Targeted Investments Program Overview

TI Participants: Several due dates for the Pediatric and Adult Behavioral Health, Pediatric and Adult Primary Care, and Justice Milestones have been extended. The due dates for Milestones with September 30, 2018 deadlines have not changed. Please see the Core Component/Milestone documents for details

Attestation Process: Documentation in support of attestations will be uploaded through the TI Attestation Portal, which will be available through AHCCCS Online in June 2018. We will be posting an educational module in the upcoming weeks that explains the attestation process in detail including the documents that will be submitted.

Enhancements have also been made to the TI webpage to make it easier to view information and navigate the content, including the addition of participant lists for each Area of Concentration in the program.

Please notify the TI Team at targetedinvestments@azahcccs.gov if you have any questions.

The Targeted Investments (TI) Program is AHCCCS’ strategy to provide financial incentives to eligible AHCCCS providers to develop systems for integrated care. In accordance with 42 CFR 438.6(c) and the 1115 Waiver, managed care plans will provide financial incentives to eligible Medicaid providers who meet certain benchmarks for integrating and coordinating physical and behavioral health care for Medicaid beneficiaries. AHCCCS will incorporate these payments into the actuarially-sound capitation rates. The TI Program aims to:

1: Reduce fragmentation between acute and BH care. 2: Increase efficiencies in service delivery for members with BH needs by improving integration at the provider leve. 3: Improve health outcomes for members with physical health and BH needs.
  1. Primary Care Provider Eligibility Requirements: To participate in the TI Program, Primary Care Provider sites must have a minimum threshold of assigned AHCCCS members across all health plans with which they are contracted, must attest to a) having an Electronic Health Record (EHR) which has the ability to exchange and use electronic health information from other systems without special effort on part of the user and b) having completed a Behavioral Health integration assessment using one of the AHCCCS-specified tools (Pre-Application Self Assessment)
  2. Behavioral Health Provider Eligibility Requirements: To participate in the TI Program, Behavioral Health providers must have delivered an AHCCCS-defined minimum number of qualifying outpatient services to members during a recent 12-month period, must attest to a) having an Electronic Health Record (EHR) which has the ability to exchange and use electronic health information from other systems without special effort on part of the user and b) having completed a behavioral health integration assessment using one of the AHCCCS-specified tools (Pre-Application Self Assessment)
  3. Hospital Eligibility Requirements: To participate in the TI Program, hospitals must have at least have had an AHCCCS-defined minimum number of qualifying member discharges across all health plans during a recent 12-month period and must attest to having an Electronic Health Record (EHR) which has the ability to exchange and use electronic health information from other systems without special effort on part of the user.

** Federally Qualified Health Centers (FQHCs) have a federally-mandated reimbursement mechanism that facilitates investment in system transformation activities. Additionally, the federally mandated cost based reimbursement structure has led to significant increases for FQHCs since 2009 while other providers in the AHCCCS system still have rates below 2009 levels. As a result, FQHCs are not eligible to participate in TI. The only exception to this decision is related to FQHCs that are selected to participate in the Adults Transitioning from the Criminal Justice System Area of Concentration. FQHCs that are selected by RBHAs to participate in the Adults Transitioning from the Criminal Justice System Area of Concentration will also be instructed to participate in the Adult Ambulatory Project.

BH Outpatient Clinics [Provider Type 77] whose services are limited to crisis line call centers do not provide the range of services necessary to meet the Targeted Investments requirements and are not eligible to participate in the TI Program.

Indian Health Service and 638 providers are not eligible to participate in the TI Program. Indian Health Service and 638 providers may be eligible to participate in a separate American Indian Medical Home program currently being developed by AHCCCS. [information available on the AHCCCS website]

Financial incentives will be paid on an annual basis to participating eligible primary care, behavioral health, and hospital providers based on requirements that vary over the five years of the Targeted Investments Program. For Year 1 of the TI Program, participating TI providers will receive payment following acceptance into the program. For Years 2 and 3 payment of directed incentive payments will be tied to completing Core Components and related Milestones [see section below that links to Core Components]. For Years 4 and 5 payments will be based on meeting or exceeding performance improvement targets for specified quality measures [in development].

Targeted Investments Program
Incentive Payment By Year
TIY 1 (10/16-9/17)
Contingent upon acceptance into the program
TIY 2 (10/17-9/18) and 3 (10/18-9/19)
Contingent upon successful completion of Core Components and Milestones for Ambulatory and Hospital Projects
TIY 4 (10/19-9/20) and 5 (10/20-9/21)
Contingent upon meeting or exceeding performance improvement targets

Primary care, behavioral health and hospital providers completing required Core Components within their chosen area of concentration for one of the two TI Program projects: 1. Ambulatory Project and 2. Hospital Project.

  1. Ambulatory Project: The Ambulatory Project incentive dollars will be based on demonstrated performance for three focused populations: (i) adults with Behavioral Health needs, (ii) children and youth with Behavioral Health needs, including children and youth engaged in the child welfare system with Autism Spectrum Disorder (ASD); and (iii) adults who have transitioned from a criminal justice facility.

    Within the Ambulatory Project, there are five Areas of Concentration, each of which contains Core Components that describe an action that help to further integrated primary care and behavioral health. The five Areas of Concentration are:

    1. Ambulatory Project for Primary Care Providers Treating Adults with Behavioral Health Needs
    2. Ambulatory Project for Behavioral Health Providers Treating Adults with Behavioral Health Needs
    3. Ambulatory Project for Pediatric Primary Care Providers Treating Children/Youth with Behavioral Health Needs
    4. Ambulatory Project for Behavioral Health Providers Treating Children/Youth with Behavioral Health Needs
    5. Ambulatory Project for Providers Serving Individuals Transitioning from the Justice System
  2. Hospital Project: The Hospital Project incentive dollars will be based on demonstrated performance for adults with a primary diagnosis of mental illness or designated by AHCCCS as individuals with Serious Mental Illness (SMI).

The TI provider attestation portal will be available through AHCCCS online spring 2018.

Access to the TI Program Attestation Portal with this link to AHCCCS online. The link will provide a prompt response to sign in. The Targeted Investments Attestation Portal link is located in the menu bar on the left side of the page in AHCCCS online.

Please keep documentation of completed Milestones in your records throughout the program.

Future dates are approximate timeframes and are subject to change

Frequently Asked Questions and Definitions

Updated FAQs coming soon

FAQs

CMS Correspondence

On January 18, 2017, the Centers for Medicare and Medicaid Services (CMS) approved Arizona's request to begin a Targeted Investments Program that will make almost $300 million available over five years to Arizona providers who assist the State in promoting the integration of physical and behavioral health care, increasing efficiencies in care delivery, and improving health outcomes.

Contact Us

AHCCCS uses Constant Contact to send out notifications and program updates to TI Providers. To make sure that these messages do not end up in spam, please add the Targeted Investments email address: TargetedInvestments@azahcccs.gov, to your email address contact list.

The Targeted Investments email address will continue to be available if you have questions or concerns.

If you would like to update your TI participating site contact information please submit an update here: https://www.surveymonkey.com/r/T2XZF58.