Arkansas Medicaid launches second component of payment improvement initiative

    2:52 PM, Jan 14, 2014   |    comments
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    Little Rock News:

    LITTLE ROCK, Ark. (ADHS) - Hundreds of primary care physicians in Arkansas will soon begin receiving supplemental monthly payments to help them provide better and more comprehensive patient care as part of Medicaid's effort to transform the state's health care system.

    The "care coordination" payments are for physicians who enrolled to be Patient Centered Medical Homes (PCMH), a concept that uses financial incentives to encourage physicians to focus more on management of chronic medical conditions, prevention and empowerment of patients through health education.

    "Arkansas Medicaid and private insurers have been working aggressively over the last two years toward a more efficient and effective health care system," said Medicaid Medical Director Dr. William Golden. "We recognized that investing in our state's primary care physicians through medical homes was a fundamental part of moving the system forward."

    Golden said the medical home program not only offers needed financial support to physicians, but also enhances patient experience and should lead to better patient health. Participating physicians, for example, will offer more same-day appointments and provide 24/7 live voice access for patients. Both of these requirements are intended to increase patient access to care and to reduce the inappropriate use of the emergency room.

    The launch of medical homes is an expansion of the Arkansas Health Care Payment Improvement Initiative, which began in 2012 when the state changed the way it pays for certain acute medical episodes, like upper respiratory infections and pregnancy. The overall initiative aims to reward hospitals, physicians and others who adapt their practices so that they are providing high-quality, cost-effective care.

    Although the medical home concept has been around for years, Arkansas's approach includes several innovative components. In addition to the care coordination payments, participating physicians also will have available practice transformation support and will be able to share in savings generated by the program.

    Open enrollment for the first year of the medical home program closed on Dec. 16. A total of 637 primary care physicians from across the state are participating. Their practices cover nearly 243,000 Medicaid beneficiaries with 40,000 of those beneficiaries covered by practices participating in a state/federal program called the Comprehensive Primary Care Initiative (CPCI), which is considered to be the first wave of medical homes in Arkansas. Together, medical homes and CPCI cover about 72 percent of all PCMH eligible Medicaid beneficiaries

    "Enrollment has far exceeded our expectations," Golden said. "We had hoped to have at least 40 percent of eligible Medicaid beneficiaries covered. Clearly, physicians are excited about the additional support and the opportunity to do more to keep their patients healthy."

    A second wave of enrollment for participation beginning July 1, 2014 has begun and will close May 15, 2014. Enrollment for participation in 2015 will open on October 1, 2014.
    Alongside medical homes, Medicaid also is initiating a pilot project in 39 Delta counties called the Delta Primary Care Case Management (PCCM) program. That program, as described in Act 1453 of 2013, serves as a second option for primary care physicians looking for additional support so they can better serve their patients. Rather than paying physicians directly as is done in the medical home model, Medicaid will contract with a vendor to provide care coordination for practices enrolled in the pilot project. Medicaid issued a request for proposal for those services today.

    "The pilot project really gives the state an opportunity to see what aspects of both models best support physicians so that they can empower their patients to be healthier and more proactive when it comes to their health care needs," said John Selig, Director of the Department of Human Services, which oversees Arkansas Medicaid.

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