Friday, September 7, 2012

Friday night line

Posted By on Fri, Sep 7, 2012 at 4:43 PM

QUTTING TIME: Somebody sent this to me today, asking if this was a picture of me at work. No. I have more chins.
  • QUTTING TIME: Somebody sent this to me today, asking if it was a picture of me at work. No. I have more chins.

Open for your comments. Finishing up:

DENNIS MILLIGAN: A good deed by circuit clerk? Or did he dupe press?
  • DENNIS MILLIGAN: A good deed by circuit clerk? Or did he dupe press?
* LETTER TO THE EDITOR: YOU'VE BEEN HAD: Over the last week I've gotten calls, mail and blog comments that I and others have been played like a fiddle by Saline Circuit Clerk Dennis Milligan in his announcement that he'd give up commissioner fees for foreclosure sales which commissioners, including county and circuit clerks and others can receive, and turn the money over to the county. The turnback is a good thing, I wrote. That's still true. But a string of correspondents claim that Milligan cast a bad situation about his handling of foreclosure sales in a way to accrue positive press for himself, the latest in a string of Milligan publicity efforts aimed at burnishing his reputation in a run for higher office in 2014, perhaps state treasurer. Much more is to be developed on this, clearly. But in the meanwhile, I thought I'd share one extended criticism of my and other press work about Milligan. The opinions there are, of course, those of the anonymous writer and not necessarily those of the blog. I've asked Milligan for a response, but haven't heard back.

* ARKANSAS TECH GROWTH CONTINUES: Arkansas Tech says the Russellville university has experienced enrollment growth this fall for the 14th consecutive year, with the total just short of 11,000 students. Maybe they can go Division I football, too.

* UCA REPORTS STRONG ENTERING CLASS: The University of Central Arkansas dropped slightly on enrollment this fall, but reports a 10 percent jump in important freshman enrollment, to 2,157. Overall enrollment dropped from 11,163 last year to 11,108 this year.

* MARCH FOR THE CHILDREN OF SYRIA: University of Arkansas faculty member and writer Mohja Kahf will lead a walk for trhe children of Syria, a UNICEF, benefit, from 10 a.m. to noon Saturday, beginning on the steps of the Arkansas Capitol. It's one of 20 walks around the country help children in the battle-torn country.

* CHARTER SCHOOLS, AGAIN WITH THE NO RESULTS FINDING: Another study on the efficacy of charter schools versus public schools, specifically those run by nonprofit management organizations. Another finding we've seen before:

The study found that, on average, CMOs did not have a statistically significant impact on middle school student performance on state assessments in math, reading, science, or social studies. Similarly, there was not a statistically significant impact of CMOs on graduation rates and rates of post-secondary enrollment for high school students. However, there was substantial variation in the direction, magnitude and statistical significance of the impacts for individual CMOs.

Tell me again why the billionaires and Republicans want them so badly. Maybe because there's money be made in the contracts to run them?

* DONT CONFUSE ANYONE WITH FACTS: On this blog and all over Twitter Republicans, in between criticizing statements at the Democratic National Convention, claimed nobody was watching it. Particularly, they said, everybody watched the Dallas game Wednesday night. Actually, no. Ratings were higher for the DNC than the Dallas football game. So says the AP. But don't tell that to the faith-based crowd that won't let their campaigns be deterred by fact-checking.

* RIP LUCKY: Comments in the thread tonight have included news of the passing of Elwood's terrier Lucky and condolence notes from friends. Elwood passed along a recent photo of Lucky for those who might be interested.

* ARKANSAS ON THE CUTTING EDGE ON MEDICAID REFORM: I mentioned earlier that Arkansas's plan to remake Medicaid is drawing national attention. The state Human Services Department announced today:

The Center for Medicare and Medicaid Services (CMS) has given its official approval of the state’s plan to transform its health care payment system by offering financial incentives to physicians and hospitals that provide high-quality, efficient care to patients for certain medical episodes.

States routinely submit amendments to their Medicaid State Plans and receive approval, but this is the first time CMS has granted approval of an amendment that gives a state the ability to offer efficiency-based, provider incentive payments through a state-administered Medicaid program. The State Plan is a contract between the state and the federal government describing how Arkansas will administer its Medicaid program.

“This is a true milestone for the Medicaid program and the last hurdle for initial implementation of our transformation efforts” said Andy Allison, Arkansas Medicaid Director. “The new system is the first of its kind in the nation, giving the Arkansas and CMS teams the rare opportunity to bring fresh ideas to
the table.”

Arkansas’s approach is different than what some other states have done. The incentive payments go directly to providers and depend solely on their ability to direct efficient, high-quality care, and do not change the underlying reimbursement rates in Medicaid.

Incentive payments are the core element of the Arkansas Health Care Payment Improvement Initiative, which uses a focus on high-quality care as a way to manage growing health care costs for Medicaid and the state’s two largest private insurance companies. The initiative launched a “preparatory period” in July, and Medicaid will begin tracking provider performance for possible incentive payments in October.

Arkansas’s new approach uses certain qualifications to identify the physician or hospital that serves as a patient’s “principal accountable provider,” the one most responsible for a patient’s care for a given episode. Medicaid will pay incentives to those providers if they give high-quality care while still keeping their average costs of treating patients with similar conditions down. This plan was created after months of consultation with Arkansas providers. The incentives also work in reverse if providers have average costs that significantly exceed historic experience of their Arkansas peers.

To achieve savings, physicians and hospitals will have to reduce the inefficiencies in their system, such as unnecessary tests or preventable hospital readmissions, Allison explained, noting that a newly-released report
from the Institute of Medicine identifies hundreds of billions of dollars are spent on unnecessary medical services.

“The Institute’s report underscores the magnitude of the problem and the likelihood that our approach will result in significant savings and better health care for patients,” he said.

For more information on the payment initiative, please go to

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