Arkansas Hospitals, Fall 2018

ARKANSAS

Leading Together

HOW HEALTH CAR E

STAYS HEALTH Y

Leaders of the Health Care Team are Attorneys Megan Hargraves and Zach Steadman

At Mitchell Williams, our industry focused team of health care lawyers works with hospitals and health care systems, ambulatory surgery centers, physicians’ groups, and others providing strategic counsel to help navigate this highly-regulated industry. When hospitals and health care systems experience regulatory and operational challenges, our team’s depth in regulatory, litigation and transactional matters enables us to develop and deliver targeted solutions to address the obstacles our health care clients face. Our goal is to help clients solve problems so they can effectively deliver health care services.

Little Rock | Rogers | Jonesboro | Austin MitchellWilliamsLaw.com

Mitchell, Williams, Selig, Gates & Woodyard, P.L.L.C. 425 W. Capitol Ave., Suite 1800 | Little Rock, AR 72201 R.T. Beard, III, Managing Director

Arkansas Heart Hospital Bryant, Arkansas

HELPING BUILD A HEALTHIER ARKANSAS. Clark Contractors is proud to be a part of creating the healthcare infrastructure essential to the well-being of our state and our people. We thank you for your confidence and look forward to continuing our efforts to build a healthier Arkansas.

www.clarkcontractors.net

Features 10

Finding the "Secret Sauce": Accountable Clinical Management and Physician Engagement

ARKANSAS HOSPITALS IS PUBLISHED BY THE ARKANSAS HOSPITAL ASSOCIATION 419 Natural Resources Drive • Little Rock, AR 72205 Elisa M. White, Editor-in-Chief Nancy Robertson, Senior Editor & Contributing Writer DESIGN TEAM: Jamison Mosley, Jamie Smith, Kellie McAnulty

18

From Batesville to Brazil: The Perioperative Surgical Home Collaborative

24

Your Hospital's Culture Determines its Safety

DEPARTMENTS

NEWS

5 6 7 9 9

36

Victims of Sexual Assault Presenting in the ED

42

Allies in Health Care: The AHA Physician Alliance

46

Profile: Brad Parsons, NEA Baptist

HOSPITAL HEROES

50

AHA Services Presents: SUNRx Solutions

17 Dr. Willard Burks

51

What is 340B?

QUALITY AND PATIENT SAFETY

53

Hospitals Win Big at Governor's Quality Awards

31 Focus on Quality

55

AHA Services: A Competitive Advantage

Team Sport of 32 The Antimicrobial Stewardship

POLICY AND ADVOCACY

The Path to Better Care 35 Coordination for ACOs

58

President’s Message AHA Calendar Editor’s Letter All About Hospitals Newsmakers & Newcomers

COACH’S PLAYBOOK Science Meets the 40 Medical Art of Persuasion

62 64

Coverage At Risk: Reporting Challenges under Arkansas Works The Capitol Report The Value Initiative

BOARD OF DIRECTORS: Darren Caldwell, Newport / Chairman Chris Barber, Jonesboro / Chairman-Elect Peggy Abbott, Camden / Treasurer Ryan Gehrig, Fort Smith / At-Large Molly Burns, Magnolia Greg Crain, Little Rock Barry Davis, Paragould David Deaton, Clinton Phil Gilmore, Crossett John Heard, McGehee Vince Leist, Harrison James Magee, Piggott Mike McCoy, Danville Ray Montgomery, Searcy Ron Peterson, Mountain Home Larry Shackelford, Fayetteville Darlene Tuohy, Bella Vista Doug Weeks, Little Rock Debra Wright, Nashville EXECUTIVE TEAM: Robert “Bo” Ryall / President and CEO Jodiane Tritt / Executive Vice President Tina Creel / President of AHA Services, Inc. Elisa M. White / Vice President and General Counsel Pam Brown / Vice President of Quality and Patient Safety Lyndsey Dumas / Vice President of Education DISTRIBUTION: Arkansas Hospitals is distributed quarterly to hospital executives, managers and trustees throughout the United States; to physicians, state legislators, the congressional delegation, and other friends of the hospitals of Arkansas.

Arkansas Hospitals is produced quarterly by Vowell, Inc., 910 W. 2nd St., Suite 200, Little Rock, AR 72201.

Periodicals postage paid at Little Rock, AR and additional mailing offices.

The contents of Arkansas Hospitals are copyrighted, and material contained herein may not be copied or reproduced in any manner without the written permission of the Arkansas Hospital Association.

Articles in Arkansas Hospitals should not be considered specific advice, as individual circumstances vary.

Products and services advertised in the magazine are not necessarily endorsed by the Arkansas Hospital Association.

To advertise, call 501-244-9700.

PRESIDENT’S Message

6 . FALL 2018

EDITOR'S

Letter

BEHAVIORAL HEALTHCARE SYSTEM

Specializing in mental health treatment for children & adolescents Pinnacle Pointe Behavioral Healthcare System is located in Little Rock and is one of Arkansas’ largest behavioral health facilities. We offer acute inpatient and residential services for children and adolescents ages 5-17 who are struggling with emotional or behavioral health issues.

We Provide a Full Continuum of Behavioral Healthcare Services • Residential inpatient care • School-based services • Partial hospitalization • Acute inpatient care • Outpatient services

TRICARE® is a registered trademark of the Department of Defense, Defense Health Agency. All rights reserved.

11501 Financial Centre Pkwy.

Little Rock, AR 501.223.3322 • 800.880.3322

Your New Home for Patient-Centered Surgical Care

Centerview Surgery Center offers patients the exceptional care they have come to expect from Arkansas Urology, in a state-of-the-art facility equipped with the latest technology.

Located adjacent to Arkansas Urology, the new Center is a place where physicians and providers of Arkansas Urology perform urologic procedures and surgeries, and provide patients with world-class care.

Features: n Fully accredited facility – meeting the highest quality and safety standards n The most advanced medical technology for urologic treatment n A streamlined and patient-centered approach to care – convenient and less complicated n Less costly for patients

1310 Centerview Dr. 501-410-1127 Monday – Friday 6 a.m. to 5 p.m.

ArkansasUrology.com

REDUCING TRANSPORTATION GAPS Transportation and the Role of Hospitals is the latest in a series of free guides and resources released by the American Hospital Association, the Health Research & Educational Trust and the Association for Community Health Improvement on how hospitals and health systems can address social determinants of health.

Each year, 3.6 million people in the United States do not obtain medical care due to transportation issues. These include lack of vehicle access, inadequate infrastructure, long distances and lengthy times to reach needed services, transportation costs, and adverse policies that affect travel.

Often thought of as a problem only in rural areas, transportation challenges impact both urban and rural communities.

Multiple strategies may be needed to reduce transportation gaps for patients. This guide discusses the role of hospitals and health systems and recommends strategies for addressing transportation issues, including screening and evaluating patients’ transportation needs and providing transportation services through community partnerships or programs. The guide includes four case studies on hospitals and health systems and their interventions to reduce transportation barriers in their communities.

Download this guide and others in the series by visiting www.hpoe.org and clicking on “Guides.”

NEWS

STAT

Fractured payment strategy?

Everyone needs a trusted advisor. Who’s yours?

bkd.com/hc | @BKDHC

A Coordinated System of Perioperative Care

© 2018 AMERICAN SOCIETY OF ANESTHESIOLOGISTS.

PSH Learning Learning Collaborative Collaborative1.0 1.0and and2.0 2.0Members Members -- 88 unique organizations organizations comprised of: of:

AKAK

• Academic Academic Medical MedicalCenters Centers • Community Community Hospital/Health Hospital/Health Systems Systems • Pediatric Pediatric Hospitals Hospitals • Physician Physician Group GroupPractices Practices

-- 32 states represented represented

PSHLearning Learning Collaborative & 2.0 Participants PSH Collaborative1.0 1.0 & 2.0 Participants © © 2018 2018 AMERICAN AMERICAN SOCIETY SOCIETYOF OFANESTHESIOLOGISTS. ANESTHESIOLOGISTS.

2

11

© 2018 AMERICAN SOCIETY OF ANESTHESIOLOGISTS. 11

© 2018 AMERICAN SOCIETY OF ANESTHESIOLOGISTS.

2

Figure 4 PSH Overlap with Population Health Management

RISK Time spent per patient

HIGH

MEDIUM

Number of patients

LOW

PSH Patients

MEDIUM

LOW

HIGH

© 2018 AMERICAN SOCIETY OF ANESTHESIOLOGISTS.

The PSH Collaborative Helped its Members Reduce Cost of Care and Achieve Return on Investment

Reduced Length of Stay (up to 50%) & Episode of Care Costs (up to $4-10k)

• • • •

Improved Quality & Patient Satisfaction (e.g., decreased pain scores by 75%)

Reduced Hospital Acquired Conditions (up to 30%) & Readmissions (up to 75%)

Alignment with Bundled Payment and ACO programs (e.g., reduced SNF use by up to 50%)

Engaging specialists in value-based care and fostering specialist-hospital collaboration Eliminating silos and fragmented care Decreasing unnecessary testing and utilization, improving room turnover Ensuring appropriate post-discharge care

The PSH Collaborative Helps Providers At All Stages

Core Collaborative: Launching PSH Pilots

• • • • •

Advanced Cohort: Improving PSH Performance & Preparing for VBP programs

Advanced Bundles Payment Add-On: Implementation and operating bundled payments

Emeritus Cohort (invitation only): Scaling PSH Pilots & Aligning with VBP programs

Protocols, pathways, templates, toolkits Best practice sharing 1:1 Dedicated Partner coaching on SMART and stretch goals Monetization arrangements Data collection and benchmarking

Supported by:

In collaboration:

22 . FALL 2018

Interested in joining? Email PSH@asahq.org

• PTCOA has clinics in Hot Springs, Jonesboro, Little Rock, North Little Rock, White Hall, Conway, and Bentonville. PTCOA is also proud to serve through its sister clinics in Batesville, Searcy, and Mountain Home.

• PTCOA’s team consists of physicians and nurse practitioners with over 100 years of combined pain management experience • PTCOA provides truly comprehensive pain management, embracing both med management and interventions.

ARKANSAS’ LARGEST COMPREHENSIVE PAIN MANAGEMENT PRACTICE SPECIALIZING IN THE TREATMENT OF ALL CHRONIC PAIN CONDITIONS.

WWW.PTCOA.COM Phone: (501) 773-6993 Toll Free (844) 215-0731 Fax: (888) 630-8885

• PTCOA accepts all major insurances including Medicare, Medicaid, and all government expansion programs.

24 . FALL 2018

ARKANSAS HOSPITAL ASSOCIATION . 25

High Reliability 2011-2018 Certified Zero Awards ICU Central Line Associated Bloodstream Infections (19) ICU Catheter Associated Urinary Tract Infections (22) Hospital-Wide Central Line Associated Bloodstream Infections (7) Hospital-Wide Catheter Associated Urinary Tract Infections (6) Ventilator Associated Pneumonias (23) NHSN Hip Arthroplasty Surgical Site Infections (1) NHSN All Surgical Site Infections Retained Foreign Bodies (48) Iatrogenic Pneumothorax (26) Accidental Punctures and Lacerations (8) Pressure Ulcers Stages III & IV (38) Hospital Associated Injuries (9) Deep Vein Thrombosis and/or Pulmonary Embolism (2) Deaths Among Surgical Inpatients with Serious Treatable Complications (1) Birth Traumas (18) Obstetric Trauma in Natural Deliveries with Instrumentation (6) Serious Safety Events 1&2 (25) Serious Safety Events 1 & 2 for 1000 Days (2) All Serious Safety Events (1) Early Elective Deliveries (17) Manifestations of Poor Glycemic Control (24)

304

1

ARKANSAS HOSPITAL ASSOCIATION . 27

THE CARE YOU NEED. WHERE YOU NEED IT.

Gold Award

product 2O15

GRAND PRIZE

Pamela Hughes 501.708.2090 www.wielandhealthcare.com

Insta

Our patients place their trust and health in our hands, and caring for patients is a privilege and a responsibility we never take for granted.

We are committed to our mission — to provide quality healthcare and improve the health of our communities.

. . l E L a e SSIB R s i e O l P g s i g Y u R r E t The Snd RECOV a

In Arkansas, mental health issues are affecting people of all ages and the suicide rate across all ages is at an all-time high. But there is hope.

The BridgeWay provides a continuum of care that is safe, secure and serene. Just as each patient is different, so too are our programs. The BridgeWay is the only psychiatric hospital in Arkansas with distinct programs for seniors 55 and older, adults 18 and older, adolescents, ages 13-17, and children, ages 4-12. Whether it is for mood, thought or substance abuse disorders, we provide separate units for each population.

21 BridgeWay Road, North Little Rock, AR 72113 1-800-BRIDGEWAY | thebridgeway.com

arkansasrelay.com/captel

Reconnect.

Captions for your phone calls.

arkansasrelay.com/captel

Reconnect.

Captioned Telephone service from Arkansas Relay offers the ability for anyone with hearing to phone communicate Captions forloss your calls. on the telephone independently. LISTEN, READ and Captioned Telephone service from®Arkansas phone! Relay offers RESPOND to your callers with ease on the CapTel

the ability for anyone with hearing loss to communicate

If you have a hearing loss and are eligible to use LISTEN, the READ and on the telephone independently.

CapTel service, contact Telecommunications RESPOND to yourarkansasrelay.com/captel callers withAccess ease on the CapTel® phone!

Program (TAP) and a representative will loss provide you a If you have a hearing and are eligible to use the CapTel service, contact Telecommunications Access CapTel phone at no cost*.

SAMHSA RELEASES OPIOID OVERDOSE TOOLKIT IN SPANISH The Substance Abuse and Mental Health Services Administration has released a Spanish-language version of its Opioid Overdose Prevention Toolkit. Also available in English, the toolkit offers information and resources to help first responders, prescribers, patients, families and community members prevent opioid overdose.

The American Hospital Association also offers a toolkit, Stem the Tide, to help hospitals and health systems work with their patients, clinicians and communities to tackle the opioid epidemic.

Download the SAMHSA kits free-of-charge at store.samhsa.gov.

– AHA Today

Reconnect.

Program (TAP) and a representative will provide you a

CapTel phone at no cost*.

Captions for your phone calls.

■ 800-981-4463

Captioned Telephone service from Arkansas Relay offers ■ 800-981-4463 ■ www.arkansasrelay.com/tap (TAP Information) the ability for anyone with hearing loss to communicate ■ www.arkansasrelay.com/tap (TAP Information) ■ (CapTel on the www.arkansasrelay.com/captel telephone independently.

LISTEN, READ and Information) ■ www.arkansasrelay.com/captel (CapTel Information) ® RESPOND to your callers with ease on the CapTel phone!

*

If you have a hearing loss and* are eligible to use the CapTelCapTel service, contact Telecommunications Access is a registered trademark of Ultratec, CapTel is aInc. registered trademark of Ultratec, Inc. Program (TAP) and a representative will provide you a CapTel phone at no cost*.

■ ■ ■

800-981-4463 www.arkansasrelay.com/tap (TAP Information) www.arkansasrelay.com/captel (CapTel Information)

* CapTel is a registered trademark of Ultratec, Inc.

NEWS

STAT

When he takes a break from studying.

A perfect moment to talk about alcohol.

Alarming numbers of pre-teens are drinking alcohol—which makes it urgent drinking. For tips on how—and when—to begin the conversation, visit:

www.underagedrinking.samhsa.gov

AAHQ Arkansas Association for Healthcare Quality

www.arkahq.org

Every successful intervention/policy is based on good education and trusting relationships.

Only a

CLICK

away!

Connect

to order free health care resources and tools!

Go to afmc.org and get instant access to information that health care providers like you need every day. You’ll find free tools available for order and download, details about AFMC’s quality improvement and disease prevention projects, survey results, professional publications geared toward Arkansas health care providers and MORE!

REVISED SEPTEMBER 2017

Sexual Assault/Child Sexual Abuse: Emergency Department Response All Licensed Emergency Departments Shall Provide Medical Forensic Examinations for Sexual Assault Victims per Arkansas Code 12-12-403 a; 403 e

Allegation of sexual assault/abuse: Is the patient under 18 years of age?

NO

1. Ask patient if they would like an advocate. If so, call _________. It is not a HIPAA violation to place this call.

2. If the sexual assault occurred within 96 hours, ED will offer/provide a Rape Kit Exam.

3. The incident does not have to be reported to law enforcement in order to provide Rape Kit exam.

4. If patient wants to report for investigation, make police report.

5. No exam shall be performed without patient’s consent.

6. Basic health exam and STI/pregnancy prophylaxis should still be offered even if Rape Kit collection declined.

ARKANSAS DEPARTMENT OF HEALTH

YES Make mandated report to AR Child Abuse Hotline (1-800-482-5964). Include safety concerns in report.

Report Accepted by Hotline?

No

Yes

Ask hotline if Arkansas State Police/Crimes Against Children Division (ASP-CACD) or Department of Children and Family Services (DCFS) will be assigned as primary

Arkansas State Police/ Crimes Against Children Division (ASP-CACD) assigned: -HOLD for contact by Arkansas State Police/ Crimes Against Children Division to coordinate plan of care

Department of Children and Family Services (DCFS) Assigned: -No rape kit needed if offender < 10 years old (regardless of time frame) -Basic health exam -Contact Department of Children and Family Services (DCFS) on-call if immediate safety concern

Provide/refer for Rape Kit Exam

Yes

Is the patient under 18 years of age AND there was either lack of consent or ability to consent?

OR Is the patient under 16 years of age and more than 3 years age difference between age of patient and alleged offender (regardless of consent)?

Yes

Make police report

Did the event occur in the last 96 hours?

No

Rape kit not indicated. Basic health exam.

Test for Sexually Transmitted Infections (STIâ&#x20AC;&#x2122;s) and pregnancy if indicated.

Let Us Take Care of Facilitating your patients' medical transportation needs on both sides of the horizon Advanced Life Support Paramedic-Staffed Critical Care and Specialty Care Transports for ICU/ CCU patients • ZOLL Impact Ventilators/ RSI Capabilities • ZOLL X Series Cardiac Monitors • Medication monitoring and administration

ALS Ground Ambulance | Medical Helicopter | CCT/SCT Fixed-Wing Air Ambulance 2 0 1 7 A L S S e r v i c e o f t h e Ye a r b y t h e A r k a n s a s A m b u l a n c e A s s o c i a t i o n

855.367.9911 Celebrating 50 Years of Service

Evidence-based best practices so often cited in the literature require more than just clinical evidence.

They also require the art of persuasion, as all change initiatives do.

People change when they see the value in relinquishing what has worked for them in the past in exchange for what is possible in the future.

NEW DIABETES

RESOURCE With contributions from leading diabetes experts from around the world, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), a division of the National Institutes of Health, has completed the third edition of a resource designed to be a preeminent source for crucial scientific information on diabetes and its complications: Diabetes in America, 3rd Edition.

“Diabetes doubles the risk of many devastating conditions in the body, from hearing loss to heart disease to nonalcoholic fatty liver disease,” said NIDDK Director Griffin P. Rodgers, M.D. “With this third edition of Diabetes in America, we hope to shine a light on the many consequences of this costly and chronic disease and how research continues to improve the outlook for people with, or at risk for, diabetes or its complications.”

Learn about the key points of Diabetes in America, 3rd Edition by reading the fact sheet (PDF), or dive into the data by viewing the full publication. Both are available free of charge at niddk.nih.gov.

NEWS

STAT

Advancing Health in Partnership

42 .FALL 2018

The relationships between physicians and hospitals have never been more important.

You take care of your patients & we’ll take care of your practice Our medical malpractice team has the experience to handle the most complex legal issues faced by Arkansas’ hospitals — both large and small. We recognize that many Arkansans receive quality healthcare through our state’s community hospitals, and we take pride in working with these hospitals in facing the challenges created by the ever-changing business, legal and regulatory landscapes.

Let us put our experience to work for you.

Rogers

Little Rock

wlj.com

DOES YOUR HOSPITAL RECEIVE

ACCURATE PAYMENT? SPECIALIZING

in clinical documentation improvement and coding accuracy. Our services include but are not limited to: Clinical Documentation Improvement Inpatient/Outpatient Coding & Billing Assessments Hospital Chargemaster Review & Update Denials Management Education

405-878-0118 www.acsteam.net

Tame the wave of rising benefit costs.

How do you control your benefits spend when you need to invest in talent?

Your ability to maneuver determines your competitive edge.

With healthcare plan design changes, you can ride the crest of a strong total rewards offering without wiping out your budget.

To learn more, visit ajg.com or contact us at your nearest Gallagher office: 6325 Ranch Drive Little Rock, AR 72223 501.485.3075 Š 2018 Arthur J. Gallagher & Co. | AJG.COM 34274A

PROFILE

We know our mission and our strategy resonate with our patients and their families.

Building Partnerships. Delivering Excellence.

The professional liability and property protection for your healthcare facility deserves the expertise of specialists. The Healthcare Division of BXS Insurance is one of the largest and most experienced group of medical professional liability and property specialists for hospitals, PHOs, IPAs, surgery centers, clinics, physicians, surgeons, and nursing homes in the Southeast. Call Tom Hesselbein today for more information at (501) 664-7705.

Professional Liability | Property | Loss Control | TPA Services (501) 664-7705 | bxsi.com 1. BXS Insurance is a wholly owned subsidiary of BancorpSouth Bank. 2. Insurance products are • Not a deposit • Not FDIC insured • Not insured by any federal government agency • Not guaranteed by the bank • May go down in value. 3. BXS Insurance is an insurance agent and not an insurance carrier. 4. Always read your policy for coverage terms and conditions.

FINANCING IS THE FIRST STEP. Our Capital Markets professionals have the industry experience and client-first approach you need to complete upcoming projects. Planning new construction? Refinancing? Equipment leasing?

We can customize the right capital structure. Call or click today and find out what Crews can do for you.

A First Security Company

INVESTMENT BANKING | PUBLIC FINANCE BONDS | LEASES | LOANS Paul Phillips 501.978.6309 pphillips@crewsfs.com

800.766.2000 | crewsfs.com Member FINRA & SIPC

Patient Goes to their provider

Provider

Writes prescription. prescription discount card and gives it to patient with prescription

Contract Pharmacy Patient takes prescription and SUNRx prescription discount card to their pharmacy

Claim adjudicates in real time

Patient pays pharmacy the lowest price available for their medication

COMMUNITY PARTNERS Like so many members of the Arkansas Hospital Association, North Arkansas Regional Medical Center (NARMC) is a proud supporter of its surrounding communities. When NARMC found out that Valley Springs School District had a specific need the hospital system could meet, hospital staff began the process of fulfilling the district’s request.

The need? A hospital bed for the nurse’s office in order to serve students better.

“When we found out about this need, I knew this was something we could help with,” says NARMC Vice-President of Clinical Services and Chief Nursing Officer Sammie Cribbs. “We recently upgraded several beds in order to enhance patient care, and we were able to donate a bed we were no longer using. We are proud to be able to serve our local communities in such a way.”

NARMC staff delivered the bed before school began in late August. School Nurse Shannon Tennison relocated her office to make room for the bed.

“As a school district, we want to make sure our students’ needs are met, whether that comes in the form of pencils and paper or more specific needs,” Superintendent Judy Green said. “We are thankful NARMC was able to provide the equipment we needed.”

NEWS

STAT

The 340B Drug Savings Program:

HELPING HOSPITALS KEEP PATIENTS & COMMUNITIES HEALTHY Prescription drug prices skyrocket

N E WS

What is 340B?

PR ES CR IP DR UG PR TI ON IC ES

340B

New York Times:

“Runaway drug prices”

COST

S

$$ $465 $$$ $ 164 $1295 5 $$$$ $5289 $$$$ $

Washington Post:

“Drug prices top Americans’ list of health care concerns” The rapidly rising cost of prescription drugs is threatening access and affordability for millions of Americans who need life-saving medications.

Hospitals use 340B savings to provide:

The 340B program requires pharmaceutical manufacturers participating in Medicaid to sell outpatient drugs at discounted prices to hospitals and other organizations that care for communities with many low-income and uninsured patients.

Small program, big benefits for patients and no cost to the government

340B cost (2.8%)

increased access to care Rx

clinical pharmacy services community outreach programs free vaccinations transportation to follow-up appointments

If 340B were scaled back or eliminated

Rx

Rx

$

$457 Billion annual drug purchases

in the U.S.

340B is a small program that constitutes less than 2.8 percent of the $457 billion in annual drug purchases made in the U.S., and it does not cost the government or taxpayers money.

Congress should preserve the 340B program to

PROTECT PATIENTS’ ACCESS TO CARE Learn more at:

www.aha.org/protect340B Despite a 25-year track record of increasing access to care for vulnerable patients and communities, some want to scale back or eliminate the 340B program.

This would hurt patients while adding to the record profits of pharmaceutical companies.

ARKANSAS HOSPITAL ASSOCIATION . 53

Health Insurance the Arkansas Way. Quality, affordable health insurance plans are available for qualifying Arkansans through My Arkansas Insurance. Open Enrollment begins November 1, 2018.

Arkansans who experience a life event that affects family size, location, income, or other big changes may qualify to get marketplace health coverage outside of the open enrollment period. Visit myARinsurance.com for Special Enrollment Period qualification information.

HIPAA Compliance & Training Licensure Matters Employment Issues Medical Malpractice Defense Regulatory Law & Governmental Affairs

Enrollment Information:

Medical Device & Pharmaceutical Products Defense

Online: Visit myARinsurance.com

By Phone: Call 844-355-3262, Monday – Friday, 8:00 a.m. – 4:30 p.m.

Quality Health Insurance for Arkansans

You take care of your patients & we’ll take care of your practice

Insurance Defense myARinsurance.com

Let us put our experience to work for you.

Who can save up to 8 lives and improve the health of up to 200 simply by saying “yes?”

YOU! when you register to become an organ and tissue donor

Say “YES” to donation when you register today.

Rogers

Little Rock

wlj.com

Your Complete Travel Solution ÂŽ

Enjoy the comfort, ďŹ&#x201A;exibility, security and privacy that simply cannot be equaled by any form of public transportation.

Call for Details Phil Gustafson 501.975.9328 / phil@central.aero

Since 1939

1501 Bond Avenue, Little Rock, Arkansas |

| www.central.aero | 501.375.3245

Arkansas Works Program

August 2018 Report

As of July 8, DHS data showed just over 62,000 Arkansas Works enrollees were subject to the work requirement in August. Most are already meeting the requirement through work, school, or other life situations that made them exempt from reporting. Numbers below are a point-in-time snapshot of the requirement and some fluctuate daily.

1,218 Satisfied reporting requirement

62,635* Originally estimated to be subject to work requirement in August

16,357 Did not satisfy reporting requirement

265,223 Total Arkansas Works population as of August 1, 2018.

Between July 8 and Sept. 9, 2018, 2,623 fewer people became subject to the requirement due to case closures unrelated to compliance or a change in circumstances. That left 60,012 subject to the requirement in August.

One month non-compliance

6,174** **

2,247 Reported an exemption since receiving notice

40,190 Meeting requirement due to work, training, or other activity.

Notices explained these enrollees are exempt from reporting their activities.

Three months

Two months non-compliance non-compliance (closed)

5,076**

4,353

due to closures unrelated to compliance & as of Sept. 9, 2018

*Enrollees ages 30-49 are being phased into the requirement from June through September 2018. Those 19-29 will roll in starting January 2019.

ARKANSAS HOSPITAL ASSOCIATION . 59

60 .FALL 2018

ARKANSAS HOSPITAL ASSOCIATION . 61

State

OfďŹ ce

Party

State House of

Pennsylvania Representatives District 193 Republican Arkansas

Winning Losing Winning Losing Vote candidate candidate votes votes difference Torren Ecker

Vincent Cockley

State House of Jana Della Kendon Representatives District 90 Republican Rosa Underwood

1,784

1,783

1

1,068

1,066

2

Oregon

State House of Representatives District 53

Republican

Jack Zika

Ben Schimmoller

3,771

3,769

2

Montana

State House of Representatives District 92

Republican

Mike Hopkins

DJ Derek Smith

414

412

2

California

San Diego City Council District 8

Antonio Nonpartisan Martinez

Christian Ramirez

4,087

4,084

3

West Virginia

State House of Delegates District 16

Republican

Vera Miller

Jarred Cannon

848

844

4

Nevada

Clark County Public Administrator

Republican

Aaron Manfredi

Thomas L. Fougere

29,514

29,518

4

Oklahoma

State House of Representatives District 12

Republican

Kevin McDugle

Nick Mahoney

2,338

2,333

5

Texas

State House of Representatives District 107 Republican

Jo Ruzicka

Brad Perry

2,064

2,058

6

Maine

State House of Representatives District 110 Republican

Mark Andre

Jacob Imes

210

203

7

HOSPITALS TAKE ADDRESSING AFFORDABILITY HOSPITALS TAKETHE THELEAD LEAD IN IN ADDRESSING AFFORDABILITY www.aha.org/TheValueInitiative www.aha.org/TheValueInitiative

ONE ONE IN FOUR FOUR IN

Americans say the cost of health Americans say the cost of health care is their biggest concern. care is their biggest concern.

1

1

people have difficulty affording their prescription medicine.

2

people have difficulty affording their prescription medicine.

2

Hospitals and health systems have held price increases under 2% in each of the last four years.

3

Hospitals and health systems have held price increases under 2% in each of the last four years.

3

HOSPITALS ARE:

HOSPITALS ARE:

Redesigning the delivery system to cut costs and improve patient and community health.

Redesigning the delivery system to cut costs and improve Improving the quality and outcomes of care. patient and community health. the for quality andbyoutcomes DeliveringImproving high-value care patients embracingof care. risk and new reimbursement models.

Delivering high-value care for patients by embracing Implementing operational solutions to reduce costs. risk and new reimbursement models.

Sources: 1. Monmouth University Polling Institute. Health Care is Top Concern of American Families. Accessed at https://www.monmouth.edu/ polling-institute/reports/MonmouthPoll_US_020717/; 2. Peterson Kaiser Health System Tracker. What Do We Know About People with High Out-of-Pocket Spending? Accessed at: http://www.healthsystemtracker.org/chart-collection/recent-forecasted-trends-prescription-drug-spending/?_sf_ s=recent+trends#item-people-taking-rx-drugs-say-can-afford-treatment-1-4-difficult-timeaffording-medicine; 3. Bureau of Labor Statistics.

Producer Price Index data, 2007 - 2016, for Hospitals (NAICS Code 622).

Implementing operational solutions to reduce costs.

Sources: 1. Monmouth University Polling Institute. Health Care is Top Concern of American Families. Accessed at https://www.monmouth.edu/ polling-institute/reports/MonmouthPoll_US_020717/; 2. Peterson Kaiser Health System Tracker. What Do We Know About People with High Out-of-Pocket Spending? Accessed at: http://www.healthsystemtracker.org/chart-collection/recent-forecasted-trends-prescription-drug-spending/?_sf_ s=recent+trends#item-people-taking-rx-drugs-say-can-afford-treatment-1-4-difficult-timeaffording-medicine; 3. Bureau of Labor Statistics.

Producer Price Index data, 2007 - 2016, for Hospitals (NAICS Code 622).

WELCOMES

Stephen Webb PRESIDENT/CEO HOSPITALS • CLINICS • SPECIALISTS Searcy | Newport | Beebe | Bradford | Cabot | Clinton | Heber Springs

Unity-Health.org

Arkansas Children’s Northwest Springdale, Arkansas

Arkansas Children’s Northwest Springdale, Arkansas

CONSTRUCTION

CONSTRUCTION

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INDUSTRIAL

INDUSTRIAL

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CIVIL

CIVIL

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E N V I R O N M E N TA L

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E N V I R O N M E N TA L

WE BUILD PLACES TO HEAL

WE BUILD TO HEAL At Nabholz, thePLACES buildings that matter to you matter to us.

At Nabholz, the buildings that matter to you matter to us.

It might look like just a hospital, but to the 200,000 children and families Arkansas Children’s Northwest serves in Northwest Arkansas, it’s a beacon It might look like just a hospital, but to the 200,000 children and families of hope and healing, providing care close to home. With over 300 team Arkansas Children’s Northwest serves in Northwest Arkansas, it’s a beacon members who call this region home, we understand that difference.

of hope and healing, providing care close to home. With over 300 team members who call this region home, we understand that difference.

479.659.7800 | www.nabholz.com

479.659.7800 | www.nabholz.com

S P E C I A LT Y

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S P E C I A LT Y