The Arkansas Center for Health Improvement orchestrated a little end-of-year cheer for its partner groups at a reception at the Clinton Presidential Center on Dec. 10, as well it should -- 2014 was a monumental year for health care in the state.
The revelry comes amid a transition in the executive branch of state government that leaves the center's director, Dr. Joe Thompson, divested of his surgeon general title. The outgoing governor opened his remarks with this reassurance, "I've been [asked to] be sure and remind you people who work with the doctor, he's not fired. He still has a job. He's not going to be the surgeon general but he's still going to be around. Quit writing his eulogy," Mike Beebe said.
"I, on the other hand ... ."
Created in 1998, ACHI (pronounced AY-kye) falls under the University of Arkansas for Medical Sciences umbrella. Its sponsors include Arkansas Children's Hospital, the state Department of Health and Human Services, Blue Cross Blue Shield, Delta Dental and UAMS, and it has coordinated or aided these sponsors' responses to childhood obesity, fluoridation, the tobacco excise tax (which funds the statewide trauma response system), widening health-care coverage for small businesses and, perhaps most famously, implementation of the state's private option Medicaid expansion.
This year was a particularly big one for health insurance build-out. The private option Medicaid expansion is credited with holding down premiums and shrinking the number of uninsured in the state from 22.5 percent last year to 12.4 percent this year -- the largest percentage drop in the nation, according to a survey by Gallup Inc.
"A number of years ago," Beebe told the assembled, "I came away from a meeting in Boston convinced that I had to do what I could to end the old fee-for-service model because it's unsustainable. America ends up with the highest medical care costs and some of the worst returns in terms of quality of all the industrialized nations."
Along with Medicaid expansion, the state has implemented a substantive change in the commerce of health care. The Arkansas Health Care Payment Improvement Initiative aims to oversee doctors' average costs for all patients treated for a particular "episode" (knee replacement, pregnancy, heart failure, to name a few) and reward them for containing costs and yielding positive patient results.
"Through hard work primarily led by your surgeon general" and other people in the room, he said, "I think we have the model for the rest of the country.
"It actually rewards quality, rewards efficiency."
When Beebe finished, Thompson took the microphone and said that, along with chief executive officers and directors of the center's five sponsors, it is additionally advised by 21 health policy advisers, many of whom were in the audience.
"So effectively, I have 26 bosses, and I just lost one," he said, referring to Beebe, "but I would say those 26 bosses represent collectively the willpower of Arkansas, and through them your interests and commitment to this state."
High Profile on 12/21/2014