A STATES USE OF THE ELECTRONIC MEDICAL RECORD - A MEANS TO ADDRESS ARKANSAS HEALTH-CARE RESPONSIBILITIES TO HER CHILDREN - PROMOTING ACCESSTO COST-EFFECTIVE CARE

A state-wide approach to finance health care for children, 18 and unde r, through Arkansas Project Access (APA) began with the intention of c reating a seamless, quasi-public system through which a state-wide, pa ediatric/adolescent managed care system would be established. Successf ul managed care systems require a valid system of communication that i s robust, timely, user-friendly - one that integrates essential data e lements to foster adherence to program goals, as well as reduces hassl es for claims payment. The Arkansas Verification of Eligibility and Cl aims Submission System (AVECS) was jointly developed by the State's Me dicaid Office and a for-profit data system corporation. Three types of data input devices were furnished providers, the choice of which was based on individual, user preference. The system became mandatory for claim submission as of summer 1993. Administrative costs are less than 10 cents per transaction. Payment is made in a timely fashion; i.e., ten working days - far faster than most private insurance plans. Provi der payment denials have declined from an average of 25% to 30% with p aper claims to an average of only two (2) to 10% with the AVECS.