Demographics, Social Determinants and Outcomes

Since July 1, 2016, and the process of administrative simplification, AHCCCS has spent a great deal of time soliciting stakeholder feedback in a variety of ways regarding provider reporting of Demographic and Outcome Data Set (commonly known as the DUG) data. After extensive research, numerous workgroups, and a thorough review of this critical stakeholder feedback, AHCCCS has developed a plan to transition the collection of demographic data. The goal of the transition plan is to facilitate the reduction of the number of data points behavioral health providers will be required to report in order to relieve administrative burden, and to ensure that the current burdensome process is not duplicated with the implementation of the AHCCCS Complete Care (ACC) Program effective October 1, 2018.

AHCCCS’ transition plan consists of a three-pronged approach to collecting members’ demographic data.

  1. The Use of Alternative Data Sources

    AHCCCS, with the assistance of stakeholders, has identified demographic elements that currently exist in other AHCCCS data systems, and/or available through other data source agreements. These elements include:

    • T/RBHA ID
    • AHCCCS ID
    • Date of Birth
    • Race
    • Gender
    • Diagnosis (behavioral health and physical health)
    • Behavioral Health Category
    • Assessment Date
    • Member Enrollment and Disenrollment From Services (will be determined through the AHCCCS Behavioral Health Enrolled and Served methodology, which identifies members who are actively receiving behavioral health services via claims and encounter data)
  2. The Use of Social Determinants of Health ICD-10 Diagnosis Codes

    AHCCCS will begin to use Social Determinants of Health diagnosis codes reported on applicable claims to track member outcomes where possible. AHCCCS will require the usage of these codes beginning April 1, 2018, as outlined in the attached memorandum. AHCCCS expects all providers with ICD-10 coding capabilities will use these codes as appropriate. For further information see Use of Social Determinants of Health Codes for Member Outcomes and ICD 10 List.

  3. The Demographic Portal

    For those demographic elements with no identified alternative data source or Social Determinate identifier, AHCCCS will create an online portal to be accessed directly by behavioral health providers for the collection of the remaining data elements for members receiving behavioral health services. It is AHCCCS’ intent that the provider organizations that historically provided data for the DUG will transition to providing the required data via the portal on 10/01/2018.

For Questions about contents on this page, please email CodingPolicyQuestions@azahcccs.gov.