Case Studies

PCMH: Medicaid Sharing Savings Update

October 1, 2015

Contact

Joseph W. Thompson, MD, MPH
President & CEO
501-526-2244
achi@achi.net

 

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 initiatives to achieve higher-quality, more patient centered, cost-effective care. The Arkansas Health Care Payment Improvement Initiative (AHCPII) is at the core of these efforts and includes two primary strategic models for supporting these efforts: patient-centered medical homes (PCMHs) and episodes of care. Both models are designed to incentivize providers and reward those who meet quality and financial targets while providing better-coordinated, high-quality care. Support for Medicaid components of the state strategy includes a team of individuals at the Arkansas Department of Human Services, Hewlett-Packard, General Dynamics Health Solutions, the Arkansas Foundation for Medical Care, Qualis Health, and the Advanced Health Information Network, among others. These efforts include providing quarterly progress reports and leading, not only practice support initiatives across the state, but also monthly advisory calls with front-line physicians to shepherd the effort. For PCMH providers who achieve practice transformation and quality of care targets, the program offers a shared-savings opportunity in which practices may receive up to half of the generated savings. The 2014 outcomes from the PCMH program demonstrate a reduction in cost growth and improvements in quality outcomes, resulting in significant shared savings for some providers.

This fact sheet describes Arkansas Medicaid’s shared-savings methodology and 2014 results.