CYE 15 Payment Reform Initiative – E-Prescribing Shelli Silver May 21, 2014.

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Presentation transcript:

CYE 15 Payment Reform Initiative – E-Prescribing Shelli Silver May 21, 2014

E-Prescribing Initiative (E-Rx) MCOs will be required to increase E-Rx rate for original prescriptions by specified % by end of CYE 15 AHCCCS may consider 2 tiers, potentially: o For MCOs below 50% E-Rx across all original prescriptions – increase by 20% o For MCOs at or above 50%, increase by 10% o Thoughts on these tiers/increases? 2 Reaching across Arizona to provide comprehensive quality health care for those in need

E-Prescribing Initiative (E-Rx), cont. AHCCCS will extract data to determine each MCO’s baseline of E-Rx for original prescriptions MCOs will have discretion as to how to achieve the increase Draft contract language to be distributed for comment in June 2014 ACOM Policy to follow 3 Reaching across Arizona to provide comprehensive quality health care for those in need

E-Prescribing Initiative (E-Rx), cont. Outstanding questions: o Does initiative cross all lines of business?  Need to understand barriers for any line of business  Need to understand barriers for specific services o Should standard in rural GSAs be different than urban?  Data review may shed some light o What is consequence of failure to meet specified %? 4 Reaching across Arizona to provide comprehensive quality health care for those in need

E-Rx Executive Summary AHCCCS will require submission of an Executive Summary, to include: o MCO’s strategies to increase E-Rx o Whether or not the MCO will utilize any payment incentives/disincentives o Due in October Reaching across Arizona to provide comprehensive quality health care for those in need

E-Rx Ongoing Initiative CYE 15 to be first year of a continuing mandate Percentage of increase and or specifics of mandate could change from year-to-year MCOs should consider future strategies that might necessitate heavy lifting such as working with practices to implement EHRs 6 Reaching across Arizona to provide comprehensive quality health care for those in need

E-Rx Ongoing Initiative, cont. AHCCCS would consider an AzAHP collaborative if desired by Association AHCCCS would consider collaboration with REC and/or AHCCCS regarding EHR adoption incentives 7 Reaching across Arizona to provide comprehensive quality health care for those in need