As detailed in the 3rd Annual State Tracking Report, Arkansas’s Healthcare Payment Improvement Initiative (AHCPII) has continued to demonstrate improvements in quality and reductions in costs. The Arkansas Center for Health Improvement (ACHI) has worked with participating payers including Arkansas Medicaid, Arkansas Blue Cross Blue Shield, QualChoice, Centene / Ambetter, HealthSCOPE, Walmart, Arkansas State and Public School Employee Plans, and Arkansas Superior Select to track AHCPII progress. The third annual Statewide Tracking Report includes outcomes of the state’s unique total cost of care Patient-Centered Medical Home (PCMH) program, Episodes of Care (EOC) model, and other key components.
In 2015, the United States spent over $3 trillion on health care. That year, national leaders set goals to gradually shift a majority of the country’s health system to one that increasingly ties health care payments to quality and value. As the national debate on healthcare coverage continues, states have a renewed responsibility to spend health care dollars as efficiently and appropriately as possible. In pursuit of this goal, in 2016 Arkansas became the first state to successfully complete a three-year federally-supported State Innovation Model (SIM) grant. With the continued success of AHCPII, Arkansas is now recognized as a national leader in value-based healthcare innovation.
The 2017 report includes the following findings:
§ The AHCPII continues to receive broad multi-payer support, with Arkansas Medicaid and the state’s largest commercial carriers and employers now participating.
§ The majority of eligible providers in the state are now participating, with approximately 83 percent of eligible Medicaid beneficiaries and a large and increasing proportion of private plan beneficiaries now served under AHCPII.
§ By incentivizing appropriate use of preventive services and improved chronic disease managements, the PCMH model has improved quality of care in areas such as diabetes management and increased breast cancer screenings.
§ In 2015, for the second consecutive year, Medicaid realized direct cost-avoidance through trend reduction with PCMH practices experiencing cost growth of 0.7 percent compared with the 2.6 percent benchmark trend and 1 percent growth among non-participating practices. This means that Medicaid avoided $54.4 million in unnecessary costs in 2015. As part of the PCMH provider incentive structure, a portion of these savings ($4.6M) was shared with participating providers who met quality and financial targets
§ Through improved access in the PCMH program, hospitalizations were reduced by 16.5 percent and ER visits were reduced by 5.6 percent for Medicaid in 2015.
§ Select episodes of care demonstrated improvements in quality and cost savings compared with previous average episode costs, including perinatal, tonsillectomy, and congestive heart failure.
While there is still work to be done, the AHCPII has improved quality and helped contain cost growth. Due to the state’s significant advancement towards value-based payment models, Arkansas providers are positioned to succeed as similar value-based efforts are pursued at the federal level. Continued engagement and input from providers, patients, state leaders, and other stakeholders are necessary to sustain the progress and success of AHCPII.
A one-page summary of the 2017 report is available at http://achi.net/Docs/455/. This year’s report will be shared with the public on Tuesday, May 23, 2017. AHCPII progress will continue to be tracked in 2017 and beyond and will be included in future updates.