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An Unlikely State Schools Nation on Healthcare Payment Reform

Christopher Cheney, for HealthLeaders Media, April 23, 2014

Thompson told me that a universal payment system can be a powerful driver of change in any state's healthcare reform efforts, such as setting consistent incentives for providers to attain quality and cost containment goals. "We have all of our public and private payers pulling in the same direction," he said. "We are looking at a total system transformation."


Gov. Mike Beebe

Arkansas Gov. Mike Beebe

Crisis Spurs Healthcare Payment Reform in Arkansas


I have been politically aware since Jimmy Carter was elected president and a member of the workforce nearly as long. The level of cooperation and conciliation that is on display in Arkansas appears unprecedented.

The political maneuvering to establish and maintain a key element of the state's healthcare reforms, Medicaid expansion, has been an epic struggle.

After Election Day in 2012, Democratic Gov. Mike Beebe faced a huge obstacle in his quest to expand Medicaid to provide coverage for half of the state's uninsured residents – as many as 250,000 adults. Republicans had taken control of both houses in the Arkansas legislature for the first time since Reconstruction. The GOP caucus opposed Medicaid expansion. And 75 percent majority votes were required in the House and Senate to change the state's Medicaid program.

"There were two general groups of Republicans, all of whom don't like the ACA, don't like Obamacare," Beebe told me last week. "Some are honestly opposed, some are afraid of elections."

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