HJAR Jan/Feb 2024

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2024 39 Larry “David” Ballard Business Operations Manager Division of Medical Services Arkansas Department of Human Services beneficiary panel to identify the beneficiaries for outreach. This lets them close gaps in care or discusses overutilization of medical ser- vices and summarizes provider performance across their attributed patient population, regardless of where patients receive care. It also helps providers focus on key metrics for preventive care, medication, therapy man- agement, chronic disease management, and utilization of high-cost services. Provider engagement has also been a significant factor for the PCMH program’s success. There is a large participation rate in the bi-monthly strategic advisory group calls as well as in the quarterly webinars where providers and official staff can join to receive updates on Medicaid and PCMH policies. Providers and official staff who come together in either setting freely share thoughts, challenges, and successes, building each provider’s knowledge base and high- lighting best practices. This shows our practices’ dedication to the program and improving the patient’s health. There are great providers through- out the state, and their willingness to share with each other how they have overcome some of the challenges they have faced with their practices and encourage other practices is amazing. The PCMH model is now in its 10th year, sustaining robust participation and substan- tial impact on the content and viability of primary care in a rural state. Larry “David” Ballard is the business operations manager for the Division of Medical Services within theArkansas Department of Human Services.Ballard has worked at DHS for eleven years and has overseen the PCMH project for the last seven years. He lives in Sherwood with his wife Shelly, and they have five children and seven grandchildren. structure was designed to support primary care transformation by helping practices that are often dependent on a high volume of acute care visits to focus on team-based strategies, chronic care coordination, and healthier patient outcomes. Enrollment in the PCMH program is voluntary, but there are incentives for practices to participate. To qualify for a monthly risk-adjusted care coordination fee, for example, primary care practices must provide 24/7 access to care, track the next available appointments, ensure that beneficiaries with higher risk scores or chronic conditions have care plans completed per year, and conduct screenings for literacy and social determinants of health. The PCMH program also pays bonuses to practices that pass quality of care measures and rank in the top percentile in managing acute care episodes such as emergency de- partment utilization (EDU) and acute hospital utilization (AHU). Since implementing this model, the program has seen a reduction of over 33% in EDU and 31% in AHU. There are several key factors in the suc- cess of the PCMH program. The main two have been the data the program has been able to provide those practices enrolled in the program and robust provider engagement. In 2018, we developed and launched the Population Health Management Report (PHMR) for PCMHs. The PHMR is beneficial to PCMH providers and care coordinators because it utilizes near real-time data, so pro- viders can become familiar with their benefi- ciary population. It assists PCMH providers in understanding gaps in care using quality metrics based on point-in-time beneficiary panel profiles and reduces the burden on PCMH providers by easily segmenting their “There are several key factors in the success of the PCMH program. The main two have been the data the program has been able to provide those practices enrolled in the program and robust provider engagement.”