PHOENIX – One year ago, Cabinet Executive Officer Carmen Heredia took the helm of the Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, and guided the agency through an extraordinary year of accomplishments and change.
“In 2023, AHCCCS faced challenges head-on, made significant progress, and achieved remarkable milestones because of our employees’ unwavering dedication to the members we serve,” Heredia said. “Our accomplishments stand as a testament to our adaptability, innovation, and unyielding resolve in the face of turbulent times.”
Some of those successes and operational enhancements are highlighted below; see the full list in the 2023 Year in Review document.
On April 1, AHCCCS began the monumental task of determining eligibility for all 2.5 million enrolled members, and met its legislative year-end deadline to finish the renewals for all individuals who’d been continued during the pandemic. For its renewal effort, KFF recognized Arizona as one of the top-performing states in the nation.
Following its 12-month strategic plan, the agency aligned renewals for more than 2.5 million AHCCCS member households with their SNAP benefit renewals, when possible, to ease the process for millions of Arizonans.
The agency maintained a monthly dashboard of renewal progress, and built an interactive zip code map of areas most at risk of disenrollment due to non-response.
To ensure a smooth process for the return to regular renewals, AHCCCS launched AHCCCS Connect, a text/email/phone communication tool that follows an applicant through their Medicaid lifecycle and alerts them of decisions and responses needed. It also launched SAM, a chatbot on www.healthearizonaplus.gov that can answer more than 80 renewal questions in English and Spanish, update a member’s contact information, and transfer a chat to a live agent during business hours.
AHCCCS extended coverage to Medicaid-eligible women for up to 12 months postpartum and added Rapid Whole Genome Sequencing for children as a covered service. The agency is currently negotiating with the Centers for Medicare and Medicaid Services (CMS) to obtain approval to pay parents as caregivers for their minor children with disabilities, and to expand the upper income limit of KidsCare.
Calling it one of the biggest scandals in state government, Arizona Attorney General Kris Mayes, Governor Katie Hobbs, and CEO Carmen Heredia announced crackdowns in May on more than 100 providers for fraudulently billing for Medicaid services and a new hotline to assist members impacted by provider closures. The list of suspended providers grew to over 300 through the year as AHCCCS made numerous operational and administrative system changes to strengthen program security, close the door on bad actors looking to exploit the system and members, and maintain Arizona’s robust behavioral health system.
Using American Rescue Plan (ARP) investments, AHCCCS disseminated more than $365 million to Home and Community Based Services (HCBS) organizations through its Managed Care Organizations (MCOs), awarded $17 million to more than 60 HCBS providers for impactful community projects throughout the state, and will award another $47.5 million in ARP Program Awards in 2024.
In addition to these investments, AHCCCS launched the Targeted Investments 2.0 program to incentivize registered providers to develop and enhance whole person care and address health-related social needs. This innovative program received the Arizona State University President’s Social Embeddedness Award.
Recognizing statewide shortages in the health care and direct care workforce, the agency invested in innovative programs to address the state’s current and future needs. AHCCCS is building the healthcare workforce with scholarships for community college students in health care programs, free talent management courses to HCBS providers, the AZ Healthcare Careers website, and programs to develop nursing workforce.
In the coming year, AHCCCS will continue to secure and maintain program integrity and invest in critical service and technology enhancements that will maintain Arizona’s status as one of the nation’s most innovative Medicaid programs.
