Projects for Arizona Health Care Cost Containment System

Public/Private Design Concepts

Service Category: Public/Private Insurance InitiativesPublic/Private Insurance Initiatives

AHCCCS hired B&A to research options for expanding health insurance through private sector, public sector and public/private mechanisms. Specific policy papers were drafted related to: (1) Identifying populations already eligible for Medicaid that are not enrolled; (2) Options for implementing a premium subsidy program for low-income workers; (3) Developing a high-risk pool product; (4) Options for developing a health insurance exchange; (5) Opportunities for employees if a Section 125 mandate for employers was in place; and (6) Other cost containment strategies designed to lower premium costs.

Waiver Renewal Assistance

Service Category: HIFA and Other Waivers

Peter Burns assisted AHCCCS with their 2006 waiver renewal, particularly with budget neutrality. This included writing the waiver chapter on budget neutrality, creating the design approach, reviewing calculations, negotiating with CMS on the waiver and Terms & Conditions, and responding to CMS questions.

For AHCCCS’s 2001 waiver renewal, Mr. Burns performed these same functions as well as assisting in incorporating all uninsured citizens below 100% FPL (a state ballot initiative) into the waiver. Arizona was the first state to gain approval through the HIFA waiver process.

Development of Assessment Tools

Service Category: Supports Intensity Scale and other Assessment Tools

In the early 1990s, Gretchen Engquist was instrumental in the development of the pre-admission screening tools for the elderly, people with physical disabilities, and people with developmental disabilities for the ALTCS program (Arizona Long Term Care System), the first Medicaid managed long term care program in the country. Since then, she has participated in completing periodic updates of tools for AHCCCS.

Update DSH Methodology – AHCCCS

Service Category: Disproportionate Share and Upper Payment Limit Program Financing

Peter Burns assisted AHCCCS with instituting CPE for DSH. Tasks included reviewing existing DSH for compliance with federal and state law and waiver Terms & Conditions, developing reporting frameworks to allow costing of each uninsured claim, creating reporting schedules for public and private hospitals to supply information for DSH calculations, conducting meeting with hospitals to explain the new reporting requirements, and negotiations with CMS.

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