Medicaid

Arkansas's management of Medicaid

A poll released by the American Medical Association this week finds that both the Obama-era Affordable Care Act, in place since 2014, and the Republican American Health Care Act under consideration in the Senate, have image problems among Arkansas voters. Medicaid, meanwhile, is pretty popular.

The survey conducted by Alexandria, Virginia-based Public Opinion Strategies finds that 44 percent of registered Arkansas voters sampled oppose the program commonly known as Obamacare.  The Republicans’ American Health Care Act, which is not law but would replace Obamacare, is opposed by 40-percent of respondents in its current form.

The 3rd Annual Tracking Report from the Arkansas Center for Health Improvement finds that the state is having success with a new health care business model that puts the focus on improved outcomes and cost savings.  
Unlike fee-for-service, the model used by the vast majority of health care providers, the Health Care Payment Improvement Initiative offers no financial incentive for ordering unnecessary tests.  Providers instead earn bonuses for improved outcomes for patients and for reducing costs.

It’s already saved the state some $54 million in Medicaid costs, according to Mike Motley, assistant policy director at ACHI.  The tracking report found that total Medicaid costs predicted at $660.9 million came in at $606.5 million in 2015, due to cost avoidance.  The savings were then shared between the state and the providers who helped avoid unnecessary costs.

Motley said the value-based model benefits patients as well by emphasizing outcomes and putting them in closer contact with their caregivers.

Joe Thompson is CEO of the Arkansas Center For Health Improvement
Sarah Whites-Koditschek / Arkansas Public Media

For lawmakers, caregivers and patients  a solution to the state legislature’s multi-year process of bringing a new type of coordination to a traditional Medicaid population is set to be finalized this summer.

PASSE, or Provider-led Arkansas Shared Savings Entity, will be a new oversight entity made up of nonprofit and for-profit health providers to manage the care of the state’s medically needy Medicaid population. It includes the elderly, developmentally disabled and mentally ill. The deadline for these companies to apply to be in PASSE is June 15, according to the Department of Human Services and the Arkansas Insurance Department.

Funding cuts for mental health services through Medicaid are taking effect October 1, despite a last-ditch effort at the state legislature Friday to walk back a change that some say could have dire consequences.

The cuts, finalized last week, would limit group therapy length from an hour and a half to an hour and set a cap of 25 counseling visits per year for Medicaid recipients who might otherwise go every week.

The vote to revisit the decision failed to gain two thirds from the Arkansas Legislative Council Friday morning.

Arkansas’s Legislature took a step toward its pledge to trim $835 million from the state’s Medicaid budget over five years today when it voted to limit group therapy for about 10,000 low-income Arkansans from 90 minutes to 60 minutes, 25 times a year.