FFY 2025 HEALTHII Performance Measure Calculations and Reporting

2026-11-03

The purpose of this Task Order is to procure data collection , analysis , calculation , and reporting services on quality measures for AHCCCS ’ payment reform initiative , Hospital Enhanced Access Leading to Health Improvements Initiative ( HEALTHII ) program for the Federal Fiscal Year ( FFY ) 2025 Measurement Period . 4 . 1 One of AHCCCS ’ strategic priorities is to pursue and implement long - term strategies that bend the cost curve while improving member health outcomes . A critical tool in achieving this strategic priority is Value - Based Purchasing ( VBP ). VBP arrangements seek to reward providers through financial incentives for providing high - quality care to members while promoting value , meaning payments are tied to improving health outcomes while reducing the cost of care . AHCCCS VBP encompasses a variety of initiatives for payment reform including but not limited to : 4 . 1 . 1 State Directed Payments which require AHCCCS health plans to pay specific amounts to providers under their managed care contracts . The directed payments work to advance delivery system reforms and / or performance improvement initiatives . 4 . 2 The HEALTHII program is described below : 4 . 2 . 1 In March 2020 , the Arizona Legislature passed , and Governor Ducey signed into law HB 2668 ( Laws 2020 , Chapter 46 ) which established a second assessment effective October 1 , 2020 . Monies from this assessment are to be deposited into the Health Care Investment Fund ( HCIF ) to 1 ) make directed payments to hospitals pursuant to 42 CFR § 438 . 6 ( c ) to persons eligible for Title XIX services , 2 ) increase base reimbursement for services reimbursed under the dental fee schedule and physician fee schedule , and 3 ) to pay for the non - federal share of the costs for AHCCCS expenses to administer this program , not to exceed one percent of the total assessment monies collected . The HCIF assessment revenue , when matched with federal funds , will result in hospitals receiving approximately $ 3 billion in directed payments , which after accounting for the HCIF collection amount , reflects a net increase of approximately $ 2 . 3 billion . AHCCCS named the quarterly directed payments the Hospital Enhanced Access Leading to Health Improvements Initiative ( HEALTHII ) payments . AHCCCS received approval by the Centers for Medicare and Medicaid Services ( CMS ) through a 438 . 6 ( c ) initiative which requires AHCCCS to recommend and track quality measures . Through a series of workgroup meetings from December 2021 - April 2022 , AHCCCS engaged provider stakeholders to review and select quality measures that would tie HEALTHII payments to performance . Since November 2022 , AHCCCS has engaged a health information technology vendor to calculate rates for each measure in the HEALTHII program .

Arizona

2026-03-27