Arizona Healthcare Update and Statistics
Discover the latest updates and statistics related to Arizona's healthcare system, including information on AHCCCS population growth, budget requests, marketplace enrollment, and more. Get insights into the comprehensive health care services provided across Arizona for those in need.
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AHCCCS by the numbers 2,291 8 years 1.92 per day 1,888,000 >200 318,782,391 46 days KidsCare lives added Highest cap increase Death opioid/heroin AHCCCS population Provider org. join HIE FY 16 electronic trans. Length of Sabbatical Reaching across Arizona to provide comprehensive quality health care for those in need 2
Reaching across Arizona to provide comprehensive quality health care for those in need 3
AHCCCS Population as of July 1, 1985 2016 1,800,000 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 - Reaching across Arizona to provide comprehensive quality health care for those in need 4 .
Historical GF Spend vs Population $2,000,000,000 2,000,000 $1,800,000,000 1,800,000 $1,600,000,000 1,600,000 $1,400,000,000 1,400,000 $1,200,000,000 1,200,000 $1,000,000,000 1,000,000 $800,000,000 800,000 $600,000,000 600,000 $400,000,000 400,000 $200,000,000 200,000 $- - GF Spend/Approp 7/1 Population *FY2017 does not include BHS merger GF Reaching across Arizona to provide comprehensive quality health care for those in need 5
AHCCCS GF Budget Requests Historical AHCCCS GF Requests (in millions) Submittal Revision $153.2 $93.6 $82.4 $81.1 $71.8 $36.8 $19.5 $13.5 $(2.0) $(2.5) $(24.2) FY13 FY14 FY15 FY16 FY17* FY18 *Does not include $517.3M BHS Base Mod Reaching across Arizona to provide comprehensive quality health care for those in need 6
Marketplace Enrollment: Arizona 250,000 200,000 150,000 100,000 50,000 0 2014 2015 2016 Reaching across Arizona to provide comprehensive quality health care for those in need 7
Marketplace Enrollment Growth Rate: Arizona vs. National 9% 2016 -1.28% National Arizona 31% 2015 71% -20% 0% 20% 40% 60% 80% Reaching across Arizona to provide comprehensive quality health care for those in need 8
2016 Enrollment by Health Plan Type: Arizona vs. National 80% 70% 60% 50% Arizona 40% National 30% 20% 10% 0% Catastrophic Bronze Sliver Gold Platinum Reaching across Arizona to provide comprehensive quality health care for those in need 9
Marketplace Cohort by Age: 2016 35% 30% 25% 20% Arizona National 15% 10% 5% 0% <18 18-25 26-34 35-44 45-54 55-64 65 Reaching across Arizona to provide comprehensive quality health care for those in need 10
AHCCCS Cap Rate History 8 6.6 6 4 2.1 2 0 2005-2009 2010-2012 2013-2016 -2 -4 -4.6 -6 Reaching across Arizona to provide comprehensive quality health care for those in need 11
Provider Rate Changes (2009-16) Provider Change Provider Change Hospital IP (16-20)% Emergency 29.5% Hospital OP (8.7)% NEMT (11.3)% NF (EPD) 2.3% ASC 5.6% Behavioral Health OP (4.6)% Dental (12.5)% Physician (13.2)% FQHC 37% Reaching across Arizona to provide comprehensive quality health care for those in need 12
AHCCCS VBP Fee Schedule Changes 2014 Hospital IP APR-DRG 2015 MCOs/DFSM pay FQHC full rate 2016 - Hospitals bump for sharing data with HIE and meeting MU2 2016 - SNFs increase for those above avg with pneumococcal vaccine 2016 - Integrated Clinics- physical health 2016 stand alone ED new provider type 2016 Treat and Refer Reaching across Arizona to provide comprehensive quality health care for those in need 13
Treat and Refer Treat and Refer (T&R) Begins on 10/1/16 or CMS Approval whichever is later T&R services are not equivalent to emergency services (which can be provided and MCOs must pay for without a contract) T&R services are for non-emergent referrals in response to a 911 call To be reimbursed by Medicaid: o EMS providers must receive T&R recognition from ADHS (protocol located on their website) T&R providers must be contracted with our MCOs and in their network to receive reimbursement Reaching across Arizona to provide comprehensive quality health care for those in need 14
Network Growth 200 180 Number of Participants 198 160 140 120 100 80 60 78 40 11 23 33 20 33 - 2011 YE 2012 YE 2013 YE 2014 YE 2015 YE 2016 YTD Reaching across Arizona to provide comprehensive quality health care for those in need 16
Network Hospital Participation 100% 91% 90% 90% Percent of Arizona's Total Volume 80% 70% 56% 54% 54% 60% 53% 53% 49% 49% 48% 50% 40% 30% 20% 13% 13% 10% 0% 2011 YE 2012 YE 2013 YE 2014 YE 2015 YE 2016 YTD Inpatient Discharges ED Visits Reaching across Arizona to provide comprehensive quality health care for those in need 17
Network Provider Participation 70 64 60 53 50 Number of Participants 40 30 20 20 20 13 10 10 6 6 5 2 2 2 1 1 - - - - - 2011 YE 2012 YE 2013 YE 2014 YE 2015 YE 2016 YTD FQHCs & RHCs Community Providers Behavioral Health Providers Reaching across Arizona to provide comprehensive quality health care for those in need 18
Member Engagement - Technology Engaging Members through Technology: The Contractor shall engage its membership through web based applications. The Contractor shall identify populations who can benefit from web based applications used to assist members with self-management of health care needs such as, chronic conditions, pregnancy, or other health related topics the Contractor considers to be most beneficial to members and the Contractor shall submit an executive summary to AHCCCS, DHCM, Medical Management Unit by December 1, 2016 to include at a minimum: Reaching across Arizona to provide comprehensive quality health care for those in need 19
Member Engagement - continued a. Criteria for identifying at least 10% of Contractor s members who can benefit from web based applications, b. Listing of identified population(s), c. Description of web applications in development or being utilized to engage members, d. Strategies used to engage the identified members in the use of the web applications, and e. Description of desired outcomes" Reaching across Arizona to provide comprehensive quality health care for those in need 20
Provider Revalidation 2016 PT77 Outpatient Clinics = 318 PT31 Physician Osteopath = 1341 PT92 School Based Transport = 95 PT93 School Based Attendant Care = 1183 PT94 School Based Nurse = 210 2017 PT08 Physicians = 12,692 Reaching across Arizona to provide comprehensive quality health care for those in need 21
Arizona Coalition for Military Families resourcecommand.org Seeking BH provider participation for being identified as a community resource Requires the completion of a form and a commitment to attend a coalition training on working with the military. Website similar to 211 type system Reaching across Arizona to provide comprehensive quality health care for those in need 22
Questions? Reaching across Arizona to provide comprehensive quality health care for those in need 23
