Arkansas has been a leader among states in full-scale healthcare system transformation. The state’s transformation efforts have been successful in part because of multi-payer collaboration from both public and private sectors and alignment of financial incentives across multiple initiatives to achieve higher-quality, more patient-centered, cost-effective care. The Health Care Independence Act of 2013, which expanded coverage to low-income Arkansans by offering them premium assistance to purchase coverage through the health insurance marketplace, reinforced this principle of aligning financial incentives across multiple initiatives. It did so by including a provision requiring marketplace insurers to participate in the Arkansas Health Care Payment Improvement Initiative (AHCPII), including support for the patient-centered medical home (PCMH) model. The Arkansas Insurance Department (AID) developed a rule to implement the requirement for insurers to offer PCMH support, although several of the state’s insurers were voluntarily participating in PCMH efforts across the state.
This fact sheet describes the Arkansas PCMH model adopted by the AHCPII participants and the insurer participation requirements in the AID rule.