ARHOME: Arkansas Health & Opportunity for Me Demonstration Project

The ARHOME project in Arkansas aims to improve health outcomes and economic independence by transitioning Medicaid recipients to private insurance while maintaining eligibility and federal funding. With measurable goals focused on health improvement and poverty reduction, ARHOME seeks to drive quality care and incentivize health activities among members. The project emphasizes annual health improvement targets and Quality Assessment and Performance Improvement Strategic Plans to ensure accountability and quality improvement over the next five years.

• Arkansas
• ARHOME
• Health outcomes
• Economic independence
• Medicaid

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1. ARHOME: Arkansas Health & Opportunity for Me Demonstration Project of National Significance for Improving Health Outcomes & Economic Independence 8/25/21 PRESENTATION

2. Arkansas Works to ARHOME Arkansas Works: Arkansas s Medicaid expansion program under the federal Affordable Care Act. Serves adults: Between 19 and 64 years old With household income below 138% FPL Federal government pays 90%; Arkansas pays 10% Currently established as a Medicaid waiver program; uses Medicaid dollars to buy private insurance for clients The Arkansas Works state law and waiver expire December 31, 2021. Act 530 of 2021 authorizes the Department of Human Services to apply for a new five-year waiver. 2 2 8/25/21 PRESENTATION

3. Current Arkansas Works Population Nearly 325,000 people are currently enrolled in ARWorks. About 19% of Arkansas s non-elderly adults receive health coverage through ARWorks. SFY 2021 expenditures totaled $2.46 billion. 3 3 8/25/21 PRESENTATION

4. ARHOME: What Stays the Same No changes to member eligibility; existing clients who remain eligible will seamlessly transition to ARHOME. DHS will continue using Medicaid dollars to purchase private health insurance. ARHOME will continue drawing 90% federal match. 4 4 8/25/21 PRESENTATION

5. Three Measurable Goals for ARHOME 1. Improve health outcomes among Arkansans in: Maternal and infant health Rural health Behavioral health Chronic disease 2. Provide opportunities to reduce poverty through employment, education, and training. 3. Slow the growth in spending for ARHOME while maintaining the economic and fiscal benefits of coverage through Qualified Health Plans. 5 5 8/25/21 PRESENTATION

6. ARHOME: Primary Focus is Health Improvement Require Health Plans to meet annual health improvement targets based on the Medicaid Adult Core Set used to monitor trends in performance on standardized indicators of quality of care related to primary and preventive care, maternal and perinatal care, care of acute and chronic conditions, and behavioral health care. The next presentation will present the baseline on 21 measures. The purpose of these measures is to drive quality improvement over the next 5 years. Health Plans will provide incentives to their members or providers to encourage health improvement activities. Health Plans are required to submit annual Quality Assessment and Performance Improvement Strategic Plans. Each of the health plans will present their strategic plans. DHS may assess penalties if targets are not met. 6 6 8/25/21 PRESENTATION

7. Requirements for Strategic Plans Strategic Plans must include: Activities to support health improvement and economic independence Activities to meet quality and performance metrics Activities to improve health outcomes for: Pregnant women Individuals with mental illness Individuals with substance use disorders Individuals with chronic diseases Initiatives for improving health outcomes in rural areas 7 7 8/25/21 PRESENTATION

8. Health and Economic Outcomes Accountability Oversight Advisory Panel New joint Executive-Legislative Oversight Panel Panel ensures essential program transparency and stakeholder involvement. Primary purposes: Review health plans annual strategic plans Make recommendations on performance improvement targets 8 8 8/25/21 PRESENTATION

9. Arkansas Works Demographics, July 2019

10. Highest Percentage Enrollment in Poorest and Most Rural Counties AR Works Enrollees as % of County Residents 20 to 64 Years Old, July 2019 8/25/21 PRESENTATION 1/30/21 DRAFT PRESENTATION 10 10

11. AR Works Enrollees by Gender AR Works by Gender, July 2019 AR Works by Gender, July 2019 Male Male 41% 41% Female Female 59% 59% 8/25/21 PRESENTATION 11 11

12. AR Works Enrollees by Race/Ethnicity July 2019 Not Answered 18% White/Caucasian 56% Black/African American 19% Alaskan Native or American Indian 2% Hispanic or Latino 3% Other 2% 8/25/21 PRESENTATION 12 12

13. AR Works Enrollees by Age 50,000 45,254 45,000 40,000 33,541 35,000 30,180 28,221 30,000 23,354 25,000 21,455 20,977 20,431 20,000 17,314 15,000 10,000 5,000 0 19-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 13 13

14. AR Works Enrollees by FPL % 120,000 99,335 100,000 80,000 60,000 40,000 28,104 26,582 25,456 20,630 17,713 20,000 14,988 7,919 - 0 to 20% 21 to 40% 41 to 60% 61 to 80% Federal Poverty Level 81 to 100% 101 to 120% 121 to 138% Over 138% 8/25/21 PRESENTATION 14 14

15. Contact Us Dennis Smith Dennis.G.Smith@dhs.arkansas.gov Elizabeth Pitman Elizabeth.Pitman@dhs.arkansas.gov Nell Smith Nell.M.Smith@dhs.arkansas.gov 15 15 8/25/21 PRESENTATION

16. We Care. We Act. We Change Lives. 16 16 8/25/21 PRESENTATION