HJAR Sep/Oct 2019

HEALTHCARE JOURNAL OF ARKANSAS I  SEP / OCT 2019 41 effective birth control agents. For the last four years, DMS has sponsored the development and distribution of educational materials for college infirmaries and partnered with the Health Department to teach appropriate techniques for IUD and hor- monal implant insertion to better expand the population of health professionals who could offer these services to interested patients. DMS even has a LARC booklet in Marshallese for Arkansas’ large population of Mar- shallese residents to help expand their access to that information. For future im- provement, DMS is working with CMS to gain approval for innovative billing reforms to facilitate greater use of LARC technology. Tdap immunization: The CDC recom- mends all pregnant women receive tetanus/ pertussis boosters during gestation. This is an emerging standard of care and rates are WilliamGolden, MD Medical Director Arkansas Medicaid correspondingly low. DMS now includes it as an expectation of its bundled payment for pregnancy. Maternal Mortality Interventions: While still an uncommon event, death of a mother after delivering a newborn has devastating family consequences and represents a ma- jor source of premature mortality. DMS has partnered with others in the state to system- atically identify solutions to this challenge and has added adoption of specific hospital policies to its Pay for Performance program and sponsored an educational video for new mothers to help them identify warning signs that need immediate attention lest they evolve into life-threatening complications. Perinatal Depression Screening: New motherhood should be a time of excitement, but it also can be stressful and overwhelming. Postpartum depression is unfortunately too common and has substantial consequences to the mother and her children. Some cases can be quite severe and resistant to treat- ment. DMS is partnering with the Arkansas Foundation for Medical Care (AFMC) and hospitals to incorporate depression screening for new mothers when they leave the hos- pital and when they receive follow-up care regardless of clinical setting. The project also includes strategies for follow-up and sup- port for women who screen positive. DMS hopes this new effort, along with other on- going efforts by others, will make significant improvements in care delivery processes and perinatal outcomes in Arkansas. Arkansas Medicaid has an extensive his- tory of initiating and sup- porting innovative, targeted efforts to improve the health of our communities beyond paying for the care of thou- sands of Arkansans. Analy- sis of claims data, when tied to payment incentives, can highlight important, action- able messages to the clinical community. While program efforts span a wide variety of clinical topics, DMS has espe- cially focused on perinatal care, such as its financial support for the University of Ar- kansas Medical School’s ANGELS program. Arkansas Medicaid is committed to improv- ing population health as part of its mission to financially support the care of many patients in our state. n