Episodes of Care Provider Portal
The goal of the initiative is to reward providers who deliver high-quality, coordinated and cost-effective care for certain medical episodes. The Provider Portal is a key component of the payment initiative approach. The portal is a HIPAA-compliant online tool that allows hospitals, physicians, mental health providers and other providers to submit a limited set of additional quality metrics data that will to be tied to the initiative’s financial incentives. The portal also allows providers who are designated as PAP access to comprehensive reports of their average quality, costs, and utilization for episodes during a given time period. This is the first time that Medicaid and the state’s private insurance companies will make such detailed analytical information available to providers. To help providers navigate the reports, we have created an easy-to-understand guide that explains how to read the report using an illustrative example. For those needing assistance using the portal, here you will find step-by-step instructions.
During a three- to six-month preparatory period beginning in July, data submission of additional quality metrics beyond those captured by claims will be available through the portal. At the end of July, PAP performance reports will be posted to the portal for physician/hospital providers or available via secure messaging for non-physician providers. After the preparatory period, the payers will use some of the data entered into the portal for the ADHD, Congestive Heart Failure and Hip and knee replacement episodes to determine whether a provider is eligible to share in savings or excess costs across their episodes. No additional data will be required for Upper Respiratory Infection or Perinatal episodes. All future reports are expected to all be available online. This Medicaid data is a public record, but is not intended to influence any person’s choice of qualified medical provider.
Physician practices, hospitals, RSPMI providers and other qualifying providers can click here: Advanced Health Information Network to access the portal using an existing Advanced Health Information Network (AHIN) username and password. If you do not have an active AHIN account and would like to register contact Customer Support (501) 378-2336 or email firstname.lastname@example.org
Arkansas Medicaid has opted to use the AHIN Provider Portal for RSPMI, psychologists and other mental health providers who are participating in the Attention Deficit/Hyper Activity Disorder episodes of care. Access is free. Beginning Oct. 1, 2012, provider portal data entry of quality metrics is required to be eligible for gain-sharing for selected episodes. If you have questions, please contact the Medicaid payment initiative customer service center at 501-301-8311 or at ARKPII@dxc.com.