American Indian Medical Home

The Centers for Medicare and Medicaid Services (CMS) has approved Arizona's State Plan Amendment for the American Indian Medical Home (AIMH) Program for the American Indian/Alaska Native (AI/AN) members enrolled in the American Indian Health Program (AIHP). The AIMH Program supports Primary Care Case Management (PCCM), diabetes education, and care coordination for its AIHP enrolled members. AIMHs will help address health disparities between American Indians and other populations in Arizona by enhancing case management and care coordination.

IHS and Tribal 638 Facilities will be able to submit the AIMH applications to become a medical home by October 1, 2017. The AIMH Program is a voluntary program for individuals who are participating in the Fee for Service American Indian Health Program (AIHP).

To Learn More:

Workgroup meetings with Indian Health Services (IHS) and the Tribal 638 Facilities will be scheduled beginning on July 6th, 2017 to discuss the application and the implementation process of the AIMH.

Schedule of Stakeholder Meetings

If there are any inquiries regarding the AIMH or if your facility would like to participate in the workgroup meetings, please email: AIMH@azahcccs.gov.

Eligible IHS/638 Provider Types

02 – Hospital

05 – Clinic (excluding Dental Providers)

IC – Integrated Clinic

C2 – Federally Qualified Health Center (FQHC)

29 – Community/Rural Health Center (RHC)

*Coming soon - updates to this page will display the list of approved American Indian Medical Homes

The American Indian Medical Home (AIMH)

AHCCCS provides Medicaid services to American Indians and Alaskan Natives (AI/AN) through the American Indian Health Program (AIHP) under the Fee For Service Program (FFS). As an added benefit to choosing AIHP as your health program, AIHP members may choose to be a part of an American Indian Medical Home (AIMH). The AIMH allows for improved coordination of services through the use of a Primary Care Case Manager (PCCM) who is able to assist AIHP members in coordinating the health care services they receive.

The AIMH program is a voluntary program. AIHP members who choose to participate may dis-enroll or change AIMH sites at any time. IHS and Tribal 638 Facilities will be able to submit the AIMH applications to become a medical home by October 1, 2017. AIHP members can sign up at that time.

Information about the American Indian Medical Home (AIMH)

IHS and Tribal 638 facilities may choose whether or not to provide an American Indian Medical Home Program. In order to receive the per member per month (PMPM) rate for services provided by their Medical Home, facilities must submit evidence of meeting the Medical Home criteria initially, and annually thereafter to the AHCCCS Division of Fee For Service Management (DFSM).

The AIMH Program is a voluntary program for individuals who are participating in the Fee For Service (FFS) American Indian Health Program (AIHP). AIHP members will have the option to decline participation, dis-enroll, or switch AIMHs at any time. Reimbursement will be based upon only those members that are formally part of the medical home. To ensure there is choice given, the AHCCCS FFS member must sign a form at the facility stating they are in agreement to be empaneled to that particular facility. An AHCCCS FFS member may also call in to AHCCCS Member Services to become empaneled to a particular facility of choice.

Provider Payments

The American Indian Health Program (AIHP) has worked in conjunction with Tribes and IHS Facilities to determine the cost of delivering a Medical Home, which would reimburse for Primary Care Case Management, a 24 hour call line and care coordination among sites. A baseline PMPM payment of $13.26 with an annual increase of 4.6% is based on an average annual increase of the outpatient all inclusive rate over the past 10 years. For approved Medical Homes providing diabetes education pursuant to guidelines established with that model, an additional $2.00 PMPM with an annual increase of 4.6% would be available. For sites also participating in the state Health Information Exchange (HIE), an additional $7.50 PMPM with an annual increase of 4.6% would be available. PMPM payments will be made with 100% FFP dollars and will only be available for IHS and tribally operated 638 facilities for FFS AIHP members. Due to the approved payment methodology, payments are prospective only.

AIMHChart


AIMH 4.6% rate increase calculation – 10 year forecast

10 Year Forcast

AIMH Provider Packet Submission Documents

IHS/638 Facilities may submit application packet materials on or after 10/1/17 by email at AIMH@azahcccs.gov, via fax at 602-256-4667, or by US Mail or hand delivered to:

AHCCCS
Division of Fee-For-Service Management
701 E Jefferson Street – Mail Drop 8900
Phoenix, AZ. 85034

AIMH Member Sign-up Form – The form below should contain the Member’s signature and remain as part of the AIMH Provider’s Member record.