HJAR Jan/Feb 2025

care, including bonuses for high-quality outcomes or penalties for unnecessary procedures. Collaborating with the Arkan- sas Department of Human Services and others to explore state-led initiatives that align with federal models, such asAccount- able Care Organizations (ACOs), will further enhance this transition. Over the next five years, Northwest Arkansas can implement value-based care tools and models that focus on improving primary care, addressing social determi- nants of health, and fostering innovation. One example of a value-based payment model is Primary Care First (PCF), which empowers providers (PCPs) to innovate care delivery and receive capitation pay- ments, incentivizing improved patient out- comes and reducing emergency department and inpatient hospital use. This model also incorporates behavioral health and social determinants of health, ensuring a holis- tic approach to patient care. Programs such as eConsults, introduced by Arkan- sas BlueCross and BlueShield, allow PCPs to collaborate electronically with special- ists, improving care efficiency while easing access to specialist care. The PCF program has shown promising results, with higher compensation for high-performing provid- ers and better utilization of low-cost pri- mary care settings. Arkansas BlueCross and BlueShield also collaborates with health- care analytics companies like Embold to measure provider performance and help patients access top-performing physicians, which can reduce care costs and improve outcomes. A Northwest Arkansas value- based healthcare coalition should be fur- ther developed with multiple insurers to leverage these insights to refine provider performance. Vision: Leveraging Federal Funding and Expanding Healthcare Access Northwest Arkansas can explore oppor- tunities to leverage federal funding to sup- port the push for increased regional wage index. Medicaid expansion, demonstra- tion projects, and other federal initiatives can provide states with enhanced match- ing funds that can be utilized to supplement reimbursement rates for specific services or populations. Addressing challenges related toMedicaid enrollment and eligibility is also crucial for ensuring that more individuals access these benefits, ultimately increas- ing the volume of services provided and enhancing the financial stability of health- care providers. Other states have successfully imple- mented strategies to increase Medicare and Medicaid reimbursements. Minnesota, for example, has emphasized value-based care models like ACOs and Medicaid man- aged care programs. These initiatives have improved care coordination, reduced costs, and improved health outcomes. Similarly, Oregon’s Coordinated Care Organizations (CCOs) have integrated physical, behavioral, and dental health services to improve patient care and reduce healthcare costs, leading to higher reimbursement rates. Massachusetts has also led in payment reform, adopting alternative payment mod- els and value-based purchasing programs. The state has invested in healthcare work- force development and expanded access to primary care services, which has helped improve care quality and reduce unneces- sary healthcare spending. Other states have implemented similar programs aimed at improving care coordination, chronic dis- ease management, and overall healthcare delivery. These initiatives have resulted in higher Medicare and Medicaid reimburse- ments for participating providers and have contributed to better patient outcomes. Addressing wage index disparities is another critical policy action to ensure that healthcare providers in Northwest Arkan- sas receive fair compensation. Policymak- ers and healthcare advocates can propose various approaches to align wage index rates with the actual costs of care in rap- idly growing regions. For instance, exam- ining successful strategies implemented in states, where local wage indices are adjusted to reflect healthcare costs better, can pro- vide valuable insights. n SOURCE The Northwest Arkansas Council and Heartland Whole Health Institute, Northwest Arkansas Health Care Vision 2030 report, accessed De- cember 2024, https://online.flippingbook.com/ view/199987982/. Reprinted with permission. Final Thoughts from the Editor: There is a lot of inspiring healthcare vision happening in Northwest Arkansas, aimed at addressing the significant hurdles of our current U.S. healthcare system, with its built-in, fee-for-service inequities for poorer states and its focus on transactional rather than value-based care. This little corner of the world will be watched closely as it boldly forges what may be the most exciting U.S. medical school established in our lifetime, with its commitment to bringing a global perspective on “health” to our citizens. The passion and tenacity to leverage every advantage and influence at the federal level to equalize the abysmal reimbursement rates that richer, more populated states have imposed on Arkansas and other less affluent states may transform the state’s healthcare landscape — and perhaps inspire the nation. Godspeed. HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2025 25