LITTLE ROCK — Arkansas Medicaid will offer monthly “webinars” to help educate providers on developments in the state’s first-in-the-nation payment overhaul for the $4.6 billion program, Department of Human Services officials said Monday.
State Medicaid Director Andy Allison told lawmakers Monday that the agency will begin broadcasting the web-based informational broadcasts this month to help doctors, hospitals and other health-care providers stay abreast of the quickening pace of the cost restructuring.
On Friday, lawmakers in a joint meeting of the Public Health, Welfare and Labor committees had said they wanted providers to have more input into the changes, which involve revamping the way Medicaid and the state’s two largest private insurers - Arkansas Blue Cross, Blue Shield and QualChoice of Arkansas - reimburse for medical costs. The current system, called “fee for service,” rewards providers for the number of tests, consultations and procedures that they perform. The Department of Human Services wants to change that system, creating financial incentives for eliminating waste by tracking the overall costs of treatment for particular illnesses or conditions. The treatment of a single illness or medical need - from start to finish - is called an “episodes of care.”
Over the next year, average costs for episodes such as upper-respiratory infections, attention deficit hyperactivity disorder and maternity care will be tracked statewide. In the coming months and years, almost all medical conditions will be categorized in episodes for the state’s 780,000 Medicaid recipients.
The overhaul is designed to help reduce costs by 2 percent annually over the next decade, eventually saving billions of dollars, according to Department of Human Services estimates. Currently, the state pays 30 cents of every Medicaid dollar; the federal government pays for the rest.
Providers will be ranked on average cost per episode over the course of a year. If providers’ average costs exceed an acceptable range, they will have to pay back half of the cost overrun. If their costs fall below the acceptable average, they’ll make money, pocketing half of the savings. Providers whose average costs fall within the range of acceptable costs will break even.
The first session is scheduled for Nov. 14 between 3-5 p.m. Information on how to sign up to view the Power-Point presentation with audio components will be on the payment improvement initiative web site shortly, said agency spokesman Amy Webb.
That website is paymentinitiative.org.
Sen. Percy Malone, an Arkadelphia Democrat, said he wanted to make sure the complicated subject matter was accessible to providers and lawmakers.
“The lack of information is what kills us,” said Malone, a member of the Administrative Rules and Regulations Subcommittee of the Arkansas Legislative Council.
Webb said the monthly webinars will include question-and-answer sessions with top department officials and allow providers to ask technical questions about the process.
“It will allow us to sit down and get into the weeds a little bit,” Webb said.
The state’s overhaul has attracted attention from lawmakers, providers and the media, prompting Rep. John Burris, a Harrison Republican, to question why the rule change authorizing two new episodes of care - congestive heart failure and joint replacements - had been listed as “non-controversial” in materials provided to the committee.
“At minimum, we can say this is mildly titillating to some people, wouldn’t you agree with that?” Burris asked Allison.
“I find this extraordinarily interesting myself,” Allison said.
Arkansas, Pages 7 on 11/06/2012