2019 State HIT Connect Summit

Arkansas has ambitious goals to improve its Medicaid program, with goals to achieve $835 million in savings through SFY 2021 – mainly through program efficiencies, proper utilization of services, and better outcomes – while providing more coordinated and comprehensive services to those who need them.
Critical to this effort will be effectively coordinating care for a relatively small group of Medicaid beneficiaries who represent a significant percentage of costs due to their complex medical and behavioral health conditions, as well as their need for supportive services. This group encompasses about 35,000 beneficiaries accounting for about $500 million in annual spending.
To assess who needs what services – including how many and how often – the Arkansas Department of Human Services selected Optum to complete functional independent assessments; working closely with the state and providers, Optum completed more than 66,000 functional assessments in nine months-with many more to come. Results of the assessments are used to determine whether individuals are eligible for certain behavioral health Medicaid services; appropriateness of home- or community-based care versus more expensive institutional settings; and to develop care plans to improve this group’s health and quality of life. 
This session examines how Optum and Arkansas completed the assessments in nine months-conducting as many as 700 a day at one point – by tailoring a comprehensive assessment tool; employing health and human services professionals to conduct assessments; customizing the underlying technology platform required to support the tool and collect and report data, and offering provider training, support, and outreach.