AHCCCS has several initiatives underway aimed at building a more cohesive and effective health care system in Arizona by reducing fragmentation, structuring provider reimbursements to incentivize quality outcomes, leveraging health information technology and working with private sector partners to further innovation to the greatest extent. This page highlights ongoing initiatives with links to more detailed information and will be updated as more information becomes available.
Building A Health Care System: Care Coordination and Integration
Today’s health care system is a series of parts not yet connected to each other. AHCCCS has various initiatives designed to improve care coordination and communication while reducing fragmentation to weave these series of parts together. Learn more about Care Coordination and Integration.
Incentivizing Quality: Payment Modernization
Modernizing the way health care services are purchased means rethinking the end product. Today’s reimbursement structure favors the provider with higher production numbers. In order to bend the cost curve, there must be a paradigm shift such that reimbursement favors the provider who achieves a quality health outcome. Learn more about Payment Modernization.
Improving Communications: Health Information Technology
The State Medicaid Health Information Technology Plan (SMHP) describes the Agency’s historical, current, and future efforts to improve health outcomes by leveraging electronic health record (EHR) deployment, adoption, and use by providers. In addition, AHCCCS continues to be an active participant in the Health Information Network of Arizona (HINAz), Arizona’s Health Information Exchange. Learn more about Health Information Technology.
Connecting Communities: The Importance of Private Sector Partners
The AHCCCS program was founded upon a competitive, public/private partnership model. AHCCCS began in 1982 as the first statewide mandatory managed care program, placing all enrollees (except American Indians/Alaska Natives) in private health plans for acute care, long term care and behavioral health (known as Regional Behavioral Health Authorities). Medicaid managed care has evolved and answered the call toward continued innovation and population health strategies. Learn more about Private Sector Partners.
Transforming Health Care Delivery: Targeted Investments Program
The Targeted Investments (TI) Program provides financial incentives to eligible AHCCCS providers to develop systems that integrate and coordinate physical and behavioral health care. The TI Program aims to reduce fragmentation that occurs between acute care and behavioral health care; increase efficiencies in service delivery for members with behavioral health needs, and improve health outcomes for the affected populations. Applications accepted through August 18, 2017. Learn more about Targeted Investments.
Integrating Technology: Electronic Visit Verification
Electronic Visit Verification ensures timely service delivery for members including real time service gap reporting and monitoring. EVV shall serve as an electronic verification method to help reduce administrative burden associated with hard copy timesheet processing as well as generate cost savings from the prevention of fraud, waste, and abuse. AHCCCS is mandated to implement Electronic Visit Verification (EVV) for non-skilled, in-home services (attendant care, personal care, homemaker, habilitation, respite) by January 1, 2019 and for in-home skilled nursing services (home health) by January 1, 2023. For more information: EVV Webpage.