JUNE 2001

Table of Contents

Arkansas Center for Health Improvement

Under the umbrella of ACHI based at UAMS in partnership with the Arkansas Department of Health, a three community health-care networks in rural Arkansas are engaged in new initiatives to address rural health-care issues on a broad scale. Although these networks are located in different parts of the state with unique local situations, they have several health-care and access problems in common:

• a high proportion of impoverished and uninsured residents
• fragile health care systems
• low numbers of primary care practitioners relative to the number of residents
• populations with increased risk of cardiovascular disease and diabetes
• relatively high numbers of low-birth-weight babies and teen pregnancies
• problems in accessing services – often both financially and geographically.

These networks, which are being developed through the Arkansas Southern Rural Access Programs (ASRAP), are working to strengthen their rural hospitals and provider networks as well as to improve local economic viability.

Rural Health Networks

I. Arkansas River Valley Rural Health Cooperative

The Arkansas River Valley Rural Health Cooperative is developing an innovative community-based health plan that will give low-income uninsured or underinsured residents in Franklin, Logan, and Scott counties affordable access to needed health care services.

II. Crittenden Community Health Network

The Crittenden Community Health Network plans to expand services through three rural clinic sites in isolated Delta communities operated by Crittenden Memorial Hospital. The expansion will include building a community-wide health services and fitness facility and improving access to health care and social services.

III. White River Rural Health Network

The White River Rural Health Network is developing a comprehensive health center that combines public and private health systems, including behavioral health, to serve uninsured and impoverished citizens in north central Arkansas.

Rural Health Revolving Loan Fund

This fund improves access to capital among rural health-care providers who would not otherwise quality for a loan. The fund specifically targets organizations and individuals who address health-related needs in medically underserved rural areas throughout Arkansas.

The fund was established in October 1999 with a $500,000 Robert Wood Johnson Foundation (RWJF) grant and other start-up funds for a total of $899,000. With this corpus and through other financial partners, a total of $16 million is available to leverage current and future loan funds, loan guarantees, and loan repurchasing. The leveraging of funds allows the Revolving Loan Fund to create workable loan packages for rural health-care providers who are considered poor credit risks by traditional lenders. Loans from the fund can provide for setting up new medical practices, enhancing existing clinical facilities, installing information systems, and other related investments. To date, four loans have been closed or approved for:

• physician recruitment at a Delta-area hospital
• a new clinical services facilities in NE Arkansas
• support of a nurse midwife in central and SW Arkansas
• a Delta-area medical clinic
  

Arkansas Health Insurance Expansion Initiative

Arkansas has a documented high proportion of uninsured individuals, history of poor health among its citizens, costly health-care networks with little competition, relatively low levels of health insurance coverage through employer-sponsored plans, and a large “working poor” population without coverage or the means of obtaining it.

Historically, Arkansas has provided public support for health care through Medicaid at the minimum federal requirements. During the past decade, efforts to increase the availability of health insurance in the state have produced some successful expansion efforts; however, significant challenges remain.

With a planning grant from the state, ACHI will form the Arkansas Health Policy Roundtable as a coalition of state government leaders, health-care purchasers and providers, consumers, and insurers and will help develop specific plans for expanding health insurance coverage in Arkansas.

As demonstrated by the ARKids First program and the Tobacco Settlement Proceeds Act, the Arkansas health-care system can work cooperatively to facilitate substantive and expeditious change. With bipartisan support in the Arkansas General Assembly and firm commitment from the Governor, consumers, employers, and the health-care sector, this project will substantively increase the number of Arkansans who have affordable health insurance as a foundation for a better quality of life in every county of the state. The results will be generalizable to states in the mid-South with similar socio-demographics as well as to market areas dominated by small group and individual insurance needs.

© 2001 University of Arkansas for Medical Sciences
Division of Institutional Advancement
4301 W. Markham St., Slot 716
Little Rock, AR 72205
501-686-5685

06/25/01