By setting standards for care alongside the cost thresholds, Arkansas' payment system is intended to make value a driving force in the state's delivery of healthcare services. Physicians who provide services above the cost threshold have to pay money back. "It's not just about lowering cost," Thompson said. "The idea is to improve quality first, then achieve efficiency to lower cost."
Joseph Thompson, MD
Arkansas Surgeon General
PCMHs help physicians coordinate care, marshal resources, and provide the best value to their patients, said Steve Spaulding, VP of enterprise networks at Arkansas Blue Cross Blue Shield, the state's largest private healthcare insurer. "When they refer to somebody, they can be sure they're referring to the best value in the system," he said of the doctors who lead medical homes.
Not surprisingly in the home of college football's Razorbacks, Thompson calls medical home leaders "quarterbacks."
"We're wrapping a team around a lead physician," the pediatrician said, adding that a doctor working in a medical home practice could have as many as 5,000 patients. "The team helps carry the load. It helps their efficiency. It helps their effectiveness."
Medical homes will be crucial in helping physicians treat thousands of previously uninsured Arkansas residents, said David Wroten, Executive VP of the Arkansas Medical Society.
"The Payment Improvement Initiative, particularly the primary care medical homes, is hopefully how we will be able to handle this increased access to medical care," he said of the half million previously uninsured Arkansas residents who now have the option to obtain healthcare coverage through Medicaid or the state's new public exchange, Arkansas Health Connector.