AHCCCS Finalizes CYE 2020 DAP / by AzHHA

Debbie Johnston, Senior Vice President of Policy Development

The Arizona Health Care Cost Containment System (AHCCCS) has released its finalized differential adjustment payment (DAP) rates for CYE 2020. The rate adjustments, which the Centers for Medicare & Medicaid Services must still approve, include the following:

  • Up to 4% for short-term acute care hospitals that meet quality metrics related to participation in the state’s health information exchange (HIE), sepsis care, and pediatric preparedness.

  • Up to 28.5% for critical access hospitals that meet quality metrics related to participation in the state’s health information exchange, geographic-specific level IV trauma care, and pediatric preparedness.

  • Up to 4% for specialty hospitals that meet quality metrics related to (1) participation in the state’s health information exchange and (2) Medicare pressure ulcer care performance for rehabilitation and long-term care facilities or Medicare IPFQR benchmarks for inpatient psychiatric facilities.

AHCCCS is also providing differential adjustments for other provider types, including physicians, nursing homes and integrated clinics, that meet quality metrics. For most metrics, eligibility is based on performance as of May 1, 2019. Participation in the HIE requires a letter of intent (LOI) to be sent to Health Current and AHCCCS by May 15, 2019. AzHHA members will receive a more detailed overview of the DAP notice, including and LOI template.