UAMS Study Finds Mothers Living in Rural Areas or Covered by Medicaid Less Likely to Receive Prenatal Care

By David Wise

LITTLE ROCK — Arkansas mothers who live in rural areas and/or who have a Medicaid-covered birth are less likely to receive early prenatal care or receive an adequate number of prenatal care visits, according to a study published recently by researchers at the University of Arkansas for Medical Sciences (UAMS) Institute for Community Health Innovation.

The study, “Sociodemographic factors associated with prenatal care utilization in Arkansas, United States,” analyzed prenatal care utilization among women in Arkansas. Researchers found that mothers with a Medicaid-covered birth were more likely to have fewer than the recommended number of prenatal care visits, more likely to initiate prenatal care late, and more likely to have no prenatal visits at all.

Researchers also found that some minority groups — specifically Black and Native Hawaiian/Pacific Islander populations — were more likely to experience late or less than the recommended number of prenatal care visits compared to white mothers.

UAMS Study Finds Mothers Living in Rural Areas or Covered by Medicaid Less Likely to Receive Prenatal Care

Arkansas awarded $17 million grant to support maternal health initiatives

by Talk Business & Politics staff (staff2@talkbusiness.net)

Arkansas has been awarded a $17 million grant, the Transforming Maternal Health (TMaH) Model, from the U.S. Department of Health and Human Services’ (HHS) Center for Medicare and Medicaid Services (CMS), the Department of Human Services announced Monday (Jan. 6).

Applying for the TMaH grant was among the recommendations made by the Strategic Committee for Maternal Health established by Gov. Sarah Sanders’ executive order last year. The funds will support efforts to improve the health of pregnant women, new mothers, and babies, the Arkansas Department of Human Services (DHS) said.

The grant will provide the funding over 10 years to several state Medicaid agencies, including Arkansas, with a goal of reducing disparities in access and treatment.

Arkansas awarded $17 million grant to support maternal health initiatives

Weekly update from State Representative DeAnn Vaught

Maternal health will likely be a key focus of the 2025 Regular Session of the Arkansas General Assembly as lawmakers work to address an ongoing challenge in our state. 

Addressing maternal health will not only save lives but will also strengthen Arkansas families and communities. Currently, Arkansas faces one of the highest maternal mortality rates in the nation. More than 60% of Arkansas counties have limited maternity care, and many counties have none at all. Limited access to quality health care before, during, and after pregnancy creates serious risks for families. 

In March 2024, Governor Sanders signed an Executive Order to Support Moms, Protect Babies, and Improve Maternal Health. The order established the Arkansas Strategic Committee for Maternal Health, which brought together over 100 stakeholders representing organizations from across the state. 

The committee's comprehensive report offers several recommendations to address the maternal health crisis, including:

• Creating Medicaid pathways for doulas and community health workers as provider types with reimbursable services.

• Expanding prenatal care services at local health units where care is currently limited or unavailable.

• Establishing a Family Medicine Obstetrics Fellowship and exploring the creation of obstetrics and gynecology residencies and a school of midwifery in Arkansas.

• Considering the establishment of maternal health homes and expanding the Life360 Maternity Care Homes program.

The proposals represent solutions to combat the maternal health disparities affecting our communities and ensure that every Arkansan has access to the support and care they need during one of life’s most critical moments. The Governor’s budget proposal also includes $13 million in new Medicaid funding for recommendations made by the committee. 

The General Assembly will convene on January 13, 2025. All meetings of the House of Representatives will be streamed live and available for replay at arkansashouse.org.

CD4 debate: Healthcare, economy, Middle East conflicts discussed

by George Jared (gjared@talkbusiness.net)

U.S. Rep. Bruce Westerman, R-Hot Springs, and his opponent Democrat Risie Howard of Pine Bluff agreed on some key issues but were diametrically opposed on others during their Fourth Congressional district, PBS Arkansas debate on Thursday (Oct. 10).

If elected, Howard said she would support and protect the Affordable Care Act, commonly referred to as Obamacare. About one in three Arkansans are on Medicaid and it was expanded through the act. If the act were repealed, something that former President Donald Trump has suggested if he’s re-elected, many would be without health insurance, she said.

Westerman said he wouldn’t vote to repeal the act, but the Medicaid expansion is driving up federal and state debts. He supports the Fair Care Act, legislation that fixes some of the problems with the act, but he didn’t give any specifics.

CD4 debate: Healthcare, economy, Middle East conflicts discussed

State of the State Mid-Year 2024: Medical providers pinched by disparity in costs, payments

by Steve Brawner (BRAWNERSTEVE@MAC.COM)

Arkansas health care providers are facing increasing costs without matching payment increases from government payers and insurance companies. It’s a major issue in a state that ranks near the bottom in maternal and infant mortality rankings.

Dr. Joe Thompson, president and CEO of the Arkansas Center for Health Improvement, a healthcare research and policy development organization, said the state is “still in a recovery mode from the acute effects of COVID.” Thompson was referring to inflationary pressures caused by the pandemic, when labor and supply costs increased dramatically. While hospitals are no longer relying on high-paid traveling nurses, the use of that resource during the pandemic has driven up labor costs for full-time staff.

At the same time, Medicaid, which serves primarily lower-income individuals, hasn’t increased payments, while Medicare, which serves older Arkansans, hasn’t increased them enough. Commercial insurance, the health care system’s other primary payer, is trying to limit reimbursement increases.

State of the State Mid-Year 2024: Medical providers pinched by disparity in costs, payments

Alliance forms with $250,000 Walton gift to support doulas, seek coverage

by Steve Brawner (BRAWNERSTEVE@MAC.COM)

A newly formed group will seek Medicaid and other insurance coverage for doulas, who provide nonmedical support for women going through pregnancy and the birthing process.

The Doula Alliance of Arkansas (DAR) announced Aug. 7 that had it been formed with help from a $250,000 grant from Ingeborg Initiatives, a group seeking to improve maternal health that was founded by Olivia Walton, granddaughter-in-law of Walmart founder Sam Walton. DAR will use that seed money, which will be spread over two years, to hire an executive director.

That part-time position, the search for which was launching that day, will work to gain state recognition of doula certification and work toward coverage of the service by Medicaid and other insurance providers. The grant also will pay for a fall conference, continuing education, and other expenses.

Alliance forms with $250,000 Walton gift to support doulas, seek coverage

DHS to end Medicaid managed care dental program, return to fee-for-service

by Talk Business & Politics staff (staff2@talkbusiness.net)

The Arkansas Department of Human Services (DHS) announced Monday (June 3) that it will end its Medicaid managed care dental program and return beneficiaries who qualify for dental coverage to the Medicaid fee-for-service program beginning later this year.

DHS expects to launch this program on Nov. 1, 2024, and efforts to support this change are being prioritized immediately, it said.

The dental managed care program within Arkansas Medicaid has been in effect since Jan. 1, 2018, and as of this month serves 572,047 beneficiaries.

DHS to end Medicaid managed care dental program, return to fee-for-service

1 in 5 Arkansas children lost Medicaid during ‘unwinding’ process, report finds

KUAR | By Mary Hennigan / Arkansas Advocate

From the Arkansas Advocate:

About 20% of children insured in Arkansas’ Medicaid program lost access during the state’s “unwinding” period, according to a report released Thursday from the Georgetown University Center for Children and Families.

“Arkansas did move very aggressively, and I think you can see that reflected in their losses,” said Joan Alker, executive director of the Georgetown organization.

In six months, the Arkansas Department of Human Services disenrolled 184,500 people from Medicaid; more than half, 94,000, were children.

The report, which analyzed every state’s performance during the unwinding as of December 2023, ranked Arkansas with the sixth highest percentage decline in Medicaid coverage for kids. Arkansas’ rate more than doubled the nationwide average of 10%.

1 in 5 Arkansas children lost Medicaid during ‘unwinding’ process, report finds

John Sykes/Arkansas Advocate

Jasmine James, third from left, talks about her experiences with Medicaid during an event held Friday in front of DHS offices in Little Rock. A group called Make Medicaid Better gathered in front of the Department of Human services offices in downtown Little Rock Friday morning to seek a response from the department about changes to Medicaid the group had suggested to DHS in an earlier meeting.

House Minority Leader Tippi McCullough shares concerns with Medicaid disenrollment process

KUAR | By Ronak Patel

Since the beginning of the year, Arkansas has been disenrolling members from Medicaid. At the end of last year, Congress passed legislation that ended the public health emergency that was enacted due to the pandemic. The legislation required that Medicaid enrollees who were only eligible as a result of the pandemic be disenrolled starting this year.

In an interview with Talk Business & Politics, House Minority Leader Tippi McCullough, D- Little Rock, said she has been concerned with how the process has gone.

“The process of forms is taking a long time. Then people are getting kicked off and reapplying to get back on so it’s such a complicated process that people are bound to fall through the cracks,” she said.

House Minority Leader Tippi McCullough shares concerns with Medicaid disenrollment process (ualrpublicradio.org)

Tess Vrbin/Arkansas Advocate

Reps. Tippi McCullough and Ashley Hudson (both D-Little Rock) talk on the House floor March 8, 2023. Both spoke against and voted against Senate Bill 199 on the floor and in the March 7 House Judiciary Committee meeting.

Arkansas Medicaid rolls drop 72,000 in August as redetermination enters final month

by Talk Business & Politics staff (staff2@talkbusiness.net)

Arkansas’ Medicaid rolls fell by more than 72,000 in August, according to new figures released by the state Department of Human Services on Friday (Sept. 8).

Arkansas is unwinding, or redetermining, Medicaid eligibility for patients as part of the ending of the federal COVID-19 pandemic. There was a continuous enrollment requirement during the crisis that prevented DHS from removing most ineligible individuals from Medicaid. State law requires the unwinding process be completed in six months.

In its fifth month of redetermination, DHS officials said 72,519 Arkansans had their Medicaid cases closed – a number that includes those added to the rolls during the public health emergency and regular renewals. In August, DHS said more than 50,000 cases were renewed after eligibility was confirmed.

https://talkbusiness.net/2023/09/arkansas-medicaid-rolls-drop-72000-in-august-as-redetermination-enters-final-month/

Federal agency asks states to pause Medicaid unwinding; DHS says request does not apply to Arkansas

KUAR | By Tess Vrbin / Arkansas Advocate

The U.S. Centers for Medicare and Medicaid Services (CMS) sent a letter to all 50 states Wednesday, asking some to restore coverage for people who were recently disenrolled for procedural reasons.

The request does not apply to Arkansas, Department of Human Services spokesman Gavin Lesnick said in an email.

DHS conducts Medicaid eligibility reviews on an individual basis and does not require eligibility information for every member of someone’s household to provide benefits to that person, he said.

https://www.ualrpublicradio.org/local-regional-news/2023-08-31/federal-agency-asks-states-to-pause-medicaid-unwinding-dhs-says-request-does-not-apply-to-arkansas

Daniel Breen/Little Rock Public Radio

Members of the group Arkansas Community Organizations protest the state's Medicaid unwinding process at the State Capitol on Aug. 22, 2023.

77,000 removed from Medicaid rolls in June

by Roby Brock (roby@talkbusiness.net)

In the third month of activity, Arkansas posted its highest level of disenrollment figures since beginning its redetermination process mandated by state and federal law.

In June, Arkansas Department of Human Services officials disclosed that “approximately 77,000 beneficiaries were disenrolled because they are no longer eligible. As of July 1, total Medicaid enrollment was 971,364, including 414,722 children, 276,764 on ARHOME, and 279,878 other adults.” More than 50,000 cases were renewed, according to DHS.

In April and May – the first two months of a six-month disenrollment process – DHS reported 72,802 and 68,838 recipients respectively.

https://talkbusiness.net/2023/07/77000-removed-from-medicaid-rolls-in-june/

DHS officials say redetermination numbers meeting estimates, work requirement waiver in ‘negotiation’ phase with feds

by Roby Brock (roby@talkbusiness.net)

Nearly halfway through a six-month process to redetermine Medicaid eligibility for hundreds of thousands of Arkansans, Department of Human Services officials said they believe estimates of where the population would land are close to projections.

DHS Secretary Kristi Putnam and Arkansas Medicaid Director Janet Mann appeared on this week’s edition of Capitol View and Talk Business & Politics. According to figures released by the agency in June, nearly 140,000 Arkansans have been disenrolled from the Medicaid expansion program, now known as ARHOME, or had their cases closed through regular program operations. New figures are expected to be released in mid-July.

“We do feel that they are tracking. We chose to do our extended category first with our regular renewals, because we had worked through the three-year pandemic on redeterminations, and if we determined that they would most likely be ineligible, we put them in the extended category. So we started with that, those categories first, to really work on right-sizing our population,” Mann said.

https://talkbusiness.net/2023/07/dhs-officials-say-redetermination-numbers-meeting-estimates-work-requirement-waiver-in-negotiation-phase-with-feds/

DHS disenrolls 43,385 extended Medicaid recipients, 68,838 total in May

by Talk Business & Politics staff (staff2@talkbusiness.net)

The Arkansas Department of Human Services said it disenrolled 43,385 Medicaid beneficiaries whose coverage had been extended because of the COVID public health emergency in the month of May, the second month Arkansas could do so under federal rules.

Another 24,453 cases were closed as part of DHS’s normal operations, bringing the total closures for the month to 68,838. Among the cases due in May, coverage was renewed for 39,848 beneficiaries.

Arkansas stopped disenrolling most Medicaid beneficiaries after former President Donald Trump on March 18, 2020, signed the Families First Coronavirus Response Act. It increased federal Medicaid matching funds for states that kept all individual cases active during the public health emergency. The state’s Medicaid rolls rose by 230,000 total during the pandemic.

https://talkbusiness.net/2023/06/dhs-disenrolls-43385-extended-medicaid-recipients-68838-total-in-may/

Arkansas Medicaid disenrollment jumps to roughly 140,000

KUAR | By Daniel Breen

Arkansas’ overall Medicaid enrollment has dropped nearly 15% in two months with about 140,000 people deemed ineligible for coverage since April. A report released Thursday by the state Department of Human Services shows 68,838 people lost coverage in May.

States were not allowed to terminate Medicaid coverage during the federal COVID-19 Public Health Emergency, which ended in May. Arkansas began the process of re-determining eligibility in April, when roughly 72,000 recipients lost coverage.

The largest number of people to lose coverage in May were enrolled in ARHOME, the state's Medicaid expansion program. That was followed by ARKids A, which serves children from the lowest-income families in the state.

https://www.ualrpublicradio.org/local-regional-news/2023-06-08/arkansas-medicaid-disenrollment-jumps-to-roughly-140-000

Daniel Breen/KUAR News

Representatives of the group Arkansas Community Organizations display signs with some of their demands for streamlining the Medicaid redetermination process in front of the Arkansas State Capitol on Thursday.

National health advocacy groups ask governor to pause Medicaid disenrollment process

by Roby Brock (roby@talkbusiness.net)

A coalition of 23 national health-related nonprofits expressed concern Thursday (May 11) over Arkansas’ early Medicaid disenrollment numbers and called on Gov. Sarah Sanders to pause the process.

The governor’s office said it is following state and federal law and has a systematic plan to evaluate and assist those whose Medicaid healthcare coverage is being redetermined.

The 23 groups (listed below) include the American Cancer Society Cancer Action Network, American Lung Association, March of Dimes, and Susan G. Komen.

https://talkbusiness.net/2023/05/national-health-advocacy-groups-ask-governor-to-pause-medicaid-disenrollment-process/

Medicaid recipients to begin losing coverage after April 30

by Steve Brawner (BRAWNERSTEVE@MAC.COM)

Ineligible Arkansas Medicaid beneficiaries will lose coverage for the first time in three years after April 30 as Arkansas exits the COVID-19 public health emergency.

The Department of Human Services this month started making the removals as a result of the federal Consolidated Appropriations Act, signed into law last December. It allowed states after March 31 to begin dropping Medicaid recipients who are no longer eligible.

All beneficiaries who have not had a renewal in the last 12 months will be redetermined. State law requires the work be completed in six months.

https://talkbusiness.net/2023/04/medicaid-recipients-to-begin-losing-coverage-after-april-30/

State lawmakers discuss changes to Medicaid as a result of COVID-era regulation ending

During an appearance on KARK Channel 4’s Capitol View, Rep. Mary Bentley, R-Perryville, and Sen. Fred Love, D-Mabelvale, spoke about upcoming changes to Medicaid.

During the COVID-19 pandemic, former President Donald Trump signed into law the Families First Coronavirus Response Act, which stopped states from disenrolling Medicaid recipients, while the public health emergency was in effect.

Through an appropriations bill at the end of last year, Congress ended the public health emergency, which will require states to disenroll Medicaid recipients who were eligible for coverage as a result of COVID-era regulations.

https://www.ualrpublicradio.org/local-regional-news/2023-04-23/state-lawmakers-discuss-changes-to-medicaid-as-a-result-of-covid-era-regulation-ending

KARK Channel 4'S Capitol View

Rep. Mary Bentley, R-Perryville, and Sen. Fred Love, D-Mabelvale, are reaching out to healthcare providers and constituents to make sure eligible Medicaid recipients don't lose coverage. Last year, Congress ended COVID-era regulations that stopped states from disenrolling Medicaid recipients.

Rural Emergency Hospital bill expected to help financial crisis for some

by Ronak Patel (rspatel.personal@gmail.com)

Rep. Lee Johnson, R- Greenwood, filed a bill aimed at helping rural hospitals in financial distress. HB 1127, the Rural Emergency Hospital Act, would grant the Arkansas Department of Health (ADH) the authority to license hospitals as “rural emergency hospitals.”

In an interview with Talk Business & Politics, Johnson explained this type of licensure can help hospitals in rural areas with their finances.

“It [Rural Emergency Act] provides a pathway for rural hospitals in Arkansas to take advantage of a new designation that was created by CMS [Center for Medicare & Medicaid Services] at a federal level. This new designation would allow qualifying rural hospitals to get reimbursed at a higher rate for outpatient services and procedures,” he said.

https://talkbusiness.net/2023/01/rural-emergency-hospital-bill-expected-to-help-financial-crisis-for-some/

Medicaid’s future looms with health care, budget ramifications for legislators, new governor

by Talk Business & Politics staff (staff2@talkbusiness.net)

Big factors affecting Arkansas’ Medicaid program loom in the near future and this legislative session will require clear health care and fiscal policy direction from Gov. Sarah Sanders and the new GOP supermajority at the state capitol.

Sen. Missy Irvin, R-Mountain View, the chair of the Senate Public Health Committee, discussed those ramifications in an appearance on this week’s Capitol View program.

For starters, the state’s health care system is fragile right now. Many hospitals, particularly in rural parts of the state, are in critical condition as pandemic funds are drying up, but personnel and supply costs remain extraordinarily costly. Federal Medicare and Medicaid reimbursement rates have remained unchanged for years, to the point that hospital administrators contend Congress has to approve higher rates in order to keep up with inflation and decades of increased costs or else they will have no choice but to close.

https://talkbusiness.net/2023/01/medicaids-future-looms-with-health-care-budget-ramifications-for-legislators-new-governor/