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Erickson, E., Rutledge, R. I., Sommers, A. S., Britvec, M. A., Bingaman, A. R., Hennessy, C. M., & Crews, M. L. (2021). Arkansas perinatal episode of care. Medicaid and CHIP Payment and Access Commission (MACPAC). Medicaid and CHIP Payment and Access Commission (MACPAC) https://www.macpac.gov/wp-content/uploads/2021/09/Arkansas-Perinatal-Episode-of-Care.pdf
In 2012, Arkansas established statewide episode of care payment models under its Arkansas Health Care Payment Improvement Initiative. The perinatal episode was selected for early implementation due to the high volume of maternity care and the ability to monitor key quality metrics associated with the episode. Arkansas ended the payment model in 2021.1 The goal of the perinatal episode was to encourage patient-centered care throughout pregnancy, reduce variation in the cost and quality of pregnancy care, and increase provider accountability for improving the quality and efficiency of perinatal care. The model was designed to create payment incentives for providers to manage costs for the entire episode of care. Accountable providers were held financially responsible when their episode costs were higher than annual state-developed thresholds. 2 Conversely, providers were eligible for additional payments when aggregate costs were under state targets, as long as certain quality metrics were met. Under contract with MACPAC, RTI International conducted interviews and examined five states (Arkansas, Connecticut, Colorado, North Carolina, and Tennessee) implementing value-based payment initiatives to improve maternity care in Medicaid. This case study includes an overview of the Arkansas perinatal model, details how the model is defined, describes the payment methodology, and summarizes the available research on the model’s effects on cost and quality.3 MACPAC has also published case studies for the other study states, as well as an issue brief summarizing the key findings (MACPAC 2021a–2021e).