Arizona Releases Medicaid Statistical Snapshot

The Arizona Health Care Cost Containment System (AHCCCS), the state’s Medicaid program, released a Medicaid snapshot, including data on enrollment, costs, claims, and utilization. 

The snapshot showed trends that signal costs lower than the national average, and an increase in claims productivity over the past couple of months. 

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Total Medicaid enrollment in Arizona was 1.8 million in April 2019, with 98 percent enrolled in a managed care plan. Long term services and supports enrollment was 64,179. Per member per month costs in fiscal 2017 were $6,100.

The total percentage of medical claims processed within 30 days has increased from 95.0 percent in February 2018, to 96.6 percent in April of the same year. The percentage of long-term care claims filed within 30 days has also increased to 99.21 percent. The goal in both metrics is 95 percent, demonstrating that Arizona is meeting their marks in this capacity.

Similarly, the state set the goal of enrolling a new provider to take 30 days. Currently it takes 34 days, just shy of their overall goal. 

Snapshot data demonstrates that Arizona is leading the way in cost-savings that occur directly from opting for in-home care. In 2018, 87 percent of ALTCS members received services in their own home or community, saving an average of $13,939 per member in FY18. These cost savings rank Arizona 5th overall in utilizing home and community based services rather than institutional services. 

The Justice Reach-In program, AHCCCS’s attempt to provide health coverage to those being released from the justice system and avoid gaps in coverage, showed growth during FY18 as well. The snapshot reveals that the program helped 10,711 individuals apply for Medicaid coverage prior to their release. Nearly 50 percent of accepted patients utilized a health care service within 90 days of their release. 

Behavioral health data is also highlighted in the snapshot. 41 school districts in Arizona receive behavioral health support, and the percentage of members receiving behavioral health care is nearing 15 percent. 

Trends in opioid and other substance abuse disorders are also featured. The number of members being served Arizona Opioid State Targeted Response grant has increased compared to data from February and March of 2018. And, of the 222,608 doses of Naloxone distributed, 6,989 overdoses have been reversed, according to snapshot data. 

The data used in this snapshot can be utilized in future legislative sessions to demonstrate policy gaps, and areas that may need additional legislation to improve overall metrics.