Leveraging Arizona s Medicaid Program to Drive Delivery System Innovation
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1 Leveraging Arizona s Medicaid Program to Drive Delivery System Innovation Shelli Silver, AHCCCS Deputy Director for Health Plan Operations April 11, 2019
2 AHCCCS Overview
3 AHCCCS Mission, Vision & Values Mission: Reaching across Arizona to provide comprehensive, quality health care for those in need Vision: Shaping tomorrow s managed health care from today s experience, quality and innovation. Values:
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5 AHCCCS Strategic Plan CYE 2019
6 AHCCCS Strategic Plan Reaching Across Arizona to Provide Comprehensive, Quality Health Care for Those in Need Bend the cost curve while improving the member s health outcomes Pursue continuous quality improvement Reduce fragmentation driving towards an integrated healthcare system Maintain core organizational capacity, infrastructure and workforce. Reaching across Arizona to provide comprehensive quality health care for those in need 6
7 AHCCCS Complete Care (ACC)
8 Vision - Integration at all 3 Levels
9 Integration Progress To Date
10 Care Delivery System as of Oct. 1, 2018
11 Behavioral Health Services in Schools
12 Strategies in CYE 2019 $3M legislative appropriation $10.4M funding in cap rates in CYE 2019 to enhance access to BH services on campus Required implementation plan and quarterly deliverable, documenting efforts to offer behavioral health services on campus $1M for targeted training in schools through interagency services agreement with Arizona Department of Education Exploring opportunities to enhance Medicaid School-Based Claiming (MSBC) program
13 Recent Waiver Approvals: AHCCCS Works & Prior Quarter Coverage
14 National Landscape: Community Engagement Waivers
15 Background Events 2015: AZ law amended to direct AHCCCS to request a waiver from CMS annually that would allow work requirements and lifetime limits for able-bodied adults in AZ, with some exceptions March 14, 2017: HHS/CMS under new administration sent letter to Governors encouraging states to seek flexibilities in administration of Medicaid programs November 17, 2017: AHCCCS submitted concept paper to CMS, which included a work requirement and flexibility to limit retroactive coverage December 19, 2017: AHCCCS Works waiver submitted to CMS after consideration of 500+ public comments April 6, 2018: AHCCCS submitted a waiver to CMS to limit retroactive coverage to the month of application, consistent with AHCCCS policy prior to 2014 January 18, 2019: CMS approved AZ s waiver amendment proposals
16 AHCCCS Works Requirements No sooner than January 1, 2020, able-bodied adults* who do not qualify for an exemption must, for at least 80 hours per month: Be employed (including self-employment); Actively seek employment; Attend school (less than full time); Participate in other employment readiness activities, i.e., job skills training, life skills training & health education; or Engage in Community Service * Adults = SSA Group VIII expansion population, a.k.a, Adult group
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19 Waiver of Prior Quarter Coverage CMS has approved Arizona s waiver request to limit retroactive coverage to the month application for all AHCCCS members except for children under the age of 19 and women who are pregnant (including post-partum) once they become eligible The waiver of Prior Quarter Coverage is effective July 1, 2019
20 Supporting Underserved Populations Impacted by the Opioid Epidemic
21 Opioid State Targeted Response MAT education and outreach Increase peer support services MAT COEs for 24/7 access to care; med units; new OTPs Hospital and ED discharge projects Diversion and incarceration alternatives Early ID and connection for re-entry population Prescriber education Public awareness campaign Support for the OAR line PPW projects Street-based outreach Community TIP development
22 State Opioid Response 1. Sustaining and Enhancing Naloxone Distribution 2. Increasing Localized Community Opioid Prevention Efforts 3. Expanding Trauma-Informed Care Prevention, Treatment and Recovery Efforts 4. Expanding Navigation and Access to MAT 5. Expanding access to recovery support services (i.e. housing, peer supports, job assistance and supportive recovery programming) and 6. Increasing public access to real-time prevention, treatment and recovery resources to create a real no-wrong door approach 7. Major focus on populations with disparities 8. Expanding prescriber training and public awareness campaigns
23 Total Number of Persons Served (Unduplicated Count), Arizona Opioid State Targeted Response (STR) Grant Year One, May 1, 2017 April 30, 2018 Number of Persons Served for Opioid Use Disorder Recovery Support Services 3,379 Number of Persons Served for Opioid Use Disorder Treatment Services 4,362 6,143 TOTAL PERSONS SERVED (UNDUPLICATED COUNT)
24 Total Number of Persons Served (Unduplicated Count), Arizona Opioid State Targeted Response (STR) Grant Year Two, May 1, 2018 December 31, 2018 Number of Persons Served for Opioid Use Disorder Recovery Support Services 7,535 Number of Persons Served for Opioid Use Disorder Treatment Services 7,177 10,897 TOTAL PERSONS SERVED (UNDUPLICATED COUNT)
25 Number of Individuals Served, Governor s Substance Use Disorder Services (GO SUDS) Fund, February 1, 2018 December 31, 2018
26 Top 5 Services, GO SUDS Fund, February 1, 2018 December 31, 2018
27 Advancing the Growth and Sustainability of the Health Information Exchange
28 Strategy for Building Out the Health Information Exchange 10+ Years: Providers want access to real time clinical data elements to improve care delivery Hospital information Laboratory Results and Medication History and Use Value Based Care Payment Arrangements A single non-governmental organizational entity was needed to ensure better policy coordination, a single set of operating rules, and an ability to have LOWER COSTS For ALL Participants
29 Arizona Health Information Exchange: Health Current
30 Drivers of Health IT Success High rates of EHR adoption Increasing HIE functionality and participation AHCCCS governance and leadership AHCCCS policies including: Mandatory Contractor HIE participation to support integration Value based payment programs focused on HIE milestones Targeted Investments Differential Adjusted Payments
31 Health Current Monthly Growth (as of January 31, 2019)
32 Questions
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