HJAR May/Jun 2025

HEALTHCARE JOURNAL OF ARKANSAS I  MAY / JUN 2025 35 Nell Smith Assistant Director Division of Medical Services considered “on track”: • Advancement: Participation in activi- ties that promote career growth, such as workforce training, apprenticeships, or internships. • Learning: Enrollment in formal or vo- cational education, skill development programs, or life skills training. • Service: Engagement in community service activities, including caring for dependent children, elderly parents, or individuals with disabilities. These engagement opportunities are de- signed not only to promote economic in- dependence, but also to reinforce the link between stable employment and improved health outcomes. There also are exemptions from these requirements, such as parents with children under 6 years of age. The Value of Coverage: A Shared Responsibility Arkansas’s Medicaid expansion, administered through QHPs, represents a significant investment in the health of the state’s residents. Recognizing the substantial public investment in these services, Pathway to Prosperity introduces a framework that encourages active participation as part of maintaining coverage. Beneficiaries who choose not to engage with the program will face suspension of coverage but will not lose eligibility. This suspension serves as a motivator, encouraging individuals to re- engage with their PDP to regain benefits. Suspension and Reinstatement: Ensuring Continued Access to Care Importantly, suspension from ARHOME does not result in disenrollment fromMedic- aid. Individuals who are suspended for non- compliance can regain full benefits simply by notifying DHS of their intent to participate in their PDP. Moreover, a new Medicaid appli- cation is not required unless the individual’s annual redetermination date has passed. During the suspension period, DHS will not make monthly premium payments to QHPs. Normal appeal rights remain avail- able to suspended individuals, ensuring that beneficiaries retain the ability to contest deci- sions that affect their coverage. A Model for Sustainable Medicaid Reform Pathway to Prosperity represents a for- ward-thinking approach to Medicaid reform that balances the need for economic self- sufficiency with the foundational mission of providing healthcare coverage. Through targeted interventions, personalized support, and a focus on meaningful engagement, Ar- kansas aims to empower Medicaid beneficia- ries to achieve better health outcomes and long-term stability. For medical professionals, the success of this initiative hinges on collaboration with care coordinators, outreach teams, and work- force development partners. By working to- gether to support individuals on their journey toward economic independence, healthcare providers play a crucial role in ensuring that Medicaid continues to serve as a bridge to prosperity for Arkansas’s most vulnerable populations. n Nell Smith has two master’s degrees — one in jour- nalism and the other in public health. She combined those interests at the start of her career,working as a journalist covering healthcare for newspapers in Illinois and Arkansas. She then worked as a researcher and administrator for the policy analysis and research sec- tion of the Arkansas Bureau of Legislative Research, which serves as non-partisan staff for the Arkansas General Assembly. She has worked at the Arkansas Department of Health and now atArkansas DHS.She’s excited to be part of ensuring all Arkansans have ac- cess to quality healthcare. individuals from demonstrating compliance. Many beneficiaries were unaware of their obligations or struggled with navigating the reporting process. In response, Pathway to Prosperity takes a more streamlined and supportive ap- proach by using data matching to identify beneficiaries who may need extra assistance to navigate their way with their health and economic goals. Instead of a one-size-fits- all requirement, individuals will be assessed as either “on track” or “not on track” using available data. Those identified as “not on track” will receive focused care coordina- tion services, including personalized guid- ance through a personal development plan (PDP) designed to help them overcome bar- riers to self-sufficiency. Personal Development Plans and Focused Care Coordination A core element of Pathway to Prosperity is the implementation of personalized care plans aimed at aligning beneficiaries’ health and economic objectives. These PDPs are tailored to the needs of each individual, in- corporating a mix of assistance obtaining employment, workforce training, education, and community engagement activities. Care coordination under the new model extends beyond traditional healthcare man- agement. It includes connecting beneficiaries with essential resources such as transporta- tion, career counseling, and vocational train- ing. For unemployed or underemployed in- dividuals, PDPs may involve participation in workforce development programs, intern- ships, or formal education to build the skills necessary for long-term success. Advancement, Learning, and Service: The Three Pillars If a person is not employed, he or she must engage in one of three core categories to be