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Modernizing the way health care services are purchased means rethinking the end product. Today’s reimbursement structure
favors the provider with higher production numbers, i.e. performs more services without regard to outcome.
In order to bend the cost curve, there must be a paradigm shift such that reimbursement favors the provider who achieves
a quality health outcome. That is why payment modernization is a critical policy strategy for moving to a financially
sustainable and value-based healthcare delivery system.
To that end, AHCCCS is pursuing the implementation of long-term strategies that bend the cost curve while improving member
health outcomes. The overall mission is to leverage the AHCCCS managed care model toward value based health care systems
where patients’ experience and population health are improved, per-capita health care costs are limited to the rate of
general inflation through aligned incentives with MCO and provider partners, and there is a commitment to continuous
quality improvement and learning.
Value Based Purchasing
State Innovation Model (SIM)
Electronic Prescribing (Coming Soon)
Care Coordination and Integration (Coming Soon)
The AHCCCS Payment Modernization Plan includes a discussion of the current healthcare delivery and payment system, the framework
for moving payment modernization forward, and actions needed for successful system transformation.
Continual Learning Process
Common Hospital Charges/Payments
Payment Modernization Blog
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