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Arkansas Department of Health

Top Flex Activities

Program Area: Support for Quality Improvement

The Arkansas Flex Program will continue to subcontract with the Arkansas Foundation for Medical Care (AFMC) for assistance with reporting and quality improvement activities for the following initiatives:

  • Education and training on how to engage physicians and staff to effectively promote influenza vaccinations to their patients through evidence-based literature and education 
  • Work with critical access hospitals (CAHs) to build processes and policies for healthcare providers to improve patient safety by ensuring all employees receive influenza vaccinations or an alternative method of protection if an employee has allergy or other reasons for not accepting the influenza vaccination
  • Work with CAHs to engage in their communities to promote involvement in community vaccination programs in their patient population areas
  • Assist CAHs in identifying and implementing processes for successful tracking and evaluation of performance
  • Provide resources and education through on-site visits, webinars, teleconferences and by email to support quality measures and performance improvement activities
  • Facilitate collaboration with other CAHs to share best practices through an annual state-wide workshop and four regional learning session meetings
  • Provide inpatient and outpatient quality data reports quarterly to 29 CAHs to improve quality measures
  • Provide data collection and quarterly reports for Emergency Department Transfer Communication (EDTC) measures for all 29 CAHs

The Arkansas Flex Program will continue building capacity for reporting influenza vaccination of healthcare worker and eligible patient population of all 29 CAHs. Activities will be measured through assistance, training, education and networking opportunities for the lowest performing CAHs in the Medicare Beneficiary Quality Improvement Project (MBQIP) outpatient quality measures to improve quality of patient care and outcomes.

Please share a success story about reporting quality data or using quality data to help CAHs in your state improve patient care.

The Arkansas ORHPC quality subcontractor, AFMC, successfully completed their statewide annual conference and regional workshops to help provide Chief Executive Officers (CEOs) and staff with tools for effective reporting. 

Program Area: Support for Financial and Operational Improvement

The Arkansas Flex Program will contract with Wipfli, LLP for assistance with collecting and analyzing financial data for the CAHs. Wipfli will use the most recent five years of data available through the Flex Monitoring Team and the most recent Medicare Cost Report to establish a financial baseline designed to identify CAHs that are at risk of closure from a financial perspective. Key indicators used to identify financially distressed hospitals are:

  • Equity decline by more than 25%
  • Negative equity (fund balance)
  • Unprofitability-negative cash or operating margin
  • Closure

The Flex Grant Coordinator will collect information on CAH day-to-day operations, relationships between the hospital and the medical staff and hospital administration and the governing body, and issues or challenges that have arisen since the last on-site visit. Wipfli will provide an individualized report for each CAH documenting key findings, including key financial indicators and make recommendations. The Arkansas Flex Program and Wipfli will encourage CAH administrators to develop strategies to prepare for new payment and delivery of care models via individual hospital reports and recommendations.

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

Twice a year, the Arkansas Office of Rural Health and Primary Care (ORHPC) meets with the CAH Chief Executive Officers (CEOs), hospital staff and other community partners to provide up-to-date information on quality and financial operations. The Arkansas ORHPC contractors (quality and financial) provide guidance and technical assistance on quality and financial improvements.

Please describe how your state Flex Program has enhanced its use of data in the past year.

The CAHs continue to report MBQIP measures. The Arkansas CAHs continue to report HCAHPS scores, and also utilize the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS). 

Please share any resources or tools that you found useful in your state Flex Program's work this past year that you would recommend to your Flex Program colleagues.

Collaborative staff site visits.

Program Statistics

Type of Organization State Government
Staffing 1.0 FTE
Number of CAHs 29
Website URL Organization Website

Flex Program Staff

Harold Clayton
Flex Coordinator, Arkansas
501-614-5377

Flex Coordinator since March 2017

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, $1,100,000 (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.