Fillable Printable Modernizing Medicaid
Fillable Printable Modernizing Medicaid
Modernizing Medicaid
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Modernizing Arizona Medicaid:
AHCCCS CARE – Choice, Accountability, Responsibility, Engagement
Douglas A. Ducey, Governor
Thomas J. Betlach, Director
With over 1.6 million Arizonans enrolled in AHCCCS,
Medicaid has a far greater responsibility for impacting
population health. Despite past innovation, we have
an opportunity and obligation to do more. The goals
of Modernizing Arizona Medicaid are to: (1) Engage
Arizonans to take charge of their health; (2) Make
Medicaid a temporary option; and (3) Promote a quality
product at the most affordable price.
The AHCCCS CARE Program: A Bridge
to Independence
Personal Responsibility is a tool in the AHCCCS CARE
program to build a bridge to independence with the right
mix of requirements and incentives.
AHCCCS CARE: Requiring Member Contributions.
•Strategic Copays
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: Up to 3% of annual
household income. Members will make monthly
services already obtained. This also removes the
burden of collecting the copay by providers at
the point of service. Copays will not be applied
to certain services such as primary care and
medications for disease management.
•Premiums: Up to 2% of annual household
income. Included in the monthly AHCCCS CARE
payment is a monthly deposit set at 2% of
income into a personal HSA.
The AHCCCS CARE Account: Giving People Tools to
Manage Their Own Health.
•The AHCCCS CARE Account is like a Health
Savings Account.
•Premium contributions go into the AHCCCS
CARE Account.
•AHCCCS CARE Account funds are only for
that individual and can be used for approved
non-covered services, like dental, vision or
chiropractic services.
•To be eligible, members must:
o Make timely payments.
o Participate in the AHCCCS Works
program.
o Meet the Healthy Arizona targets.
•Employers, and the philanthropic community
can make tax-deductible contributions into
individual accounts.
Personal Responsibility: Ensuring Member
Contribution Requirements.
•Over 100% FPL: Members will be disenrolled
from the AHCCCS program for a period of six
months for failure to make AHCCCS CARE
payments.
•Under 100%: Failure to pay is counted as a debt
owed to the State.
Healthy Arizona: Promoting Healthy Behaviors.
•Healthy Arizona is a set of targets:
o Promoting wellness: for example,
screenings, mammograms, tobacco
cessation.
o Managing Chronic Disease: such as,
diabetes, substance use disorders,
asthma.
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individualized targets.
The AHCCCS Works Program: Viewing
AHCCCS as a Pit Stop.
AHCCCS Works builds greater partnerships with the
business and philanthropic communities who share in the
goal of healthy employees and healthy families.
AHCCCS Works: Getting Back to Work.
•AHCCCS Works requires individuals to be
actively seeking employment.
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already employed or enrolled in school/training.
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Member contributions do not exceed 5% of annual household income.
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•Partner with existing employment supports
programs to provide members the tools
•Building a Personal Safety Net: Members
can transition their AHCCCS CARE Account
into a private Health Savings Account when
they transition to new employment and off of
AHCCCS.
Private Sector Partnerships: Engaging the Business
and Philanthropic Community.
•Employers may make direct contributions into
their employees’ AHCCCS CARE Account.
•The Philanthropic community can make
contributions for targeted purposes, such
as smoking cessation or managing chronic
disease.
•Private sector contributions are tax-deductible.
Today’s Medicaid: A Modern Approach
Electronic Communication: Apps, Texts and More!
•Avoid an emergency room visit by using an app
urgent care near you.
•Manage chronic illnesses or conduct your own
health screenings using an app.
•Receive text alerts for an appointment
reminder or managing medication.
•Manage your account online, including annual
renewals, address or income changes or use a
chat feature to ask questions instead of waiting
on hold or in long lines.
Value Based Purchasing: Paying for Quality, Not
Quantity.
•Increase number of value based arrangements
between health plans and providers.
•Build partnerships. When there is a quality
product – i.e. good health outcomes are
achieved – providers will be rewarded.
Building a True Health Care System: Reducing
Fragmentation.
•Strengthen existing efforts for integrated care:
alignment of dual eligible members; Children’s
Rehabilitative Services (CRS) program; and
Regional Behavioral Health Authorities
(RBHAs) offering physical and behavioral
health services.
•Examine new opportunities to align incentives
and achieve greater accountability.
•Support efforts to reduce stigma related to
mental illness, substance use disorders, and
physical or cognitive disabilities.
•Increase adoption of electronic health records
and health information exchanges that will
reduce duplication and offer better tools to
manage patient care.
Fraud Prevention: Applying Modern Tools to Curbing
Fraud, Waste and Abuse.
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program integrity.
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General (OIG) with the tools and personnel
to investigate bad actors within the Medicaid
program.
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automated systems to ensure taxpayers are not
paying for people who are over income for the
program.
The Legislative Partnership
The Arizona Legislature is an important partner in this
effort. Modernizing Arizona Medicaid will include
legislative initiatives that:
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•Ensure copayment and premium obligations.
•Eliminate non-emergency transportation.
Douglas A. Ducey, Governor
Thomas J. Betlach, Director
