Jami Snyder, director of the Arizona Health Care Cost Containment System (AHCCCS), said the agency’s 2022 priorities include the redetermination of Medicaid eligibility resulting from the imminent end of the Public Health Emergency (PHE) in 2022, as well as 1115 Waiver negotiations and increasing vaccination rates across the state. She informed the audience of AHCCCS’s 2022 priorities at the Hertel Report’s 2022 State of the State Conference on Feb. 11.
Snyder highlighted the tremendous increase in Medicaid enrollment since the beginning of the federally-declared PHE, and that no members had been disenrolled throughout the PHE per the federal Families First Coronavirus Act. She noted that Arizona’s Medicaid program remains the most efficient in the nation, with a 1.99% Medicaid administrative expense ratio compared to the national average ratio of 4.36%.
She said that although AHCCCS has not yet started the redetermination process, the agency had been redetermining eligibility for members behind the scenes in order to get a head start.
She announced that 500,000 individuals had been deemed ineligible or had failed to provide documentation to establish ongoing eligibility through this behind the scenes process.
“We’re working very closely with our contracted health plans to provide data around individuals who were due for renewal and individuals who haven’t supplied documentation so we can do some proactive outreach to those individuals to remind them that they need to get into the eligibility system and look at the notices for documentation,” said Snyder. “What we want to prevent is individuals falling through the cracks for those administrative or procedural issues.”
She added that AHCCCS will also be ensuring that individuals deemed ineligible would be connected to other coverage.
Snyder said AHCCCS would also continue to work on the 1115 Waiver negotiations with CMS, particularly emphasizing the Housing and Health Opportunities (H20) demonstration waiver. Waiver negotiations will continue through the year, and if approved—in part or in full—the next waiver will run from Oct. 1, 2022, through Sept. 30, 2027.
Snyder emphasized AHCCCS’s excitement about the H20 initiative, which has a goal of enhancing and expanding housing services and interventions for AHCCCS members who are homeless or at risk of becoming homeless. The initiative would seek to:
- “Increase positive health and wellbeing outcomes for target populations including the stabilization of members’ mental health conditions, reduction in substance use, improvement in the utilization of primary care and prevention services, and increased member satisfaction,
- Reduce the cost of care for individuals successfully housed through decreased utilization of crisis services, emergency department utilization, and inpatient hospitalization, and
- Reduce homelessness and improve skills to maintain housing stability.”
The waiver request asks CMS to not only extend certain benefits that AHCCCS offers to their long-term care population to a broader population, but also asks for the ability to reimburse for up to 18 months of transitional housing for individuals leaving an institutional placement.
“Whether it’s a correctional setting [or] an in-patient stay, what we’ve found from some blended funding models on the ground … is that that opportunity to stabilize somebody clinically and connect them to needed social supports is really instrumental in their success ultimately in permanent and supportive housing,” said Snyder.
She said AHCCCS would learn from California’s 1115 waiver, approved in December 2021, that allowed for up to 90 days of recuperative care and up to 6 months of short-term post-hospitalization housing.
Snyder said they would also be prioritizing their efforts to increase vaccination rates of AHCCCS beneficiaries statewide. She noted AHCCCS’s 46% rate of vaccination for individuals aged 12 and up, and 40% rate for individuals aged 5 and up.
“We’ve done a really good job of ensuring individuals in our long-term care programs are vaccinated and that’s due to some very focused efforts getting the vaccines out to them in their own homes and in residential settings, but we absolutely are missing the mark when it comes to the broader population,” she said.