We hope the holidays find you all healthy and happy. As physicians, we know you all work very hard all the time. While everyone else seems to be taking off to celebrate the holidays, you are still taking care of your patients. We appreciate your dedication and are thankful for the additional work you do for AFMC.
At AFMC, we feel strongly about Arkansas physicians reviewing health care delivery for Arkansas patients. You know firsthand what it is to practice here, and you understand Arkansas people. That is one of the reasons we felt so passionate about winning our largest review contract with Arkansas Medicaid. Thanks to you, AFMC has the expertise the state needs to appropriately complete the necessary work of utilization review.
In the process of bidding the review contract and working to make our bid competitive, we were able to look at a significant amount of data relating to the number of reviews completed and the time it took to complete them. The data review gave us a more accurate idea of what it costs for your time to complete reviews and how many reviews we typically send out to external reviewers each month. As a result, we were able to determine a competitive price and continue to develop more efficiencies in the review process.
Starting January 1, 2019, AFMC will be transitioning to a pay-per-review price and will discontinue an hourly rate for most of the reviews. Most of you will not see any changes in your reimbursement for doing reviews. Those of you who are highly efficient will see an increase! There will be times when an unusual or larger review may require more time and an hourly rate will be continued in those cases. We are also working with our nursing staff and associate medical directors to implement practices that will allow you to use your time more efficiently. These changes will also bring us in line with standards used by other utilization review organizations.
We appreciate you all. In the next few weeks, you will be receiving new contracts to continue your work with AFMC. If you wish to continue working with AFMC, please return that paperwork immediately. We look forward to working with you in 2019 and beyond.
Happy New Year!
Chad T. Rodgers, MD
Vice President and Chief Medical Officer, AFMC