AHCCCS Quality Strategy Overview

The AHCCCS Quality Strategy aims to promote optimized health care services by meeting current standards and individual needs. It emphasizes timely access, safe treatment, and support for individual goals. The strategy outlines a comprehensive approach to drive quality throughout the AHCCCS system, highlighting key expectations and approaches. Federal regulation requirements, such as network adequacy, quality improvement goals, and performance metrics, are discussed in detail. A timeline of milestones includes stakeholder feedback, drafting processes, public comment periods, revisions, executive review, and submission to CMS for further feedback.

• AHCCCS
• Quality Strategy
• Health Care
• Arizona
• CMS

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1. AHCCCS Quality Strategy January 31, 2018 Jakenna L. Lebsock, MPA Clinical Administrator Arizona Health Care Cost Containment System

2. Definition of Quality Health care quality is defined as services that promote optimized health and meet current standards of care Can be different for every individual Includes timely access to care, safe and appropriate treatment, and is supportive of individual needs, goals, and preferences Reaching across Arizona to provide comprehensive quality health care for those in need 2

3. Definition of Quality Member focused o Immediate attention to health and safety Strength Based Continuous improvement Open communication and opportunities to learn from each other/find the best solutions Reaching across Arizona to provide comprehensive quality health care for those in need 3

4. Purpose of the Quality Strategy A coordinated, comprehensive, and proactive approach to drive quality throughout the AHCCCS system Outlines expectations around meeting/exceeding standards related to access to care and quality of care/services Highlights Agency approaches program/system development and oversight Reaching across Arizona to provide comprehensive quality health care for those in need 4

5. Federal Regulation Requirements Topics must include: o State-defined network adequacy and availability of services o State goals and objectives for continuous quality improvement o Cover populations in the State served by MCOs o Detailed description of quality metrics and performance targets o Performance Improvement Project processes o Sanctions/regulatory actions o External Quality Review processes Reaching across Arizona to provide comprehensive quality health care for those in need 5

6. Quality Strategy Timeline MILESTONES TARGET DATES Stakeholder Feedback Complete Draft Document Finalized Posting for Public Comments Revisions Completed Based on Public Comments Post Executive Management Review Final Revisons Completed Submission to CMS Review and Incorporation of CMS Questions/Feedback Online Posting Ongoing through March 2018 1/26/2018 1/29/2018 3/16/2018 3/30/2018 4/4/2018-4/13/2018 4/19/2018 4/20/2018 6/20/2018-6/28/2018 6/29/2018 Reaching across Arizona to provide comprehensive quality health care for those in need 6

7. Major Highlights of the Quality Strategy Reaching across Arizona to provide comprehensive quality health care for those in need 7

8. Quality Strategy Goals/Objectives Clear expectations for member care Improve AHCCCS members health status Partner with sister agencies, MCOs, IHS/Tribal 638 facilities, and other providers to improve access to care Build capacity in rural/underserved areas Improve member satisfaction/experiences Continue to enhance data-driven decision making Support/promote innovative and quality care Reaching across Arizona to provide comprehensive quality health care for those in need 8

9. Agency Initiatives Autism Spectrum Disorder Integrated Health Care Opioid Crisis Care/Services for Children in the Foster Care System Grants Justice Population (Early Reach-In) Commitment to Ongoing Learning Workforce Development Employment Housing Reaching across Arizona to provide comprehensive quality health care for those in need 9

10. Major Areas of Focus: BH-Specific Reducing stigma Transparent, informed care Supportive delivery systems Seamless integration of care Fidelity of processes, regardless of delivery system Quality, responsive providers Voice without fear of retaliation Reaching across Arizona to provide comprehensive quality health care for those in need 10

11. Major Areas of Focus AI-Specific American Indian fluidity between FFS and Managed Care Integration and Ease of System Navigation Policy Efforts Care-Coordination American Indian Medical Home (AIMH) Model Data/Information Sharing Reaching across Arizona to provide comprehensive quality health care for those in need 11

12. Major Strategies Alignment with the Agency Strategic Plan Value-Based Purchasing Targeted Investments Quality Management (Critical Incident investigation) Strategic Partnerships Network Adequacy Stakeholder Engagement Reaching across Arizona to provide comprehensive quality health care for those in need 12

13. Desired Feedback Are there other initiatives or activities that we should focus on? Are we missing any major topics that are of concern? What additional strategies or opportunities should we consider? Reaching across Arizona to provide comprehensive quality health care for those in need 13

14. Thank you. Jakenna.Lebsock@azahcccs.gov 602-417-4229 Reaching across Arizona to provide comprehensive quality health care for those in need 14