Arkansas Payment Improvement Initiative: Self-Insured Participation

Designed and launched by the state’s Medicaid program and some of its largest private insurers, including Arkansas Blue Cross Blue Shield (BCBS) and QualChoice, the Arkansas Payment Improvement Initiative (APII) has been a multi-payer effort since its inception in 2011. As the APII has developed, participation from some of the state’s largest self-insured employers has increased its scope and impact.

While we’ve referenced self-insured participation in our previous blog posts, we provide more detail in the following blog post on its ongoing development and explore what it takes for self-insured plans to adapt to the Arkansas Payment Improvement Initiative’s payment model. What has been the response from Arkansas employers and plans? What is the effect on existing contractual relationships? What are the hurdles? ...

As was noted in a previous post, further expansion of private carrier participation in the PCMH model will likely occur due to the requirements of Arkansas’ Medicaid “private option.” Beginning in 2015, the Arkansas Insurance Department will require PCMH participation and support from all carriers offering qualified health plans (QHPs) on Arkansas’ insurance exchange.

As private carrier participation in PCMH increases, it is anticipated self-insured employers will also expand their support of the state’s PCMH model. Walmart, the State and Public School Employee Plans and the State University System Health Plan are also planning participation in the broader APII PCMH model and several other large self-insured employers have shown an interest in participation.