print-icon.png

email-icon.png

 

 

State News

Arkansas

Arkansas has pursued strategies to improve healthcare transparency, affordability and quality for its residents. Many initiatives are being managed through its Health Care Payment Improvement Initiative (AHCPII), out of the Arkansas Center for Health Improvement (ACHI), an independent health policy center. ACHI jumpstarted Arkansas’ cost and quality transparency efforts in 2015 with the creation of an all-payer claims database (APCD). AHCPII developed the Arkansas Patient-Centered Medical Home (PCMH) Program, which represents 80 percent of Medicaid recipients. In 2018, Arkansas passed SB 2 and HB 1010, enabling the state insurance commissioner to oversee pharmacy benefit manager (PBM) practices and ensure that PBMs offer fair reimbursements to pharmacies. 

Arkansas has expanded Medicaid, taking an important step towards making healthcare affordable for more residents. Like most states, Arkansas should consider additional steps to improve affordability for residents like enacting surprise billing protections, and protecting consumers from short-term, skimpy plan designs. Moreover, the state needs to address their exceptionally poor disparities ranking from the Commonwealth Fund, including its percentage of children without a medical home, children who did not receive recommended dental visits and vaccinations, children who are uninsured and adults with high medical costs relative to income. 

Arkansas ranked 30 out of 47 states plus DC, with a score of 29.9 out of 80 possible points in the Hub's 2021 Healthcare Affordability State Policy Scorecard.


Arkansas | Apr 23, 2024 | Report | Population Health

Maternal Health Initiative Launches in Arkansas

Arkansas’ governor has launched a new initiative to tackle the state’s maternal health crisis,
reports Little Rock Public Radio. The strategic committee plans to implement a multi-faceted line
of attack concentrating on education, access, coordination, and overall improvements to the
state’s maternal health services. Key initiatives outlined by the committee include advertising
and awareness campaigns, grants and funding opportunities, and the creation of a pilot program
pointed at counties with low rates of prenatal care.


Arkansas | Jan 15, 2024 | Report | Social Determinants of Health

Disparities in Arkansas Child Health Persist, Especially for Black Families

Arkansas’ Black children consistently have worse health outcomes from birth onward than
children of other races, reports the Arkansas Advocate. On a scale of 0 to 1,000 for child
wellbeing, Black children scored 299, compared to 397 for Latino children, 597 for white
children, 562 for children of two or more races, 616 for American Indian or Alaska Native
children, and 624 for Asian and Pacific Islander children. Arkansas has the nation’s highest
maternal mortality rate and the third highest infant mortality rate regardless of race. Arkansas’
health burdens and disparities are augmented by a shortage of providers in rural areas.


Arkansas | Oct 27, 2023 | News Story | Food Insecurity

Arkansas Leads Country in Food Insecurity

Arkansas has the high rate of food insecurity, with 16.6 percent of residents experiencing food
insecurity between 2020 to 2022, reports KARK. The Arkansas rate marked the biggest jump in
food insecurity for all states against the previous measure, a 2.8 percent increase from the rate
during the period from 2017 to 2019.


Arkansas | Jan 12, 2023 | Report | Rural Healthcare

Assessing the Effectiveness of Policies to Improve Access to Primary Care for Underserved Populations: A Case Study Analysis of Columbia County, Arkansas

The Milbank Memorial Fund assessed the effectiveness of several policies aimed at improving access to primary care in Columbia County, Arkansas, a primary care desert. Expanding Medicaid has made primary care more affordable, and the state has encouraged a Medicaid patient-centered medical home program that has helped practices deliver higher-quality primary care. However, the area’s lack of medical schools and residency programs have made it difficult for health systems and practices to recruit and retain new doctors. The county does not have any mobile clinics, federally qualified health centers, or school-based health centers, though it does have a rural health clinic that serves as a safety net provider. The pandemic encouraged usage of telehealth services, though the county’s lack of broadband has hindered widespread adoption. Furthermore, the county has a higher proportion of Black residents than the rest of the state, and many county residents lack trust in medical institutions and their providers.


Arkansas | May 11, 2022 | News Story | Drug Costs

Arkansas Sues Drugmakers, Pharmacy Benefit Managers Over Insulin Costs

Arkansas's attorney general on Wednesday accused drugmakers and pharmacy benefit managers of colluding to drive up the price of insulin drugs, the latest in a series of lawsuits to take aim at skyrocketing costs for the life-sustaining medicine, reports ReutersThe lawsuit targets three drugmakers who produce the vast majority of the insulin drugs sold in the U.S. and three of the leading pharmacy benefit managers. Arkansas’ Attorney General stated that 50,000 Arkansans with diabetes were uninsured and that many had been forced to ration insulin because of the high cost.


Arkansas | Jan 14, 2022 | News Story | Affordability

National Scorecard Ranks Arkansas 30th Among States in Healthcare Affordability

The Healthcare Value Hub’s Healthcare Affordability State Policy Scorecard ranked Arkansas 30th out of 47 states, plus DC, in healthcare affordability, reports the Arkansas Center for Health Improvement. The scorecard gave Arkansas 29.9 out of 80 possible points and provided several recommendations to improve affordability, such as: enacting stronger price transparency requirements; pursuing coverage options for residents earning too much to qualify for Medicaid; and enacting protections against short-term, limited-duration health plans.


Arkansas | Dec 31, 2021 | News Story

CMS Approves Arkansas’ Medicaid Expansion Redesign

The federal government approved Arkansas’ Medicaid expansion waiver, but will only allow premiums to continue into 2022, reports the Arkansas TimesArkansas’ new waiver does not include work requirements, which have been blocked by a federal judge, but does impose premium requirements for enrollees above 100 percent of the federal poverty level. The Obama administration originally approved the premium requirements and work requirements were approved under the Trump Administration. The Biden administration approved Arkansas’ Medicaid waiver program to begin in 2022—which purchases private insurance coverage for beneficiaries on the Marketplace—but added an addendum requiring premiums to phase out in 2022. The waiver did not request work requirements after the Biden administration revoked them in 2021.


Arkansas | Dec 10, 2020 | News Story | Drug Costs

Supreme Court Upholds Arkansas Law Regulating Pharmacy Benefit Managers

The U.S. Supreme Court upheld Arkansas’ law regulating pharmacy benefit managers (PBMs), ruling that it is not preempted by ERISA, reports Fierce Healthcare. Arkansas’ law prohibits PBMs from reimbursing pharmacies at lower rates than the cost required to dispense prescriptions and allows pharmacies to refuse to sell a drug if the upper limit that plans will pay for it is too low. Opponents of the law argue that it increases costs for patients and could potentially result in pharmacies not carrying needed medications; proponents argue that the law protects rural and independent pharmacies from too-low reimbursement rates. The ruling paves the way for other states to pass laws regulating PBMs and explore other cost-regulating measures.


Arkansas | Nov 16, 2020 | Report

Arkansas' Crisis Stabilization Units Decreased Medical Utilization and Jail Involvement

A significant portion of patients at a crisis stabilization unit (CSU) had decreased emergency department visits, inpatient or outpatient hospital stays or jail bookings in the six months following CSU intervention, according to a study from the Arkansas Center for Health Improvement. Using data from the state’s all-payer claims database, the study focused on one of the state’s four CSUs, an alternative to jails and emergency departments that provide mental health support for people in crisis who encounter law enforcement. There was an overall decrease in the number of patients who experienced a medical stay or jail involvement post-CSU, and those who did, experienced them less often than pre-CSU intervention. Total and per-member per-month costs for Medicaid increased in the post-CSU period, while costs for patients with commercial coverage decreased, possibly due to changes in utilization of costly medical services. The study also found that patients experienced a 27.5 percent decrease in total jail days in the post-CSU period.


Arkansas | Oct 15, 2020 | News Story | Rural Healthcare

Rural Healthcare Providers in Arkansas Receive Support to Implement Telehealth Services

Arkansas Health & Wellness and Arkansas Total Care will be deploying FirstNet to rural healthcare providers and federally qualified health centers (FQHCs) in Arkansas to expand access to telehealth services, according to the companies' press release. FirstNet is a high-speed broadband communications platform built for America's first responders and the extended public safety community. This program will help rural providers and FQHCs integrate virtual care into their workflows and will better enable providers to serve patients in rural areas.


Arkansas | Sep 8, 2020 | Report | Health Costs Affordability

Arkansas' Medicaid Work Requirement's Impact on Coverage, Employment and Affordability of Care

People who lost Medicaid coverage when Arkansas’ Medicaid program implemented work requirements experienced significant trouble affording care, according to a study in Health Affairs. Fifty percent of people had serious problems paying off medical debt, 56 percent delayed care because of cost and 64 percent delayed taking medications because of cost. These rates were significantly higher than among people who remained on Medicaid during the entire year. The study also found that most coverage losses were reversed after the work requirements were stopped, that the requirements did not increase employment rates and that awareness of the policy change remained poor—potentially hindering people from accessing Medicaid coverage even after the work requirements were no longer in effect.


Arkansas | Jul 22, 2020 | Report | Health Costs

Savings from Value-Based Primary Care in Arkansas

Overall healthcare spending decreased for patients participating in value-based primary care programs in Arkansas, according to a study from the Milbank Memorial Fund. The analysis found that for every dollar spent on care management fees, there was a two-dollar savings in beneficiary spending, with greater savings in later years of the programs—indicating that the return on investment increased over time. The program reduced inpatient stays and emergency department use, likely resulting in cost savings.


Arkansas | Jul 1, 2020 | Report | Health Costs

Value-Based Primary Care: Insights from a Commercial Insurer in Arkansas

Practice-level participation in innovative care models led to a $30 per member per quarter decrease in spending for three Arkansas Blue Cross and Blue Shield value-based primary care programs, according to a Milbank Memorial Fund issue brief. The brief examined changes in healthcare spending and utilization (years 2011 through 2018) associated with practice-level participation in one of the three Arkansas Blue Cross and Blue Shield value-based primary care programs. Estimated savings suggests a 2:1 return on investment, indicating that each dollar spent on care management fees among this commercially insured adult population resulted in a $2 savings in beneficiary spending. Reductions in acute inpatient stays and emergency department use likely account for the program savings. Savings were greater for participating practices in later years for each of the programs, suggesting that return on investment may increase over time. 


Arkansas | Jan 10, 2020 | News Story | Drug Costs

Arkansas Drug-Pricing Law Will Get Supreme Court Review

The U.S. Supreme Court will hear a case that could decide the validity of at least 38 states’ laws regulating how companies like Express Scripts and CVS Health make money off prescription drugs, reports Bloomberg Law. The justices agreed January 10 to take a case asking whether an Arkansas law regulating pharmacy benefit managers is preempted by the federal Employee Retirement Income Security Act. The Pharmaceutical Care Management Association, a trade group representing PBMs, successfully challenged the law on ERISA preemption grounds in the Eighth Circuit. The court’s decision to hear the case came at the urging of U.S. Solicitor General, who argued that the Arkansas law doesn’t reference ERISA plans or have an impermissible connection with them.


Arkansas | Aug 9, 2019 | News Story | Rural Healthcare

UAMS Partners with Arkansas Blue Cross and Blue Shield to Expand Comprehensive Digital Health Network

A $1 million grant to the University of Arkansas for Medical Sciences (UAMS) from Arkansas Blue Cross and Blue Shield will enable the UAMS Institute for Digital Health & Innovation to advance digital health statewide to provide more streamlined access to healthcare for patients, reports UAMS News. The first phase of the plan will focus on urgent care, in which patients will be able to consult with a medical professional by voice or video call to determine whether they need immediate care and how to obtain follow-up care. The second phase will develop digital approaches to providing primary care and certain specialized care, such as gynecology, ophthalmology, gastroenterology, oncology and orthopedics. Digital health approaches can reduce the cost of healthcare and improve access for patients, especially in a largely rural state like Arkansas.  


Arkansas | Jul 16, 2019 | Blog | Price Transparency

Arkansas Healthcare Transparency Initiative Expands to Include New Data Sets

Enabled by a 2015 state law creating the Arkansas Healthcare Transparency Initiative, the Arkansas all-payer claims database (APCD) now has several new types of data available to supplement healthcare claims and enrollment data, reports the Arkansas Center for Health Improvement (ACHI)This infographic provides an overview of what is available. The database is a key resource for pulling back the curtain on healthcare quality and prices. State agencies, academic researchers, analytic groups and private industry are using the Arkansas APCD to assess healthcare utilization, quality and price information.


Arkansas | Sep 25, 2018 | News Story | Drug Costs

To Rein in Drug Middlemen, States Go Further than Congress

Arkansas, like many states, is targeting drug middlemen in attempt to reign in high pharmaceutical prices, according to the Washington Examiner. The state enacted a law earlier this year requiring licensure for pharmacy benefit managers (PBMs), which manage drug plans for employer- and union-sponsored health plans, to conduct business in the state. PBMs must provide a “fair and reasonable” compensation program for the reimbursement of pharmacist services in order to get a license. Four other states have passed similar laws requiring PBMs to obtain licenses: Florida, Louisiana, Maryland and Tennessee.


Arkansas | Mar 15, 2018 | News Story | Rural Healthcare

Arkansas Governor Signs Pharmacy Manager Bill Into Law

Arkansas' governor signed into law a bill giving the state's insurance commissioner the power to regulate the business practices of pharamcy benefit managers (PBMs), according to the Arkansas Times. The commissioner's authority will include ensuring that PBMs reimburse pharmacies at a rate sufficient to ensure network adequacy, even in rural areas. The law does not regulate prices, however, instead stating only that PBM networks will not be adequate if they do not provide "fair and reasonable reimbursements." The Arkansas Insurance Department is expected to issue licenses to PBMs and develop rules and regulations to enforce the law by September of 2018.


Arkansas | Dec 11, 2017 | News Story

Arkansas Adopts Limits on Opioid Prescribing

Arkansas’ state medical board has joined 24 states in adopting regulations limiting the number and strength of opioid painkillers doctors can prescribe, reports The PEW Charitable Trusts’ Stateline. The new restrictions, based on 2016 guidelines from the Centers for Disease Control and Prevention, require doctors to take a variety of precautions when prescribing highly addictive opioid painkillers and limiting prescriptions for acute pain from an injury or surgery to a seven-day supply. Arkansas has one of the highest per capita opioid consumption rates in the nation and future analysis will be needed to determine the regulation’s impact on healthcare quality and cost.


Arkansas | Jun 19, 2017 | News Story

Aledade Continues Expansion, Partners with UnitedHealthcare for Accountable Care

Aledade, a company focused on physician-led accountable care organizations, is teaming with UnitedHealthcare on a new accountable care program to improve the quality of healthcare in Arkansas, reports Healthcare Informatics. The program will look to provide patient care under a value-based model focused on keeping people healthy through the delivery of quality, coordinated healthcare. Using technology that enables management across a physician’s entire patient population, the two organizations can identify clear, actionable data specific to individual patients’ health needs and potential missed care opportunities—such as an annual cervical or a colorectal cancer screening.


Arkansas | Sep 12, 2016 | News Story

State of Arkansas: Data Analytics Helps Officials Reward Healthcare Providers that Offer Best Quality, Prices

General Dynamics Health Solutions developed a data analytics application to measure each healthcare provider’s success, reports ComputerWorld. The application constructs the risk-adjusted cost curve for each provider and also collects eligibility and enrollment status, provider demographics, tax files, and client data from multiple sources. Then, the application identifies incidents of care from claims data and calculates quality scores based on claims and clinical data. In addition, providers receive report cards showing high cost areas by facility. The program has helped save $720 million in Medicaid costs since 2012.


Arkansas | Sep 1, 2016 | News Story

Arkansas Bets Farm on Value-Based Care

Arkansas is shifting to value-based care models, reported HealthLeaders. Specifically, value-based reforms are taking hold throughout the state’s provider and payer market, including the patient-centered medical home, which has become the dominant primary care physician-practice model. In addition, commercial payers and the state’s Medicaid program are operating bundled payment reimbursement and private option Medicaid expansion through the ACA influenced the sharpest decline of uninsured patient rates in the U.S. (22.5% in 2013 to 9.6% in 2015).  


Arkansas | Aug 1, 2016 | Report

Changes in Utilization and Health Among Low-Income Adults After Medicaid Expansion or Expanded Private Insurance

A Commonwealth Fund study of more than 9,000 low-income adults in Kentucky, Arkansas, and Texas revealed that low-income adults in Kentucky and Arkansas received more primary and preventative care, visited emergency departments less often and reported better health than their counterparts in Texas. The report aimed to answer how the Medicaid expansion under the Affordable Care Act has affected beneficiaries’ use of healthcare services and their health status.


Arkansas | Apr 4, 2016 | News Story

Arkansas’ Health Care Revolution

Arkansas is one of the few states that has fully embraced rewarding primary care clinics for controlling costs while hitting quality targets, reports the Times Record. These rewards also extend to orthopedic surgeons, obstetricians, and other providers. Between 2013 and 2014, Medicaid costs declined for primary care patients, hospitals reduced readmissions for complications after congestive heart failure, and several physicians cut out unnecessary tests and antibiotics after tonsil surgery.


Arkansas | Aug 10, 2015 | News Story | Rural Healthcare

University of Arkansas Receives $1.9M to Train Nurse Practitioners

The University of Arkansas for Medical Sciences was one of 21 institutions nationwide to receive funding from the Department of Health and Human Services, Advanced Nursing Education program, reports Arkansas Business. The awarded amount of $1.9 million will be invested in the Geriatric Advanced Practice program which is currently training 16 students with 15 to 20 more expected to enroll each of the next few years. The goal of this program is to train nurse practitioners to assist those older adults who have to manage at least one chronic condition, as well as improving access to care for those living in more rural areas.


Arkansas | Jul 17, 2015 | News Story

Health Consultants: State Innovative, But Should Try More Proven Strategies

Arkansas state legislators met with the U.S. Department of Health and Human Services and The Stephen Group—a healthcare consulting group—to discuss the direction of the Arkansas Healthcare Payment Improvement Initiative, reports Little Rock’s ABC affiliate KATV. The Stephen Group, who was hired by the State Legislator to assess the AHCPII program, reported that the work being done by the AHCPII is innovative, but the state should look to successes in other states to address some high-cost areas.


Arkansas | Jun 12, 2015 | Report

The Arkansas Payment Improvement Initiative: Early Perceptions of Multi-Payer Reform in a Fragmented Provider Landscape

This report—published in the American Journal of Managed Care—focuses on the early perceptions held by stakeholders directly impacted by the AHCPII during its early stages of implementation. Providers were initially skeptical about the impact that the program would have, however after participating they realized that there were many positives that came from the changes. The primary benefit noticed by providers was their ability to generate savings under both the PCMH and episode based payment initiatives. Finally Arkansas payers who were involved in the implementation of the initiatives believe that the effort and challenges were worth while.


Arkansas | May 19, 2015 | Blog

Arkansas Payment Improvement Initiative: Expanding Episodes to Other Clinical Areas

The fifth installment of a Robert Wood Johnson Foundation-funded evaluation of the AHCPII, this Health Affairs blog post highlight new episodes of care that the state added to its bundled payment program as well as highlighting the AHCPII’s desire to add more conditions. Additionally, the authors point to other states, including Ohio, Rhode Island and Tennessee, that are pursuing similar episodic payment programs. This blog post also links to the Statewide Tracking Report.


Arkansas | Jan 15, 2015 | Report

Statewide Tracking Report

This report from the AHCPII focuses on the results of the PCMH and Episode Based Payments initiatives. The PCMH initiative resulted in over 70% of the state’s healthcare providers participating, 80% of all eligible Medicaid beneficiaries enrolling in a PCMH, an increase in accessibility, a reduction in hospital admissions, a reduction in emergency room costs, and a decrease in total costs. During the time period studied the episode based payment initiative resulted in reduced use of unnecessary antibiotics, a reduction in the Medicaid growth rate by 2% to 3%, and a further reduction in the cost of care. The report concludes that the as the AHCPII moves forward in moving the delivery of more care to value-based models, more providers and payers will become involved.


Arkansas | Jan 7, 2015 | Blog

Arkansas Payment Improvement Initiative: Self-Insured Participation

This Health Affairs blog post is the fourth in a series of posts from the Robert Wood Johnson Foundation that focuses on the Arkansas payment delivery reform. This post further focuses on the participation of some of the state’s largest self-insured employers and the impact that this involvement has had on the program. The support of Walmart, the State and Public School Employee Plans and the State University System Health Plan has greatly benefited the PCMH initiative and it is expected that more large self-insured employers will participate in the effective PCMH program. Additionally Walmart, the Blue Cross Blue Shield Employee Pan, and around ten other employers participated and encouraged expansion of the episode based payment initiative. With these successes, however there are still philosophical and structural barriers to greater self-insured participation.


Arkansas | Oct 15, 2014 | Blog

Arkansas Payment Improvement Initiative: Private Carriers Participation in Design and Implementation

This Health Affairs blog post is the third post in a series by the Robert Wood Johnson Foundation that focuses on the payment and delivery reforms in Arkansas. This post focuses on the participation of Blue Cross Blue Shield (BCBS) and QualChoice - two private insurance companies located in Arkansas - in the creation and implementation of the AHCPII. This post identifies that BCBS had previously experimented with PCMH models and showed significant success in the pilot programs, therefore making the a good partner in the creation of this measure. Furthermore, BCBS and QualChoice’s participation in the episode based payment initiative has made the results more impactful than if the state run Medicare program attempted this initiative on their own.


Arkansas | Aug 15, 2014 | Report

Arkansas: A Leading Laboratory for Healthcare Payment and Delivery System Reform

This Commonwealth Fund report focuses on the AHCPII and the lessons and insights gained since the program’s inception in 2011. The general, the report’s authors find that progress is best gained through an inclusive and deliberative process facilitated by committed leadership, a shared agreement on root problems and opportunities for improvement, and strategy grounded in the state’s particular healthcare landscape.


Arkansas | May 20, 2014 | Blog

Patient-Centered Medical Homes In Arkansas

This Health Affairs blog post is a second in a series funded by the Robert Wood Johnson Foundation focusing on the development of Arkansas’ PCMH model. Additionally the post discusses the key aspects of the model, which include—payment structure, shared savings structure, quality metrics, payer involvement, provider participation, and legislative and regulatory alignment.


Arkansas | Mar 18, 2014 | Blog

The Arkansas Payment Reform Laboratory

This Health Affairs blog post is the first in a series of post describing a Robert Wood Johnson Foundation-funded evaluation of payment and delivery reform in the state of Arkansas. This post focuses on the basics of the state's patient-center medical home and episode-based payment initiatives. This post provides significant detail as to how the episode based payment is operated and how it is significantly different from the previous fee-for-service payment models.