbone of the Health System Improvement Initiative is expanded statewide adoption of electronic health records (EHR) and development of a system that will allow those records to be safely and securely shared. Over half of Arkansas’s primary care providers have committed to EHR and received more than $66 million in federal funding for implementation under the American Reinvestment & Recovery Act of 2009. Nearly 2,000 registered providers and hospitals are in the process of receiving payments. In February, the State Health Alliance for Records Exchange (SHARE) began securely sharing clinical information among doctors, hospitals and labs. To date, more than 1,000 are using the system and another 3,000 are registering. Arkansas is the first state in the nation to receive approval to move forward and implement a sharing network so that those providing medical services to patients will be able to have secure, real-time access to patients’ health records from anywhere patients have been treated. For more information visit www.ohit.arkansas.gov.

Expanding Health Insurance

In compliance with the Affordable Care Act, Arkansas is working to establish an online marketplace, or exchange, where individuals, families and small businesses can find and compare affordable health insurance plans that best meet their needs. The exchange, developed in partnership with the federal government, will include access to federal subsidies to those who qualify based on income. Although it has been politically controversial, this approach promises to increase transparency and competitiveness in the private insurance marketplace. More information can be found here.

These four areas are interrelated. No other state has a more comprehensive and well-coordinated endeavor—bridging public and private sectors—to fix what has become unsustainable in our health system. Although the Affordable Care Act brings changes, Arkansas must commit to taking advantage of the opportunities and avoiding the pitfalls to achieve the health system our citizens need.

 

 

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