Critical Issues

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Access to Care

As the backbone of America's health safety net, it is incumbent on hospitals and health systems to protect access to care for patients and communities and to ensure that the most vulnerable of those people, including children, the elderly, the disabled, and those with pre-existing conditions, are not left behind. Structural and financial access to care at Arkansas’s hospitals is an essential and central component of the health care system our state depends upon. Population health, citizen happiness, and economic prosperity all hinge upon adequate access to hospital care.

Accountability & Financial Viability

The guiding mission of our state’s hospitals is to provide top-quality care to all Arkansans. One essential part of that mission is granting patients access to the information and resources they need to understand and make informed decisions about their care. Arkansas hospitals are committed to improving patients’ access to information about the price of their care; however, because pricing for health care is complex and depends on many variables, a patient’s out-of-pocket costs are determined by his or her insurance carrier (or Medicare or other government payer). Simply stating hospital prices cannot tell the full story of patient costs.

Communicating directly and effectively with patients as they take more responsibility for their care means creating common definitions and language to describe hospital pricing information, explaining how and why the price of patient care may vary, providing context for other factors of care – like quality and safety – that can impact their health outcomes, and directing patients to additional information and resources for finding financial assistance, when needed. Our hospitals are actively working with other organizations to create tools for patients that will help them more easily navigate the health care system and come to a fuller understanding of their health insurance coverage plans.

Opioid Epidemic

Our state, along with the rest of the U.S., is experiencing an epidemic of opioid use and overdose that is driven, at least partially, by increases in opioid prescribing. In 2017, Arkansas recorded the second highest opioid prescribing rate in the nation – 105.4 opioid prescriptions per 100 Arkansans. We are one of 35 states that saw significant increases in drug overdose deaths between 2013 and 2017.

In the face of these alarming statistics, the state has committed to reducing opioid deaths and abuse in Arkansas. Act 820, passed in 2017, requires prescribers to check the Arkansas Prescription Drug Monitoring Program (PDMP) database each time they prescribe a Schedule II or Schedule III opioid, and the frst time they prescribe a benzodiazepine medication to a patient. Arkansas has had its own PDMP since 2011. Dispensers in Arkansas have been required to electronically submit information regarding each prescription dispensed for a controlled substance since that time. That has given our state a foundation of information upon which to call. 

Quality & Patient Safety

Today, more than ever, Arkansas's hospitals and health systems are engaged in – and dedicated to – the ongoing work of ensuring our patients' safety and delivering high-quality care. Providing each patient with the best outcome possible means avoiding preventable harm and delivering precisely the care they need, with an emphasis on the quality of care.

Our state's hospitals have embraced technology that mitigates risk, implemented high-reliability practices, and invested in – and engaged with – strategic quality improvement initiatives. Hospitals now talk about creating "cultures of safety," an ethic that starts with leaders. Between 2014 and 2018, hospitals directly engaged in the American Hospital Association's Hospital Improvement Innovation Network program, or HIIN, saved $1.2 billion in health care costs, prevented 141,000 harms, and saved 14,000 lives.

Workforce

Like much of the country, Arkansas is experiencing a critical shortage of health care workers. The demand for new nurses and doctors is growing, given population growth and aging. At the same time, supply is not keeping pace with demand. Many older workers are retiring; indeed, one-third of doctors currently practicing are anticipated to be older than 65 in the next decade.

This shortage has affected Arkansas more significantly than most states. There are not enough health care workers entering the workforce – either through graduating from medical education programs or by immigrating from outside the United States – to keep pace, and this imbalance of supply and demand has exacerbated the shortage of health care workers. For example, physician coverage in Arkansas is only 204 doctors per 100,000 people – far lower than the national average of 272.