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Arkansas Department of Health

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CAH Quality Improvement

The Arkansas Foundation for Medical Care (AFMC) will identify quality improvement issues, and provide technical assistance to Arkansas’ 28 critical access hospitals (CAHs) as determined by hospital performance with the Medicare Beneficiary Quality Improvement Project (MBQIP) measures data reports.  These data reports consist of Patient Safety/Inpatient/Outpatient, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), and Emergency Department Transfer Communication (EDTC) measures. The MBQIP project is for CAHs to implement quality improvement initiatives to improve their patient care and operations.

AFMC will conduct regional collaborative area learning sessions in three or four regions in the state annually. These sessions facilitate learning in small groups and provide a forum for education on new, innovative strategies for improving quality improvement scores and sharing best practices.

AFMC will provide quarterly reports to the Flex Coordinator. These written reports will include the number of CAHs contacts, a list of CAHs that are performing poorly with their measures, methods to improve poor performing CAHs, and results of those measures. Technical assistance will also be provided to CAHs via physical on-site, virtual WebEx, e-mails, video conference, or telephone.

Activities Measured:

The Arkansas Flex Coordinator will maintain ongoing communication with AFMC to provide programmatic guidance and review reimbursement requests. The Flex Coordinator will participate in site visits, webinars, and conference calls with AFMC to ensure the contractor is implementing contracted deliverables with all 28 CAHs as it relates to quality improvement.

CAH Operational and Financial Improvement

BKD LLP will provide mid-cycle revenue cycle on-site reviews of hospitals, outpatient, and clinic cases to identify coding and billing errors, as well as potential charge capture and pricing issues.  They will also provide rural health clinics (RHC) operational on-site assessments. BKD LLP will review the hospital Medicare cost report to identify financial and operational strengths and challenges and to improve the financial and operational outcomes of CAHs. 

BKD LLP will recruit CAHs for the margin improvement assessment program to aid in the overall financial and operational improvement Participating hospitals will elect the financial service(s) areas that they deem suitable for their current needs. Financial services offered will include revenue cycle reviews, clinical and operational assessments, supply and pharmaceutical cost management assessments, and cost report reviews. BKD LLP will provide financial and operational education to all Arkansas’ critical access hospitals to aid in increasing knowledge on COVID funding requirements.

Activities Measured:

The Arkansas Flex Coordinator will maintain ongoing communication with BKD LLP to provide programmatic guidance. The Flex Coordinator will participate in on-site visits, and conference calls with BKD LLP to ensure the contractor is implementing contracted deliverables with CAHs and their provider-based rural health clinics that have elected financial services.

Please provide information about network activities in your state to support Flex Program activities.

The Arkansas Office of Rural Health & Primary Care Medicare Flex Program is working closely with the Arkansas Hospital Association to provide more extensive quality improvement and financial assistance to the CAHs.

Program Statistics

Do you have any hospitals interested in converting to CAH status?:
No
Type of Organization State Government
Staffing (FTE) 1
Website Organization Website
Number of CAHs 28

Flex Program Staff

Michael Trevino
SORH Director, Arkansas

SORH Director since September 2022

Gina Gulley
Flex Coordinator, Arkansas
(501) 614-5377

Flex Coordinator since September 2021

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.