Arkansas has a strong commitment to supporting the PCMH as a foundation to state health care reform, evidenced by sweeping statewide legislation and grant funded PCMH pilots. In 2011, Arkansas Medicaid, the Arkansas Department of Human Services, Arkansas Blue Cross and Blue Shield, and QualChoice of Arkansas partnered to transform the state’s health care and payment system through the Arkansas Health Care Payment Improvement Initiative. In 2013, the Governor signed the Health Care Independence Act into law. The Health Care Independence Act requires QHPs offered on the exchange to participate in the Arkansas Payment Improvement Initiative, which includes assignment to a primary care clinician, support for PCMH and access of clinical performance data for providers.

In 2013 Arkansas was awarded a State Innovation Model grant by CMS, which further builds upon their Payment Improvement Initiative and PCMH support. In 2014, the Arkansas legislature approved the expansion of Medicaid through a "private option" platform. The "private option" allows the state to use federal funding to buy plans for low-income individuals from the state's Insurance Marketplace. In January of 2015, Arkansas Surgeon General "noted that close to 80 percent of the state’s Medicaid beneficiaries are now covered by a patient-centered medical home."