Arkansas will be at the forefront of working on how health care costs can be decreased now that it’s been awarded $42 million to improve and sustain a statewide system to monitor patient care with the goal of saving money.
“The $42 million … will allow us to better support providers as they move to a new payment model and new ways of doing business,” Amy Webb, spokeswoman for Arkansas Department of Human Services, said. “It also will help us fully engage patients in their care.”
The payment initiative aims to make providers accountable for the care they give. Arkansas recently announced savings in its Medicaid program based on using the new model.
The legislature, in an ongoing battle with Gov. Mike Beebe over accepting federal Medicaid money, will not have to approve the acceptance of the $42 million.
“We will provide the legislature with information on the grant – and we’ve already talked to them about it informally – but it does not need to be approved by the legislature,” she said.
The initiative for which the grant was given is called the Arkansas Health Care Payment Improvement Initiative, a statewide program.
Beebe suggested two years ago that Medicaid stop paying doctors on a fee-for-service basis and move to paying for quality of care. The payment improvement initiative was formed to stop paying doctors and other providers for individual services and move toward how well their patients were doing. In addition to Medicaid, private insurers are involved in the project.
The program rewards or punishes providers based on the number of times that the patient sees the provider for a particular illness, called “medical episodes,” under the new system. The program follows five types of treatment including upper respiratory infections, total hip and knee replacements, congestive heart failure, attention deficit/hyperactivity disorder, and perinatal care. The U.S. Department of Health and Human Services says these the most expensive in health-care.
The program has been in use since July. “We’ve already rolled out five episodes of care under the initiative, and plan to roll out many more. In addition, we are preparing to launch patient-centered medical homes,” Webb said. Medical homes are teams of providers, rather than physical places, that help patients who suffer from chronic illnesses such as diabetes and asthma. The payment initiative would encourage Arkansans to have medical homes in three to five years, with the goal of keeping people out of emergency rooms.
“Patients, doctors, and other providers know the system has not been working well. The approach we are taking helps support doctors and hospitals to deliver the care patients expect,” Dr. Joe Thompson, Surgeon General of Arkansas, said in a press release. According to the payment initiative, the provider’s average cost of care will be identified as acceptable or commendable, depending on the number of patient visits.
The provider will pay a portion of excess costs or be eligible to share in savings with the payer, depending on the level of care.
