HJLR Nov/Dec 2018

48 NOV / DEC 2018 I  Healthcare Journal of LITTLE ROCK dialogue column medicaid Patient Centered Medical Home Program: Evolving to Improve Patient Health in 2019 One of the key early features of the program was a strong financial incentive to manage total cost of care of a patient panel in the context of achieving targets on several quality of care metrics. Many practices have received large bonus checks for managing ra- diology use, emergency roomutilization, hos- pital admissions, and other aspects of chronic disease management. Over time, the total cost of care methodology has proven diffi- cult to sustain in a fair and reliable manner. Escalating pharmacy costs, changes to reim- bursement for ambulatory surgery, creation of the Provider-ledArkansas Shared Savings Entity (PASSE) program, and implementation of a new Arkansas Department of Human Services (DHS) medical information system have led to time-consuming difficulties in editing and sustaining a fair and consistent measurement of the total cost of care for an enrolled PCMH. Over the last five years , the Arkansas Medicaid Patient Centered Medical Home (PCMH) program has been a popular initiative that has supported the transformation of primary care to amore patient-centered, population health model. Coupled with financial support fromMedicare’s CPC+ and participation by several private payers in the state, PCMH has supplied badly needed financial resources to rebuild and redesign primary care throughout the state. This year, the Medicaid PCMH program has the active engagement of more than 200 practice sites and 1,000 primary care physicians to care for 86 percent of the eligible Medicaid population.