“Reaching across Arizona to provide comprehensive quality health care for those in need” CYE 2014 Transition Update AHCCCS Contractor Update Meeting June.

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Presentation transcript:

“Reaching across Arizona to provide comprehensive quality health care for those in need” CYE 2014 Transition Update AHCCCS Contractor Update Meeting June 26, Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System

“Reaching across Arizona to provide comprehensive quality health care for those in need” Readiness Assessment  Initial meetings held with Acute Care Contractors and UnitedHealthcare Community Plan/CRS (UHC/CRS) in April  Documenting readiness in 10 critical areas  Priority areas include staffing enhancements, network enhancements/build up (comprehensive network by 08/01), policy/procedure development/revision, systems capabilities, care coordination processes  Acute Care May and June reports submitted on 05/15 and 06/17 Results of 05/15 report  3 of 5 Contractors closed out over 70% of evaluation elements under review  AHCCCS response to 06/17 report due to Contractors on 06/27 Preliminary results of 06/17 report  4 of 5 Contractors will close out over 80% of evaluation elements under review  CRS June report submitted on 06/03  United CRS closed out 66% of evaluation elements under review 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System 2

“Reaching across Arizona to provide comprehensive quality health care for those in need” Transition of Member Data  Approximately 180,000 members will be transitioned on 10/01/13  File formats for transition of member data (DEF) finalized and sent to Contractors on 05/22/13  Acute and CRS member notices sent to Contractors for input on 06/04/13  Final notices sent to Contractors on 06/17/13  Timeline for dissemination of member notifications sent to Contractors on 06/19/12  Initial transition calls held on 06/18, 06/20 and 06/25 Relinquishing and receiving Contractors have agreed upon dates for the transition of data from  ADHS/DBHS/RBHAs to United CRS  United CRS to ALTCS E/PD Plans Proposal under consideration for transition of data from relinquishing Acute Care Contractors to receiving Acute Care Contractors – TBD during 07/09/13 transition call  Second round of transition calls scheduled for 07/09, 07/12 and 07/16 Will review questions raised pertaining to inpatient stays, DME, transportation, etc. over the transition period 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System 3

“Reaching across Arizona to provide comprehensive quality health care for those in need” Other Efforts and Issues  Ongoing technical assistance being provided to Contractors regarding systems readiness, quality management, transition of eligibility responsibility/CRS, etc.  Community outreach and engagement – CRS integration Outlying counties throughout June and July  Monitoring for adherence to requirements related to continuation of member services post 10/01/13  Completion of policy remaining AHCCCS policy revisions 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System 4

“Reaching across Arizona to provide comprehensive quality health care for those in need” Questions 30 Years of Medicaid Innovation Our first care is your health care Arizona Health Care Cost Containment System