AHCCCS Quality Management/Performance Improvement Reporting Templates & Checklists

The Arizona Health Care Cost Containment System (AHCCCS) provides Quality Management/Performance Improvement (QM/PI) templates and checklists for the Contractors to utilize when preparing and submitting required deliverables. The templates and checklists included below apply to all Contractors unless otherwise indicated.*

Reporting checklists utilized by AHCCCS in providing feedback for the Contractor’s annual Best Practices and Follow Up on Previous Year’s External Quality Review (EQR) Report Recommendations submission. For additional information, refer to policy AMPM 920.

Report templates to be utilized as part of the Contractor’s Annual/Ad-Hoc Performance Improvement Project (AHCCCS-Mandated and Contractor Self Selected) Report submissions. For additional information, refer to policy AMPM 980.

Reporting template and attachment to be utilized as part of the Contractor’s quarterly Performance Measure Monitoring Report submissions. For additional information, refer to policies AMPM 920 and 970.

Reporting checklists utilized by AHCCCS to provide feedback for Contractor Quality Improvement Corrective Action Plan (proposals and updates) submissions. For additional information, refer to policy AMPM 920.

The IRR templates are to be utilized as part of the Contractor’s Quarterly IRR Metrics and Evidence of Completed IRR submissions. For additional information, refer to AHCCCS Contract.

Reporting template and checklist to be utilized as part of the Contractor’s annual QM/PI Program Plan submission. For additional information, refer to policy AMPM 920.

The form is to be utilized when submitting data and information pertaining to non-AHCCCS required Consumer Assessment of Healthcare Providers and Systems® (CAHPS®) Surveys. Please refer to the Member and Provider Survey section in Contract for additional details.

*Contractor submissions shall adhere to the requirements set forth in contract and policy.