Arkansas Medicaid, administered by the Department of Human Services' Division of Medical Services, covers its population through three genuinely different delivery systems rather than a single managed care model. ARHOME (Arkansas Health and Opportunity for Me), a Section 1115 demonstration, covers income-eligible adults ages 19-64 either through a commercial Qualified Health Plan (QHP) purchased on the ACA marketplace with Medicaid paying the premium, or, for medically frail enrollees and those with serious mental illness or substance use disorder, through fee-for-service Medicaid or PASSE instead. ConnectCare, a state-run Primary Care Case Management program, covers the broader traditional Medicaid population: children, families, and aged/blind/disabled beneficiaries. PASSE (Provider-Led Arkansas Shared Savings Entity), a provider-owned, risk-bearing managed care model unique to Arkansas, serves members with serious mental illness, substance use disorder, or intellectual/developmental disabilities through four organizations. ARHOME's own future beyond its current term, which expires December 31, 2026, is unresolved, with the state and CMS still negotiating an extension or successor model.
PASSE, Arkansas's one genuinely risk-bearing managed care model, began in 2018 as a lighter-touch, non-risk-bearing coordination model before evolving into its current full-risk structure. Four provider-owned organizations operate statewide: Empower Healthcare Solutions (parent: Beacon, 15,895 members in 2024), Summit Community Care (parent: Anthem, 14,657), Arkansas Total Care (parent: Centene, 13,394), and CareSource (parent: CareSource, 3,923); by state law, PASSE organizations must be at least 51% owned by Arkansas Medicaid providers. ConnectCare, by contrast, is not a managed care entity at all; it is a Primary Care Case Management (PCCM) program the state runs directly, with 392,159 members in 2024, comfortably the largest single enrollment figure of any Arkansas Medicaid delivery mechanism. ARHOME's QHP arm routes eligible adults into commercial marketplace coverage rather than a Medicaid-contracted plan, which is why it does not appear in CMS's managed-care enrollment dataset at all; the program currently has six QHP options, three from Arkansas Blue Cross and Blue Shield (including its Health Advantage and Octave brands) and three from Centene (Ambetter/Arkansas Health & Wellness, QCA Health Plan, and QualChoice Life and Health), though Centene announced in July 2026 that it will exit ARHOME entirely in 2027, citing funding challenges. The demonstration's current five-year term expires December 31, 2026; CMS reportedly rejected Arkansas's request to extend it through 2031, and the state has since asked CMS for a shorter, two-year extension through 2028 to design a successor model, which DHS's own public statements describe as a choice between moving the ARHOME population to fee-for-service Medicaid or to managed care, with neither the extension request nor the successor model resolved.
Long-term services and supports run fee-for-service through DMS's own codified waiver structure, not through PASSE or any risk-bearing plan. Five active 1915(c) HCBS waivers currently serve distinct populations: AR Choices in Homecare (ages 65+ and adults 21-64 with physical disabilities, nursing facility level of care), the Community and Employment Support Waiver (autism, intellectual, or developmental disabilities, ICF/IID level of care), Living Choices Assisted Living (ages 65+ and adults 21-64 with physical disabilities), and the Autism Waiver (children ages 1-7 with an ASD diagnosis, ICF/IID level of care). PASSE members with intellectual/developmental disability needs may also access HCBS through their PASSE's own care coordination, but the underlying waiver authority itself sits outside PASSE's 1915(b) structure.
Not integrated into managed care
Behavioral health for the state's highest-need population, members with serious mental illness, substance use disorder, or intellectual/developmental disabilities, is carved into PASSE, Arkansas's provider-owned risk-bearing model, rather than paid fee-for-service or carved out to a separate behavioral-health-only vendor. ARHOME members who are medically frail or have a qualifying SMI/SUD diagnosis are specifically routed to PASSE (or fee-for-service Medicaid) rather than a commercial QHP, reflecting the same design logic. Members outside PASSE's target population continue to receive behavioral health services fee-for-service under the standard State Plan benefit.
Carved out
No separate statewide dental benefit administrator exists for the core Medicaid population; dental runs fee-for-service against the state's own published fee schedule. A separate program, AR Healthy Smiles, is a dental-only Prepaid Ambulatory Health Plan (PAHP) covering a specific population through two plans: Delta Dental Smiles (parent: Delta Dental of Arkansas, 307,358 members in 2024) and MCNA Dental (289,659 members).
Arkansas Medicaid has no separate pharmacy benefit manager contract; pharmacy claims processing runs through the state's own fiscal agent system rather than a dedicated carve-out PBM.
Non-Emergency Medical Transportation (NEMT) is regionally fragmented rather than run through a single statewide broker: Southeast Trans, Inc. is the dominant vendor (571,500 members in 2024), alongside two regional Area Agency-on-Aging-affiliated vendors, Central Arkansas Development (135,267 members) and the Area Agency on Aging of Southeast Arkansas (70,362 members).
Gainwell Technologies operates the AME Core MMIS, Arkansas Medicaid's fiscal-agent claims processing system, hosted on AWS.
Last updated: Aug 29, 2026
4 agency updates tracked for Arkansas. Available with Pro.
See them with ProGet the daily briefing.