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Celebrate 30 years of innovation in Medicaid as we outline AHCCCS's strategic direction for enhancing Arizona's health care system. Our initiatives include the implementation of the Governor's coverage proposal, leveraging the AHCCCS Managed Care Model to reduce costs and improve outcomes, and recognizing successful strategies already adopted in Arizona. Highlights include reforms in managed care for long-term care, home and community-based placements, access to essential health benefits, and enhanced care coordination efforts, all aimed at ensuring quality health care for Arizonans.
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AHCCCS Update 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System
Where are we going? AHCCCS Strategic Direction • Implement Governor’s Coverage Proposal • Develop strategies that leverage the AHCCCS Managed Care Model to bend the cost curve and improve health care outcomes • Recognize many strategies currently being pursued nationally have been implemented in Arizona • Managed care for long term care population • Home and community based placement • Dual member alignment 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System
Medicaid Restoration • Enrollment Numbers – 1/1/14 – Up 1,059 • More approvals and denials going out regularly 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System
HEAplus Update • HEAplus went live to public on 10-19-13 • Sending Account Transfers to FFM – about 31,000 (as of early January) • FFM to State • Testing as of 1-10-14 • Ongoing challenges • Next Phase - Roll out to eligibility workers 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System
Essential Health Benefits • Aligning to Medicaid package • Adding HPV vaccine for adults (21-26) – 1/1/14 • Restored well visits – 10/1/13 • Habilitation – separate 15 visit limit under PT • 25-day limit going away 10/1/14 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System
Hospital Assessment • AHCCCS worked with Navigant and hospital stakeholders • Projected need of $75 m in FY 2014 • Model shows no systems negatively impacted • Major decisions included – • Rate basis – Discharges • Time period for rates – 6 months • Quarterly Payment – first payment due Feb 15 Transparency reporting – • Exemptions – Rehab – Childrens – Small Psych • Modifications – Psych – large providers – large children’s units • March – April – Stakeholder meetings for SFY 15 rate (7-1-14) • Regulatory Action if not paid: • 90 Days – AHCCCS provider ID • 180 days – DHS license can be terminated 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System
Care Coordination • AIHP • Continuing to refine care coordination models and data sharing with select facilities • Expanding to include behavioral health resource • Super Utilizer Efforts • RBHA/Health plan coordination • Correctional Opportunities 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System
