On September 8, 2024, The Arizona Health Care Cost Containment System (AHCCCS) dismissed the recommendation of an administrative law judge and denied the appeal of Mercy Care, Health Choice Arizona and Banner-University Family Care after all three local non-profits contested the agency's award of its Arizona Long Term Care EPD contracts...
An Administrative Law Judge on August 9 decided against Arizona's Medicaid agency and in favor of insurers protesting the agency's choice of Arizona Complete Health Complete Care Plan and UnitedHealthcare Community Plan to provide long-term care services to about 26,000 AHCCCS members who are enrolled in the Arizona Long Term Care System...
Duo Health, a value-based medical group designed to manage chronic kidney disease (CKD) and end-stage kidney disease (ESKD), announced a new strategic partnership with Arizona Complete Health’s Medicare Advantage program, Wellcare by Allwell.
The value-based care program targets Arizona Wellcare by Allwell MA members with...
The Arizona Health Care Cost Containment's (AHCCCS) procurement process ended in December when Arizona's Medicaid agency chose Centene (Arizona Complete Health) and UnitedHealthcare (UHC Community Plan) to provide integrated healthcare to Medicaid eligible Arizonans who are elderly and/or have a physical disability in the Arizona Long...
Nationally CMS reports 20.3 million people have chosen a Marketplace plan during the open enrollment period which closes January 16, 2024; about 3.7 million of those consumers were first-time shoppers on the ACA Health Insurance Marketplace.
It's already a historic year for the Marketplace with more than 18 million people in the...
Our annual data edition focusing on the Arizona Health Care Cost Containment System (AHCCCS) covers a lot of territory and 15 pages to help readers keep tabs on the agency charged with overseeing the managed care plans contracted with the state to deliver care to about 2.2 million Arizona Medicaid members.
Correction: On Page 4 the...
Collectively, UHC Community Plan and Arizona Complete Health Complete Care Plan will provide health care services to the approximately 26,000 members enrolled in the Arizona Long Term Care System (ALTCS) and who are elderly and/or living with a physical disability, known as the ALTCS-EPD program. It marks the first time members across...Arizona News
Arizona Complete Health's AHCCCS membership in the sate totals 372,445 while Care1st Health Plan of Arizona serves approximately 80,626 Arizona Medicaid members. Both Centene plans also have Regional Behavioral Health Agreements in separate geographic service areas that cover Medicaid members with a serious mental illness (SMI).
Mercy...Arizona News
After a request from Congress, the Office of Inspector General analyzed prior authorization and appeals data from 115 risk-based managed care organizations (MCOs) including Centene's Arizona Complete Health & Care1st Health Plans. According to the report, in Arizona Centene denied one out of every eight prior authorization (PA)...
Most shoppers who qualify for a subsidy won't feel the cost of rising Marketplace premiums and with eligibility expanded to include the cost of family coverage, HealthCare.gov may see the busiest season ever as it celebrates its 10th open enrollment period (OEP) Nov. 1, 2022 through January 15, 2023.
Eight insurers, but not...
The Hertel Report's annual data edition focusing on Arizona Medicaid includes everything you need to know about AHCCCS and the contracted managed care organizations (MCOs) providing integrated healthcare to 2.5 million in Arizona.
AHCCCS 2022 DATA EDITION
What's Inside:
Pandemic Population Growth
AHCCCS Complete Care MCOs
...
Seven insurers, but not Bright Health, are offering individual and family coverage in Arizona on HealthCare.gov including last year's newcomers Banner/Aetna and Medica Community Health Plan. We reviewed the plan data from the Arizona Department of Insurance and Financial Institutions and provide readers a Marketplace snapshot.
Nearly...
On October 1, 2022, new ACC-RBHA contracts began with Mercy Care (Central GSA), Arizona Complete Health (South GSA) and Care 1st Health Plan (North GSA) resulting in about 6,100 members transitioning from the Health Choice RBHA to Care1st. Aligning RBHA service areas with ACC and ALTCS contracts also shifted about 1,900 members the Mercy...Arizona News
The insurer has a strong presence in Arizona, insuring about 400,000 Medicaid and 47,000 MA lives, and also competes under the Ambetter brand on the Health Insurance Marketplace.
According to reporting from the Phoenix Business Journal, Centene's notice to terminate its Medicaid contract with Tenet Healthcare's Abrazo Health...National News
The longtime leader of Centene, Neidorff died Thursday, April 7, 2022 surrounded by family and friends, he was 79 years old. London, former vice chairman of Centene was appointed CEO on March 22, 2022.
Neidorff joined Centene, now the largest Medicaid managed care company in America, as CEO in 1996 and led the company from a $40...Arizona News
Blue Cross Blue Shield of Arizona's (BCBSAZ) AHCCCS Complete Care (ACC) product, Health Choice Arizona (HCA), did not receive an expanded contract from the Arizona Health Care Cost Containment System (AHCCCS) and effective October 1, 2022, HCA's approximately 12,000 SMI members will move to Care1st, the newly awarded health plan in the...
Arizona's Medicaid program continues to grow and so does this year's data edition. Along with enrollment by county and market reports, readers will learn more about how the Arizona Healthcare Cost Containment System (AHCCCS) is bending the cost curve, responding to the COVID-19 pandemic and managing the "great unwinding". Quality...
Angela Burzynski has returned to Centene as director of payment innovation. She was previously a strategy consultant for Humana after serving as senior manager of the provider network at Centene....Arizona Comings & Goings
This is a grim holiday season in Arizona with COVID-19 cases spiking 52% in the two weeks following Thanksgiving. Healthcare workers are managing increasing hospitalizations and deaths; capacity is tightening with 92% of inpatient and 93% of ICU beds in use - the state's largest healthcare system expanded its morgue capacity with...
