A fourth company has been approved as a provider-led managed-care organization for Medicaid recipients who are developmentally disabled or mentally ill, Arkansas Insurance Commissioner Allen Kerr announced Tuesday.
The newly formed Forevercare is owned by a coalition of Arkansas health care providers and Pittsburgh-based Gateway Health Plan, according to the state Insurance Department.
Forevercare joins Arkansas Advanced Care, Arkansas Total Care and Empower Healthcare Solutions as companies that have been approved to participate in the initiative designed to reduce the cost of caring for about 30,000 Medicaid recipients with expensive health needs.
A fifth company, the Arkansas Provider Coalition, also has applied to participate but had not been certified as of Tuesday.
Kathy Grisham, director of Springdale-based Community Clinic, said her organization joined with 10 other federally funded community health centers in the state to form a company that is one of Forevercare's owners.
"We see it as a step in the right direction to hold costs down for a population that requires a lot of care," Grisham said.
Forevercare's other owners are Community Service Inc., a Morrilton-based nonprofit that provides counseling and other services for children in 11 Arkansas counties; a company formed by the Rehabilitation Network of Arkansas, which represents physical, speech and occupational therapy clinics; a company formed by the Arkansas Pharmacists Association; and Ouachita County Medical Center in Camden.
Act 775, passed by the Arkansas Legislature this year, requires the managed-care companies to be at least 51 percent owned by health care providers, to contract with providers across the state and to have at least $6 million in reserves.
Under the first phase of the initiative, which starts in February, the companies will coordinate the care for Medicaid recipients in exchange for payments of $173.33 per patient each month.
In 2019, the companies will take over responsibility for covering all of the recipients' health care needs in exchange for larger payments from the Medicaid program.
Those payments, funded by federal and state money, will be subject to the state's 2.5 percent insurance premium tax, allowing the state to recoup some of what it pays out.
Medicaid recipients who will be assigned to the program comprise about 22,000 Arkansans with significant mental illnesses and 8,000 with developmental disabilities.
The state Medicaid program, which has a budget this year of about $7.6 billion in state and federal funds, spends about $1 billion a year on medical care and other services for those recipients, state Department of Human Services officials have said. The federal government pays about 70 percent of the cost for services for most recipients, with the state paying the rest.
The provider-led managed-care companies announced their plans to participate in letters to the Insurance Department in June.
Arkansas Advanced Care said in its letter that it is owned by he University of Arkansas for Medical Sciences, Little Rock; Arkansas Children's Hospital; Baptist Health; Arkansas Blue Cross and Blue Shield; and Fort Smith-based Bost Inc.
Arkansas Total Care is owned by St. Louis-based Mercy health system, St. Louis-based Centene and LifeShare, a Centene subsidiary that provides services to the developmentally disabled.
Empower Healthcare Solutions said its owners include Boston-based Beacon Health Options; companies owning more than 100 Arkansas nursing homes; several providers serving the developmentally disabled and mentally ill; and a coalition that includes Baxter Regional Health System, North Arkansas Medical System, Unity Health and White River Health System.
The Arkansas Provider Coalition's owners include Amerigroup, a subsidiary of Indianapolis-based Anthem, and more than 70 providers of services for the mentally ill and developmentally disabled.
Metro on 11/22/2017
Print Headline: State adds 4th Medicaid care-guider; Program aims to hold down costs for 30,000 disabled or mentally ill recipients