Why Payment Improvement?
Public and private insurers in Arkansas and across the country are facing a financial crisis as health care costs rise to an unsustainable level. The Department of Human Services, Arkansas Medicaid, Arkansas Blue Cross and Blue Shield and QualChioce of Arkansas are jointly working on an initiative to address this issue in a way that works for providers and patients. The Arkansas Health Care Payment Improvement Initiative is designed to reward physicians, hospitals and other providers who give patients high-quality care at an appropriate cost. The collaborating partners developed and refined the episode model over nine months with significant contributions and comment from hundreds of physicians, health care professionals, patients and other stakeholders.
- Focuses on improving care -- not just saving money.
- Protects physician discretion and keep clinical decision-making with providers.
- Rewards high-quality providers while also creating a financial incentive for ineffective providers to improve.
- Encourages physicians to coordinate their patients’ care, which should lead to better health outcomes for Arkansans.
- Acknowledges that poor performance is a reality and should not be rewarded.
- Aims to improve the status quo and protect Arkansans from alternatives such as intrusive managed care.
This initiative also allows Medicaid to avoid making drastic cuts to the rates it uses to reimburse doctors or to programs on which tens of thousands of Arkansans depend.