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Wal-Mart adds $670,000 to health-care program

By Staff and wire reports

This article was originally published January 10, 2013 at 7:04 a.m. Updated January 10, 2013 at 6:32 p.m.

gov-mike-beebe-speaks-thursday-jan-10-2013-at-the-state-capitol-on-the-arkansas-payment-improvement-initiative

Gov. Mike Beebe speaks Thursday, Jan. 10, 2013, at the state Capitol on the Arkansas Payment Improvement Initiative.

Correction: Sally Welborn's name was misspelled in the original version of this story. It has been corrected below.

— Wal-Mart has joined a major effort to improve the way health-care costs are handled in the state, officials announced Thursday at the state Capitol.

Gov. Mike Beebe, state Surgeon General Joe Thompson and Wal-Mart Senior Vice President of Benefits Sally Welborn said the Bentonville-based retailer has joined the Arkansas Payment Improvement Initiative and has committed $670,000 to create an annual tracking report to evaluate the impact on the health changes.

The effort is aimed at moving away from a fee-for-service model to one in which insurers pay for “episodes” of care rather than individual treatments.

Beebe said the initiative, which is now in its first phase of implementation, is aimed at reducing or flattening the cost of health-care.

The changes are intended to curb the growing costs of the state’s health-care system.

"In other words, not the 8, 10 percent increase every year," Beebe said. "All this is designed to try to slow down those inflationary pressures that we've all experienced in health-care costs."

Beebe called this the start of the work and said it may take some time before results are seen. And he praised Wal-Mart for its support.

"We have worked for the past two years to bring the public and private sectors together in order to provide better health care in more cost-efficient ways," Beebe said in a statement. "It's critical that large, self-insured companies like Wal-Mart be involved in this complex work that has the potential to serve as a model for the rest of the nation."

In addition to underwriting the tracking report, Wal-Mart will serve on the newly created APII Employer Advisory Council, and fund the development and dissemination of information that explains how payments are being restructured, the statement said.

"We are very supportive of this work that will reward doctors, hospitals and other providers who offer great care at an appropriate cost," Welborn said. "Governor Beebe is leading a first-of-a-kind payment-reform effort in Arkansas that health experts elsewhere are following closely. We respect the work being done in Arkansas, and we are excited about the opportunity to offer real support to such a meaningful project in our home state."

The state began rolling out the payment changes in July. The state partnered with Arkansas Blue Cross and Blue Shield and QualChoice of Arkansas on the initiative.

Information for this article was contributed by the Associated Press and by Gavin Lesnick of ArkansasOnline.

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NONSHEEPLE says... January 10, 2013 at 8:10 a.m.

The same Walmart that doesn't like to cover its own employees is working to help the state cover others? I guess in the end their workers get coverage but it comes from MORE government....

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DEMOCRATREPUBLICAN says... January 10, 2013 at 8:12 a.m.

What does Walmart have to do with medicaid? Is it because half of their underpaid part time workers are users of medicaid? I don't know?

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DEMOCRATREPUBLICAN says... January 10, 2013 at 11:42 a.m.

Beebe: And he praised Wal-Mart for its support.

For his election or this program?

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JessePinkman says... January 10, 2013 at 12:08 p.m.

Yet Wal Mart is still more popular than our congresscum

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mhck52 says... January 10, 2013 at 12:08 p.m.

Now wait a minute. Walmart is the only major company I know of that had a health plan for part-time employees. And, it wasn't a government mandated plan. I say "had" because recently they announced ending that benefit and replacing it with Obamacare. So much for the,"You can keep your insurance if you are happy with it" promise. As for the Medicaid comment, this sounds like something more than just a plan to get Medicaid costs under control. I get from the article that the state is looking at one more requirement to impose on health insurance companies that want to do business in Arkansas. The money is to help fund a method of tracking the plan to see if it works. At least, that's what I get out of this. What I don't understand is what was meant by the comment that 57,000 Walmart employees in Arkansas will participate. That needs to be explained.

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rainbowharold55 says... January 10, 2013 at 12:10 p.m.

Because it's much cheaper to pay for a report than supply health insurance or a living eage to your workers.

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TheBatt says... January 10, 2013 at 12:15 p.m.

So - the program in question would push hospitals and doctors to accept payments for "episodes" - you get the flu and start to improve, but then end up with pneumonia and in the hospital. Well - that is part of the same "episode", so the total payment to doctor/hospital is already set...

You require surgery - surgery goes well, but after you head home, there are complications (bleeding/infection, whatever), so you have to go back in... sorry Doctor, but we only pay for the surgical episode. You will have to eat the added costs.

While I understand that part of this is to further try to cut the costs associated with poor initial diagnosis - such as people going to ER at hospital A with serious abdominal pain, are sent back home with a "diagnosis" of gas, or kidney infection, pain gets worse, got to hospital B, similar treatment. Days later, cannot walk, and getting seriously ill - got to hospital C and they discover that your appendix is ballooned and you are going to die if you don't get immediate emergency surgery... Insurance (or in the specific case I mention - Medicaid) gets bills from three different hospitals, three sets of lab work, several different doctors, for what should have been found and treated at Hospital A.

Or the patient who heads to hospital with chest pain, and other "typical" symptoms of a heart issue. A few tests run, some nitro administered, along with IV fluids, and sent home. Patient returns by ambulance hours later in full-blown heart attack... New regulations already are fining hospitals who have these kinds of cases (of course, they have to be reported... by the hospital itself....hmmm).

I am not against efficiency, so long as it IMPROVES the diagnosis and treatment, and recovery for patients. Unfortunately, such systems are far more likely to result in decreased level of care for some, and increased over-use of certain tests, scans, and other diagnosis mechanisms... until they then clamp down on that...

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TheBatt says... January 10, 2013 at 12:15 p.m.

Compare this to your car - you take it to a mechanic because it is running rough. Mechanic finds a bad spark plug and wire, replaces it, and car runs much better. You pay the man for the service he did - parts + labor (and plenty for the tax man). On the way home, the car begins to run rough again. So the next day, you swing back to the mechanic who then finds another issue that had been masked by the other issue. Fixing issue A, then uncovered issue B (that could only be fully seen by fixing issue A). Are you going to demand that the mechanic not bill you to fix this second issue because "I paid you to fix my car"? He likely is going to laugh at you.

So mechanics then just charge a flat fee for engine work? That way, if their first repair doesn't completely fix it, their costs are still covered? Go in, and the charge for diagnosing and fixing your car is $1000. Pay up front, please. If it is a $5 part, plus an hour labor - he just made a fortune. But maybe he uncovers not just a $5 part broken, but you have a blown head gasket - so his costs plus labor under the old system run around $1100... while he didn't make "extra" from you, he balances that out by those cheap easy repairs that cost him little....

I think folks can see the issue with such a system, especially for consumers.

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cdawg says... January 10, 2013 at 12:47 p.m.

This approach isn't to benefit "consumers" Batt, it's to benefit 2nd party providers, i.e., all insurance plans.
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What episodes of care will do is toss up $50K to treat a heart condition. The different players must then fight among themselves to see who can capture the greatest share. Hospitals usually win which means in the long run all players will be employees of a hospital.
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I can see how containing medical costs will benefit the U.S.' biggest employer but I can't see how it will weave into Wally's plans for walk-in clinics. So, expect some modifications in 'episodes of care' for exceptions which allow Wally and other clinics to thrive.
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Jackabbott says... January 10, 2013 at 3:08 p.m.

Agree with rainbowharold55 but would add this. Want to help the people of Arkansas, then build some factories here to produce products and pay them a living wage, rather than bringing all the cheap Chinese and Mexican stuff and pawning if off as "quality" merchangedise. Even some of the candy is now made in Mexico using their polluted, dirty water and sold to kids.

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