This year marks a decade since the Arkansas Center for Health Improvement began to collect data under the Arkansas Healthcare Transparency Initiative (HTI), Arkansas’s primary, unified source for health data. Over the past 10 years, the initiative has been an invaluable resource for healthcare leaders, researchers, and policymakers seeking better insight into health and health care in Arkansas.
Transforming Health Data Into Useful Information
In 2015, the Arkansas General Assembly recognized the need for a more transparent healthcare system. Legislators authorized a new resource that would integrate health data from multiple sources and make it possible to transform that data into useful information to support consumer choice, health policy decisions, health research, quality improvement initiatives, and evaluation of health-related programs. The HTI was created under Act 1233 of 2015, the Arkansas Healthcare Transparency Initiative Act, championed by then-Sen. David Sanders. The law placed the HTI under the authority of the Arkansas Insurance Department and designated ACHI to administer the infrastructure for the initiative. Data collection began the following year.
A core component of the initiative is the Arkansas All-Payer Claims Database (APCD), a central repository for medical, pharmacy, and dental health insurance claims data and provider and enrollment files submitted by public programs and private insurers in the state. The Arkansas APCD includes claims data for between 80% and 85% of all Arkansans with some type of healthcare coverage.
“When you visit your doctor, the clinic submits a claim to your insurer to get paid for the services provided to you. That claim for payment ultimately gets submitted to the APCD in an anonymized way that protects the identity of the patient but allows for analysis of an individual’s use of services and the associated costs over time,” said Craig Wilson, ACHI’s president and CEO. “When you put thousands of records together, you can generate real insight into the health and healthcare needs of our communities.”
About half of states have established or are developing APCDs, but the Arkansas APCD is only one part of the HTI. Over the years, the General Assembly has authorized expansions of the HTI to include other types of data, including birth and death records, hospital discharge and emergency department utilization records for the uninsured, cancer registry data, medical marijuana cardholder data, Arkansas State Police crash records, and workers’ compensation data.
“The growth of the HTI in our state means that Arkansas now has one of the most robust repositories of state health data in the country,” said Wilson.
Researchers can make requests to use HTI data for their projects, and those requests are overseen by a 13-member board to ensure that data use aligns with the initiative’s objectives and privacy standards. Since the inception of the HTI, ACHI has fulfilled more than 150 data requests for projects conducted by state agencies, major universities across the country, and private organizations. Projects by Arkansas researchers have brought in millions of research dollars into the state. In fact, of all of the National Institutes of Health research projects across the nation using APCDs since 2012, nearly 20% originated in Arkansas.
HTI-Supported Projects
HTI data have been used in numerous published research studies, including examinations of the causes of delays in breast cancer surgery, the impact of maternal mental health and substance use disorders on the risk of adverse infant outcomes, and disparities in insurance coverage among colorectal cancer patients. The Rand Corporation has used HTI data to study the rates that commercial insurers pay to hospitals and compare them to the rates that Medicare pays for the same services.
ACHI draws on HTI data for a wide range of analytical projects intended to support informed decision-making by policymakers, healthcare leaders, and consumers. These projects have shed light on topics such as behavioral health events among new mothers.
“We found that fewer than half of pregnant and postpartum women in Arkansas who experience acute behavioral health events have outpatient follow-up visits within 120 days of an emergency room visit or inpatient stay,” said Wilson. “Thanks to the Healthcare Transparency Initiative, we were able to highlight the potential for policy intervention as the state seeks to improve maternal and infant health.”
Another notable project using HTI data was an analysis of the financial impact of smoking on Medicaid and private insurance. ACHI’s analysis showed that smoking-related health issues cost the Arkansas Medicaid program $795 million annually and cost private insurance $542 million each year. That insight played a key role in the Arkansas General Assembly’s decision to raise the legal smoking age in the state from 18 to 21, a step that Arkansas took before Congress made the same change in federal law.
More recently, ACHI has begun to develop interactive dashboards that begin to allow the public to explore data on topics such as healthcare spending across the state, acute behavioral health events among new mothers, roadway fatalities, and the state’s healthcare workforce, including primary care physicians, obstetrics and gynecology physicians, and general surgeons. The dashboards have been widely used as research tools, including by journalists covering health issues in Arkansas.
Potential To Support Rural Health Transformation
Arkansas is particularly well positioned with the HTI to make the most of its share of the federal government’s $50 billion investment in rural health and health care, the Rural Health Transformation Program. The state has been allocated $208.8 million for fiscal year 2026 and could receive about $1 billion total over the next five years under the program.
Arkansas plans to use the funds for innovative programs that will address issues such as workforce development, healthcare transportation, emergency medical services, at-home care for chronic conditions, nutrition, and fitness. The Healthcare Transparency Initiative will allow Arkansas to evaluate these efforts to determine which programs are delivering the greatest impact and resulting in improving health outcomes in rural communities across the state.
Whether it’s identifying public health challenges, assessing healthcare workforce needs, or evaluating system performance, consistent and comprehensive data collection is essential to support informed decision-making. Now with a full decade of data collection, the HTI provides Arkansas with a critical tool to not just identify areas that need improvement but also understand how we can begin to make those improvements happen.
