Differential Adjusted Payment Program CYE 2023

Differential Adjusted Payment Program CYE 2023

DAP Program & Health Information Exchange

The Arizona Health Care Cost Containment (AHCCCS) Differential Adjusted Payment aims to distinguish providers that have committed to supporting designated actions to improve patients’ care experience, improve members’ health and reduce cost of care growth. An integral part of the DAP program includes participation in and meeting milestones related to a qualifying health information exchange organization, such as Contexture, Arizona’s HIE.

AzHDR AHCCCS DAP Program Requirements
Next Requirement Deadline: March 1, 2023

The Arizona Healthcare Directives Registry (AzHDR) program is working with the following Arizona providers on setting up access to the
AzHDR as part of the AzHDR AHCCCS DAP Program CYE 2023 requirements.

Participants that are part of this program include:

  • Hospital (Provider Type 02)
  • Critical Access Hospital (Provider Type CAH)
  • Psychiatric Hospital (Provider Type 71)
  • Residential Treatment CTR-Secure (17+bed Provider Type B1)
  • Resident Treatment CTR-Non-Secure (17+ bed Provider Type B3)
  • Subacute Facility (1-16 beds Provider Type B5)
  • Subacute Facility (17+ beds Provider Type B6)
  • Specialty Per Diem Hospitals (Provider type C4)

Requirements

There are three requirements for all participants that are part of the AzHDR AHCCCS DAP CYE 2023. All participants have met
requirement #1 and we’re now working with participants on requirements #2 and #3.

These requirements are:

  • Requirement #2
    No later than March 1, 2023:
    Submit a signed Healthcare Organization Registration document and execute an AzHDR Registration Agreement to participate in the AzHDR platform. After receipt of the AzHDR Healthcare Organization Registration document, the DocuSign for the AzHDR Registration Agreement will be sent to the authorized signer to complete and return.
  • Requirement #3
    No later than Sept. 30, 2023 (or as soon as reasonably practicable thereafter as determined by the qualifying HIE organization):
    Initiate use of the AzHDR platform operated by the qualifying HIE organization.

Questions?

If you have questions, need more information or want to ensure you are meeting all your requirements, contact the AzHDR DAP team at azhdr.dap@contexture.org.

AHCCCS Public Notice

Final Public Notice Posted March 18, 2022:

Letters of Intent & Social Determinants of Health Registration Forms & Spreadsheets
Due: April 1, 2022

Eligible providers must submit a Letter of Intent for each DAP Program provider type they wish to participate in. An LOI is required in order to participate in the program. If you intend to participate, please complete and return the appropriate LOI template(s) below and send to by April 1, 2022.

Provider types eligible to participate in the social determinants of health HIE incentive must complete and return the SDOH Closed-Loop Referral (CLR) Form and SDOH CLR Spreadsheet below and send to dap@contexture.org by April 1, 2022.

If you have questions about the DAP Program for CYE 2023 as it relates to HIE milestones or SDOH milestones, or if your organization has not yet signed an Arizona HIE Participation Agreement, please contact dap@contexture.org.

AHCCCS ELIGIBLE PROVIDER TYPES HIE INCENTIVE SDOH HIE INCENTIVE
Hospitals Subject to APR-DRG Reimbursement (Type 02) excluding Critical Access Hospitals

2%

0.5%
Critical Access Hospitals (CAH) 8% 2%
Other Hospitals and Inpatient Facilities (Types 71, B1, B3, B5, B6, C4) 2% 0.5%
IHS and 638 Tribally Owned and/or Operated Facilities (Type 02) 2.5% —
Nursing Facilities (Type 22) 1% —
Integrated Clinics (Type IC) 1% 1%
Behavioral Health Outpatient Clinics (Type 77) 1% 1%
Behavioral Health Providers (Types A3, A4, A5, A6) — 1%
Physicians, Physician Assistants and Registered Nurse Practitioners, (Types 08, 18, 19, 31) — 1%
Physicians, Physician Assistants and Registered Nurse Practitioners, (Types 08, 18, 19, 31) Specialty Types (Obstetrics and Gynecology, Pediatrics, Cardiology and Nephrology) 1% 1%
Home and Community-Based Services Providers: Assisted Living Centers (Type 49) 1% —
Home and Community-Based Services Providers (HCBS): Attendant Care (Type 40), Fiscal Intermediaries (Type F1), Habilitation Provider (Type 39), Home Health Agency (Type 23), Non-Medicare Certified Home Health (Type 95), Nurse-RN/LPN Private (Type 46) — 2%
Crisis Capacity Data Exchange: Subacute Facilities (1-16 Beds), Provider Type B5; Subacute Facilities (17+ beds), Provider Type B6; Crisis Services Provider, Provider Type B7 3% —

Webinars & Presentations

Watch one of the recorded DAP CYE 2023 webinars or download one of the PowerPoint presentations to learn more about the DAP Program, HIE Milestones, SDOH Milestones and Data Quality Metrics.

AHCCCS Eligible Provider Types

  • Critical Access Hospitals
  • Hospitals Subject to APR-DRG Reimbursement (Type 02) excluding Critical Access Hospitals
  • IHS and 638 Tribally Owned and/or Operated Facilities (Type 02)
  • Integrated Clinics (Type IC)
  • Other Hospitals and Inpatient Facilities (Types 71, B1, B3, B5, B6, C4)
  • Behavioral Health Outpatient Clinics (Type 77)
  • Nursing Facilities (Type 22)
  • Physicians, Physician Assistants and Registered Nurse Practitioners (Types 08, 18, 19, 31)
  • Individual Practitioners (Types 8, 18, 19, 31)
  • Specialty Types (Obstetrics and Gynecology, Pediatrics, Cardiology and Nephrology)
  • Home and Community-Based Services Providers & Assisted Living Centers (Type 49)

Questions?

  • Existing HIE Participants should contact their Contexture quality improvement advisor with questions.
  • If you’re new to the DAP Program or need more information about DAP, please contact our QI team at dap@contexture.org.

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