The state of Arkansas's health system transformation was given a significant financial boost from the state's largest company, Wal-Mart Stores, which committed to providing $670,000 to help underwrite the work of the Arkansas Health Care Payment Improvement Initiative.

But Arkansas Surgeon General Dr. Joe Thompson said the significance of the contribution stems from Wal-Mart's standing as the state's largest self-insured employer.

The initiative, Thompson said, is a multipayer effort and the intent is to make it all-payer—and this includes self-insured employers such as Wal-Mart. Thompson explained how Arkansas is part of the CMS' Comprehensive Primary Care Initiative, which has 500 practices across the nation serving as patient-centered medical homes. With those participating practices, the intent is to have 60% of their patients covered by a payer that is contributing a monthly per member care-management fee. That fee is used to cover expenses, such as staff salaries.

Sixty-nine of the 500 CPCI practices are in Arkansas, and now Wal-Mart will be contributing the care-management fee for those covered by its plan who receive care at those practices, Thompson said.

“The patient-centered medical home is at the core of our payment improvement initiative,” Thompson said, adding that Wal-Mart will also serve on a new Employer Advisory Council and help pay for an annual state tracking report evaluating the impact of the program.

According to a news release (PDF), the long-term goal is to build a sustainable healthcare system that uses team-based approaches, contains costs, and emphasizes prevention and chronic-disease management in an effort to reduce serious illnesses, costly treatments and hospital readmissions.

“This is neither a pilot nor a demonstration project,” Thompson said. “This is full-scale healthcare system transformation (PDF).”

Arkansas' transformation efforts are getting noticed. Thompson said he or other state officials are now getting regular invitations to appear on healthcare panels with representatives from Massachusetts and Oregon. The healthcare transformations of those states are widely recognized, Thompson acknowledged, “We're a little new on stage.”