Allison says the Payment Improvement Initiative is pushing for system-wide change and driving to include all healthcare payers operating in the state. "Experiments don't work because they're experiments. Providers don't change their business model on a whim."
Physicians, who have been among the most skeptical Arkansas healthcare reform stakeholders, are cautiously optimistic about the Payment Improvement Initiative. "They're busy, they're seeing 40 or 50 patients a day, and they're just seeing how this works," Wroten said. "We need to look beyond the data at this point and find out what really is going on."
Like Thompson, he has not heard complaints from doctors. "We did not get any calls from physicians who were in a position to pay money back to the state," Wroten said.
Robert "Bo" Ryall, president of the Arkansas Hospital Association, believes the new payment system is on the right track. "The pace of it has been good," he said in a phone interview. "Medicaid spending is down to flat. So we know this is working to some degree."
'A Huge Impact'
In Arkansas, there is widespread agreement that building a public-private, universal payer, value-based healthcare delivery system would have a host of benefits for many states.
"It's a huge impact," Ryall said. "You're talking about having a healthy workforce. It's also important for the health of hospitals… Having a more insured population helps the health of hospitals."
The healthcare reforms Arkansas has embraced are relieving financial pressure on providers, many of whom previously faced budget-busting uncompensated care as well as shrinking Medicaid and Medicare reimbursement rates, Gov. Beebe said in a phone interview. "You can't stay in business if you're giving away 25 percent of your services for free," he said.