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CYE 15 Payment Reform Initiative – E-Prescribing

CYE 15 Payment Reform Initiative – E-Prescribing. Shelli Silver May 21, 2014. E-Prescribing Initiative (E-Rx). MCOs will be required to increase E-Rx rate for original prescriptions by specified % by end of CYE 15 AHCCCS may consider 2 tiers, potentially:

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CYE 15 Payment Reform Initiative – E-Prescribing

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  1. CYE 15 Payment Reform Initiative – E-Prescribing Shelli Silver May 21, 2014

  2. E-Prescribing Initiative (E-Rx) • MCOs will be required to increase E-Rx rate for original prescriptions by specified % by end of CYE 15 • AHCCCS may consider 2 tiers, potentially: • For MCOs below 50% E-Rx across all original prescriptions – increase by 20% • For MCOs at or above 50%, increase by 10% • Thoughts on these tiers/increases? Reaching across Arizona to provide comprehensive quality health care for those in need

  3. E-Prescribing Initiative (E-Rx), cont. • AHCCCS will extract data to determine each MCO’s baseline of E-Rx for original prescriptions • MCOs will have discretion as to how to achieve the increase • Draft contract language to be distributed for comment in June 2014 • ACOM Policy to follow Reaching across Arizona to provide comprehensive quality health care for those in need

  4. E-Prescribing Initiative (E-Rx), cont. • Outstanding questions: • Does initiative cross all lines of business? • Need to understand barriers for any line of business • Need to understand barriers for specific services • Should standard in rural GSAs be different than urban? • Data review may shed some light • What is consequence of failure to meet specified %? Reaching across Arizona to provide comprehensive quality health care for those in need

  5. E-Rx Executive Summary • AHCCCS will require submission of an Executive Summary, to include: • MCO’s strategies to increase E-Rx • Whether or not the MCO will utilize any payment incentives/disincentives • Due in October 2014 Reaching across Arizona to provide comprehensive quality health care for those in need

  6. E-Rx Ongoing Initiative • CYE 15 to be first year of a continuing mandate • Percentage of increase and or specifics of mandate could change from year-to-year • MCOs should consider future strategies that might necessitate heavy lifting such as working with practices to implement EHRs Reaching across Arizona to provide comprehensive quality health care for those in need

  7. E-Rx Ongoing Initiative, cont. • AHCCCS would consider an AzAHPcollaborative if desired by Association • AHCCCS would consider collaboration with REC and/or AHCCCS regarding EHR adoption incentives Reaching across Arizona to provide comprehensive quality health care for those in need

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