Dan Rahn: Expanding Medicaid Critical for UAMS

by Mark Friedman  on Monday, Jan. 28, 2013 12:00 am  

Financial Incentives

Starting in October, health care providers could start seeing a financial reward for keeping a lid on health care costs.

Under the Arkansas Payment Improvement Initiative, health care providers who come in below the target price set by Medicaid and other payers for some episodes of care will get to share in the savings, said Rhonda Hill, director of health care finance at the Arkansas Center for Health Improvement.

The APII will look at the average price of care over a 12-month period to determine if the provider hit the goal. A provider that doesn’t could be on the hook for the difference, Hill said.

For UAMS, however, hitting the targets could be a challenge, Rahn said.

Not only does UAMS have a comprehensive, acute-care hospital, but it also teaches medical students, making the cost of care higher, Rahn said.

“We just need to work through how we deal with that,” he said, adding that nothing has been settled.

The Arkansas Department of Human Services still is developing its appeals process involving episodes of care, spokeswoman Amy Webb said.

On the national scene, many UAMS revenue streams are at risk, according to its fiscal 2012 audit.

One of the biggest potential blows to UAMS is the funding it receives from the National Institute of Health of Bethesda, Md., which accounted for $75 million in the fiscal year that ended June 30.

“It could mean a loss of a percentage of that” as a result of the uncertainty surrounding the budget in Congress, Rahn said.

The “sequester” cuts required by the Budget Control Act of 2011 were projected to cost UAMS $12 million a year, but the “fiscal cliff” deal in Congress left those reductions up in the air.



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