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Arkansas Health Network, LLC – Clinically Integrated Network

Dear Physicians:

Arkansas Health Network, LLC (AHN) has been created to function as a clinically integrated network. Participating practices will become involved in shared savings and similar arrangements that AHN establishes with Medicare, commercial payers, and employers. They will participate in activities designed to enhance patient engagement, promote quality, help control health care costs and promote other patient benefits. Independent physician practices and the CHI St. Vincent provider network will participate in AHN.

Please complete and return the accompanying Application Questionnaire to apply for participation in AHN. By signing and submitting the application questionnaire, you agree to provide additional information that may be required as part of the application process and to allow AHN to access other information regarding your practice.

If your application is approved, you will be asked to execute a Participation Agreement and attachments. You and other physicians/practitioners in your practice entity must agree to comply with other obligations and requirements applicable to AHN participants.

Submitting a completed Application Questionnaire does not obligate or entitle you to participate in AHN. In addition, even if your application is approved, you can decline participation in the future or terminate your participation in accordance with the Participation Agreement.

We look forward to working with you and other independent physicians to transform health care in our state. I hope you’ll complete and return the Application Questionnaire to begin this important process. Please don’t hesitate to AHN's Network Development Specialists with any questions - Tiffani Butler (501.442.5523) and Aaron Pilkington (501.552.3548)

Very truly yours,
Arkansas Health Network, LLC


Note: Arkansas Health Network is not currently accepting new applicants to its Medicare Shared Savings Program (MSSP)

Physician Application Questionaire Physician Application Questionaire (410 KB)

Participation Agreement Participation Agreement (976 KB)

INSTRUCTIONS: Please complete the above documents to apply for participation in Arkansas Health Network. Return your completed Application Questionnaire and Participation Agreement to:

Arkansas Health Network
ATTN: Bob Sarkar
Two St. Vincent Circle
Little Rock, AR 72205