HJAR Mar/Apr 2022

46 MAR / APR 2022 I  HEALTHCARE JOURNAL OF ARKANSAS MEDICAID COLUMN MEDICAID improve health outcomes, but they have de- signed their own incentives to best addresses their members’particular needs. Additionally, each plan’s performance is publicly available on our website and will be discussed during quarterly meetings of the advisory panel. The 2020 results and 2022 targets are available at humanservices.arkansas.gov/u/2020results. Through this process, we’ll not only pay for access to healthcare, but we’ll measure the value added by using health plans. The first Arkansas Works performance measures were calculated and revealed last year, and the measures showed significant differences in performance between plans. As an example, when looking at breast cancer and cervical cancer screening measures in both 2019 and 2020, there was a difference of more than 10 percentage points between the plan with the highest rate and the plan with the lowest rate. There was a difference SINCE 2014, Arkansas has used a Medicaid “waiver” to purchase healthcare coverage fromprivate insurance plans for nondisabled Arkansans ages 19-64 with household income at or below the federal poverty level. Today, 330,000Arkansans are eligible for coverage and of these, about 290,000 are covered by a private health insurance plan through the program, long known as the “Private Op- tion”and then “ArkansasWorks.”The waiver expired at the end of 2021 and has been re- placed with theArkansas Health and Oppor- tunity for Me, orARHOME. The new program, which kicked off Jan. 1, builds on the existing foundation, continuing to use Medicaid dol- lars to purchase coverage through private plans. But, for the first time in the program’s eight-year history, we will expect participat- ing insurance plans to do more than just pay medical claims. ARHOME’s focus will move beyond simply providing health coverage to actually improving members’ health. To do that, we will hold the health plans ac- countable for the medical care their members receive. We have selected about two dozen measures that are currently used to assess the healthcare quality offered through the traditional Medicaid program, and we’ll apply those measures to the private health plans participating inARHOME. For example, the selected measures assess the percentage of women receiving cervical cancer screenings, hospital readmission rates, and the rates of appropriate medication management. In December, with the help of a joint leg- islative-executive branch advisory panel, we set performance targets the plans must meet each year, and next year we’ll establish penal- ties if they don’t measure up. The plans have flexibility to design their strategies for their members. They are required to offer incen- tives — either for members or providers — to Under ARHOME, Measures Hold Health Plans Accountable for Medical Care Their Members Receive