Health Care Cost Containment System (AHCCCS) Abstract - Arizona
In 2007, 27 states received Medicaid Transformation Grants under Section 6081 of the Deficit Reduction Act of 2005. The grants were rewarded to states that proposed innovative methods which in the end of the two years are designed to produce better health outcomes at lower cost.
The Center for Health Transformation is highlighting states that have received these Medicaid Transformation Grants, and will be following their progress for the next two years. In order for key decisionmakers and industry leaders from around the country to learn from others’ successes, it is our intention to provide this resource in order to showcase innovative practices from across the nation. In the future, this site will be interactive, allowing program directors to submit updates and comments regarding their program.
The Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Single State Medicaid Agency, providing health care coverage for over one million Medicaid and SCHIP beneficiaries. The agency initiated a planning process during the past year in anticipation of this grant. AHCCCS is proposing to develop and implement a web-based health information exchange (HIE) utility to achieve the goal of giving all Medicaid providers instant access to beneficiaries’ health records via electronic connection at the point of service. The electronic health record (EHR) available through this HIE utility will include patient demographics and eligibility information, patient problem lists, medications, lab tests orders/results, radiological results and images, inpatient discharge summaries, and clinical notes. Federal funds in the amount of $11,752,500 over the next two years are requested to support its planning, design, development, testing, implementation and evaluation. This project proposes a sustainable model organized around AHCCCS as one of Arizona’s major payers of health care services.
Implementing this HIE utility will transform the AHCCCS Medicaid program and the patient care process. Providing timely patient health information at the point of service will improve the quality, efficiency and effectiveness of Arizona’s Medicaid program. Real time health information access will result in reduction of medical errors, reduction of redundant testing and procedures, better coordination of care for chronic diseases, increased preventive interventions, reduction in the inappropriate use of the emergency room, and lower administrative costs. When aggregated, these benefits will save significant state and federal taxpayer dollars (in Medicaid, SCHIP, and IHS) as well as beneficiary and provider frustration.
The proposed HIE utility will also provide the infrastructure to support the goals of the Quality and Cost Transparency Initiatives of President Bush and Secretary Leavitt by making relevant information available to Medicaid beneficiaries and providers in a user friendly format.
Developing and implementing a web-based HIE utility and application service provider (ASP) capability within two years will achieve the following outcomes:
- Reduction in overall annual acute and long term care Medicaid program medical costs of 3% on average;
- Connection of 35% of AHCCCS providers who will be actively sharing electronic health information through the HIE utility by the end of 2009, 60% by the end of 2010 and over 90% by the end of 2011;
- Reduction in overall Medicaid health system administrative costs of 2% annually through fewer manual medical record reviews, record copying, denial of claims, claims errors, and avoidance of fraud and abuse through effective beneficiary identification;
- Improved quality of care oversight and quality transparency through the provision of timely performance information;
- Improved care coordination for chronic diseases and better coordination between behavioral health and physical health services; and
- Enhanced opportunities for better self-management of chronic illnesses by beneficiaries and their families through access to their health information and online wellness materials.
