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CYE 15 Payment Reform Initiatives Acute Care Continue CYE 14 model with 1% capitation withhold and the following changes: – Minimum 10% of the value of.

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Presentation on theme: "CYE 15 Payment Reform Initiatives Acute Care Continue CYE 14 model with 1% capitation withhold and the following changes: – Minimum 10% of the value of."— Presentation transcript:

1 CYE 15 Payment Reform Initiatives Acute Care Continue CYE 14 model with 1% capitation withhold and the following changes: – Minimum 10% of the value of total payments under all contracts with providers must be governed by shared- savings arrangements – NO sub-cap contracts counted – AHCCCS considering limiting portion of shared savings with owner systems – 33% of total maximum? – AHCCCS considering adding geographic requirements – e.g. 80% maximum in any one GSA for multiple GSA plans?

2 CYE 15 Payment Reform Initiatives ALTCS EPD Implement initiative similar to Acute Care CYE 14 model: – Minimum 5% of the value of total payments under all contracts with providers must be governed by shared- savings arrangements – NO sub-cap contracts counted Minimum 2% of total Acute Care service payments Minimum 2% of total LTC service payments Remaining 3% of total spend at MCO discretion

3 CYE 15 Payment Reform Initiatives ALTCS EPD – Minimum 1.5% of Medicare DSNP total payments under all contracts with providers must be governed by shared-savings arrangements – NO sub-cap contracts counted – 1% capitation withhold Distribution based on existing performance measures Would prefer mix of Acute Care and LTC services Input on performance measures welcome

4 CYE 15 Payment Reform Initiatives ALTCS DDD LTC Services ‒DES/DDD submit plan regarding value-based purchasing to AHCCCS by April 2015 for CYE 16 implementation Acute Care Services ‒Implement initiative similar to Acute Care CYE 14 model: Minimum 5% of the value of total payments under all contracts with providers must be governed by shared- savings arrangements – NO sub-cap contracts counted Consider 1% capitation withhold Input on performance measures welcome

5 CYE 15 Payment Reform Initiatives CRS Implement initiative similar to Acute Care CYE 14 model: – Minimum 5% of the value of total payments under all contracts with providers must be governed by shared- savings arrangements – NO sub-cap contracts/block purchasing counted – No capitation withhold due to single Contractor – Consider sanction for non-compliance

6 CYE 15 Payment Reform Initiatives BHS Implement initiative for integrated RBHA – Minimum 1% of the value of total payments under all contracts with providers must be governed by shared- savings arrangements – NO sub-cap contracts/block purchasing counted – No capitation withhold due to single Integrated RBHA – Consider sanction for non-compliance


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