HJAR Sep/Oct 2021

36 SEP / OCT 2021 I  HEALTHCARE JOURNAL OF ARKANSAS MEDICAID COLUMN MEDICAID SINCE its 2013 creation, Arkansas’s Medicaid expansion programunder the federal Afford- able Care Act, currently known as Arkansas Works, has focused on ensuring low income adults in our state have health coverage. As a result, Arkansas had the second largest reduction in its uninsured rate among the states. However, we have had less success in improving health outcomes. According to America’s Health Rankings Annual Report, Arkansas has continued to rank among the bottom five states in overall health. Cover- age is clearly important, but coverage alone is not enough to make the improvements in healthcare outcomes we expect. ArkansasWorks expires at the end of this year and will be replaced by a new program, Arkansas Health and Opportunity for Me, or ARHOME. The new programwill keep some of the most popular aspects of the program. It will continue to use Medicaid funding to purchase private health insurance for low income adults. That means healthcare pro- viders will continue receiving higher reim- bursement rates than they otherwise would program that health plans have been held ac- countable for meeting annual health targets. ARHOME also requires health plans to offer incentives for members who meet education or employment goals. Extensive research tells us there’s a clear relationship between poverty, poor health outcomes and premature death, so another major goal of ARHOME is to provide opportunities that help clients move out of poverty. Using in- centives and connecting individuals with opportunities, ARHOME aims to promote economic independence and improve health. ARHOME also will offer three types of Life360 HOMEs: Maternal, Rural and Suc- cess Life360 HOMEs. Maternal Life360 HOME Arkansas ranks 49th in the nation in ma- ternal and infant health outcomes, and a third of the pregnancies covered by Arkan- sasWorks are considered high-risk. Through the Maternal Life360 HOME program, DHS will contract with birthing hospitals — those with an obstetrics unit — to provide NewARHOMEProgram under traditional Medicaid. Individual eligi- bility forARHOME will remain the same, and the federal government will continue to pay for 90% of the program. Those foundational pieces will not change. But ARHOME’s primary focus will shift from simply providing health coverage to improving health. And the programwill pay particular attention to improving maternal and infant health, the health of Arkansans in rural communities, behavioral health and the health of individuals with chronic disease. The first step in improving beneficiaries’ health is holding the health insurance plans accountable for the care their members receive. We’ll use quality metrics from the Medicaid Adult Core Set to determine how health plans measure up, and we’ll set per- formance goals they’ll be required to meet. We’ll also assess financial penalties for failure to achieve results. ARHOME also requires health plans to offer incentives, such as gift cards, to their members who get preventive screenings or visit their primary care provid- er. This will be the first time in the life of the to Focus on Improving Health, Not Just Providing Coverage