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AZHAC in the Media

2-14-19 


LAKE HAVASU CITY — The Arizona Healthcare Accountability Committee held its quarterly meeting at Lake Havasu Regional Hospital recently.

The working committee was founded by then-Mohave County Sup. Lois Wakimoto upon becoming aware of ongoing payment issues between area healthcare providers and the Arizona Healthcare Cost Containment System. Wakimoto was concerned that the issues would be problematic for doctor/patient relationships and could adversely affect healthcare in the Tri-state.

“We can’t afford to lose healthcare providers,” Wakimoto said. “I was concerned because losing providers impacts this area more than the metropolitan areas. We need to increase services and incentivize more providers to come. Our committee is a voice for providers and patients, which I feel will improve healthcare in our community.”

While AZHAC is not a government-sanctioned committee, Hildy Angius, chairman of the Mohave County Board of Supervisors, is the committee’s community liaison. The committee works closely with and has the support of state legislators. The four major county hospitals were represented, along with individual doctors and medical practices including Cheryl DeBatt, director of Westcare Arizona, a behavioral health organization.

Representatives from AHCCCS, Steward Health Choice and Care1st were in attendance, along with AHCCCS Director Jami Snyder, Steward Health Choice CEO Shawn Nau, Care1st AZ CEO Scott Cummings and Care1st Market VP Jessica Sedita-Igneri. 

The goal of the group of 12 committee members is to foster a better relationship with government payment plans while streamlining billing and authorization processes. In addition, the committee is discussing ways to bring more healthcare providers to Mohave County.

“Our goal for this committee is to have a sufficient provider network for the needs of our members and, as Lois mentioned, to provide better healthcare for all of Mohave County,” said committee member Patrick Hansen, vice president for provider network services for Steward Health Choice. “We want to look for more specialties. We need to find a way to entice sub-specialists within the county and keep them.”

Committee member Becky Hilton of Colorado River Pediatrics said, “I think this committee is great. I’m so glad that we can come together with issues and actually get them resolved.”

For more information, go to www.azhac.net or the AZHAC Facebook page.



Healthcare committee discusses new AHCCCS provider

  • JIM SECKLER, The Daily News
  • Oct 2, 2018

KINGMAN — A healthcare committee met again Tuesday to discuss the rollout of a new integrated health care plan.


The five-person Arizona Healthcare Accountability Committee met at the Kingman Regional Medical Center. The committee, which meets quarterly, was formed in January by District 5 Sup. Lois Wakimoto. The next meeting is scheduled for January 2019 in Lake Havasu City.

The round-table discussion dealt with the entry of Care 1st Health Plan Arizona, which replaced United HealthCare as one of two providers for county residents on the Arizona Health Care Cost Containment System. Steward Health Choice Arizona is the other provider for Mohave County residents.

AHCCCS Assistant Deputy Director Jamie Snyder said about 1.5 million of the 1.9 million state residents on AHCCCS Complete Care have transitioned to the new healthcare plan with Care 1st.

Wakimoto, the committee’s chair, said the committee was formed to work out issues with the Care 1st Health Plan. Care 1st and Steward Health Choice were awarded a contract in March to provide physical and behavioral healthcare to the five counties in northern Arizona.

Steward Health Choice Vice President Pat Hansen gave a brief presentation of the provider’s statistics including prior authorization requests, reimbursement services, call volume of members and providers, pharmacy management and site visits.

Arizona State Rep. Regina Cobb questioned the notification process for people who need to go into a hospital as an inpatient from the emergency room on weekends if there isn’t anyone

from the healthcare provider working on weekends. Notifications to the provider must be received within 48 hours.

Cobb, who is on the committee, asked if the providers could streamline their forms, requesting that the providers follow specific guidelines. They have been given too much latitude in the past, Cobb said.

Other committee members include Arizona State Sen. Sonny Borrelli, Mardi Benedict and private attorney D’Arcy Downs-Vollbracht. Benedict, the committee’s secretary, said the committee and its minutes are on social media including Facebook, Twitter and Instagram.

Another issue is there are few specialists in the area, especially in podiatry, who take AHCCCS patients because of the lack of payments. Wakimoto added there are no podiatry specialists in Bullhead City and only a few in Kingman and Lake Havasu City. Another problem is AHCCCS members don’t notify their provider that they have Medicaid as a secondary insurance.

Another issue is healthcare providers contracting out to either of the two laboratories, Sonora Quest or Lab Corp. Other issues include authorizations for payment for treatment by radiologists and pediatric special needs care.


http://www.mohavedailynews.com/news/healthcare-committee-discusses-new-ahcccs-provider/article_9437b2ae-c6d6-11e8-88a2-bb566d21f88a.html







Committee working with AHCCCS providers

  • By DK McDONALD The Daily News
  • Aug 2, 2018



FORT MOHAVE — A local committee focused on improving communications and service with Arizona Health Care Cost Containment System providers met at Valley View Medical Center this week with the chief executive officers of Care 1st Health Plan Arizona and Health Choice Arizona.

Attendees at the working lunch for Arizona Healthcare Accountability Committee, hosted by Valley View Medical Center, included Jami Snyder, AHCCCS assistant deputy director; David Lane, Lake Havasu City Council; Patrick Hansen, Health Choice Arizona vice president provider networking; and Valley View Medical Center Chief Financial Officer Emma Canlas and Chief of Staff Dr. Richard Benedict.

“As a health plan, our main role is to contract with providers and make sure that through those providers that our members who are assigned by AHCCCS get the services that they need,” said Shawn Nau, Health Choice Arizona CEO. One of the things we always talk about internally is that getting feedback from communities is actually the hardest thing — so one of the nice things about this group is it really does provide that service in a way that no other community in northern Arizona has.”

Care 1st Health Plan Arizona and Health Choice Arizona (Steward Health Choice Arizona) were awarded state contracts in March to provide integrated healthcare delivery — physical and behavioral healthcare — for Mohave County residents on AHCCCS. Care 1st Health Plan Arizona replaced United Health Care Community Plan and Banner University Family Health Care Plan in Mohave, Coconino, Apache, Navajo and Yavapai counties.

Service with AHCCCS Complete Care plans begin Oct. 1.

“It’s welcoming,” said Scott Cummings, Care 1st of Arizona CEO, of the committee. “I think if we were on opposite sides with a block wall in front of us and we were both banging our heads against a wall, it’s not going to work ever — I applaud them for getting this together.” 

Arizona State Rep. Regina Cobb, Appropriations Subcommittee on Health and Welfare chairperson and Health Committee vice-chairperson, also attended the meeting, which hosted discussions on the challenges with specialist physicians not accepting AHCCCS and Veterans Affairs patients, efforts to streamline and make consistent AHCCCS billing and prior authorization issues, physician credentialing process streamlining and bringing needed specialists to Mohave County.

“We’ve already been working with AHCCCS and health cares at the state level,” Cobb said. “I wanted to see what they were actually getting from the community and I wanted to see what the community has been giving them.”

The issues discussed in the meeting were not new to her, Cobb said. 

“If they didn’t have to be pushed to do the contract this year, we wouldn’t have as much cooperation,” Cobb said. “So I want to see where this is all going to go in March, April, May, next year and where they’re sitting then. I heard some positive things today and I hope they stay positive, but from what I’ve seen in the last four years, I’m not hopeful. We’ve got two new companies, so hopefully that’s going to change — but it hasn’t been that way in the past.”

Mohave County District 5 Sup. Lois Wakimoto formed the committee after she received numerous complaints from area healthcare providers regarding slow payment or no payment by Health Choice Arizona, a managed care organization and insurer contracted by AHCCCS for Mohave County residents enrolled in Medicare and receiving assistance under Medicaid. 

“Today’s meeting was very informative (and) very productive,” Wakimoto said.  “AZHAC is important because we’re holding everybody accountable; not just the providers but the insurance companies, AHCCCS, and everybody else.” 

Committee members are liaisons representing various health service sectors from within the county and include members from Bullhead City, Mohave Valley, Fort Mohave, Lake Havasu City and Kingman. Healthcare providers with issues can email Trent Pike, committee director, at trentpike@gmail.com. The committee meets quarterly.

“I’d like to see more and more meetings like these,” said Canlas, Valley View’s CFO. “People working together to get what is good for our patients and our community.” 

Wakimoto said, “We’re trying to work together to streamline things, to better service this area and make sure we bring in specialties that we need. We’re looking outside of the box, where we can overlap and serve as many people as possible while making sure that the distance they have to travel is not overwhelming for them — so that continued medical care for the citizens of Mohave County is available.”


http://www.mohavedailynews.com/news/committee-working-with-ahcccs-providers/article_6a02daf8-96e4-11e8-a6ce-030e0311d2bc.html







Committee focucounty 2-14-19














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Supervisor says health committee already making a difference

  • DK McDONALD, The Daily News
  • Feb 19, 2018

BULLHEAD CITY — A provider committee already is making a difference for health care providers in Mohave County, according to Lois Wakimoto, Mohave County supervisor for District 5.

The Arizona Health Care Accountability Committee was formed after Wakimoto received complaints from area health care providers regarding slow payment, or no payment, by Health Choice Arizona. Health Care Arizona is a managed care organization and insurer contracted by the Arizona Health Care Cost Containment System for Mohave County residents enrolled in Medicare and receiving assistance under Medicaid.

Wakimoto said she had heard from a number of area health care providers regarding medical billing more than 60 and 120 days outstanding from Health Care Arizona.

Sen. Sonny Borrelli, who along with Rep. Regina Cobb also had been working on the issue, arranged in January for Wakimoto and her assistant, Trent Pike, and representatives of local health care providers to meet in Phoenix with AHCCCS Director Thomas Betlach and Health Choice Integrated Care CEO Shawn Nau.

“The reason for the meeting was to support continued medical care for all of Mohave County,” Wakimoto said. “AHCCCS in Mohave County (covers) 77,000 people, about a third of our population, so it’s huge. So when the doctors that I see are having problems maintaining because of delayed payments, then it affects women, children, and the elderly and it affects the whole community. Keeping doctors and hospitals open is really important for us in terms of continued growth and being able to bring people in.”

Since that meeting, Health Choice Arizona has hosted three provider town halls in the Tri-cities, along with a specialty forum to help find ways to improve communication and streamline processes to ensure health care providers are paid in a timely manner, Pike said.

“We were successful with getting things done here,” Pike said. “We want to continue that moving forward and get to the point where we can say, now doctors will want to come in and they’ll want to stay because they’re getting paid for the services they provide. We’re also hoping that more doctors will want to open their doors to AHCCCS to provide more health care in this area.”

AHCAC members and area liaisons include Mardi Benedict representing Dr. Richard Benedict, Bullhead City; Dr. Catherina Blevins, Sycamore Avenue Medical Center, Kingman; Holly Balderrama, representing Dr. Dana Balderrama, Lake Havasu City; and Dave Amos, Kingman Regional Medical Center, patient financial services director.  

“Moving forward, the committee is the action group,” Wakimoto said. “In terms of communicating our problems with any subcontractor including Health Choice or AHCCCS, it is easier to have one voice, one direction — If individual providers want to march out on their own, that’s fine. We found that it was easier to have one voice with a multitude of problems addressed at the same time.”

Another goal for the committee is to bring in representatives from specialties, such as conception or senior citizens, Wakimoto said.

“I’m going to try to set up a portal for doctors on my county webpage, for all providers to get into if somebody doesn’t want to make the phone call or talk to the liaison in their area,” Wakimoto said. “They can leave information about problems and then the information will be passed on to the committee.”

Health care providers also can email Pike at trentpike@gmail.com.

“The commitment that we made to the community was to have continued input from all three areas — Bullhead City and surrounding areas, Kingman and Lake Havasu — along with anybody else who wants to contact us,” Wakimoto said. “This is to make sure that rural Mohave County continues to get the service that is required to maintain good medical health care for our citizens.”

The committee’s work is not just problem solving, but also information sharing, Wakimoto said.

“Health Choice is attempting to work with us,” Wakimoto said. “It’s an open communication that we hope to continue even after contracts are issued.”

Contracts for AHCCCS Complete Care, which will integrate physical and behavioral health care contracts under managed care plans, will be awarded on or before March 8 with implementation beginning Oct. 1. At $50 billion over seven years, the AHCCCS Complete Care contracts are the largest procurement in the history of the State of Arizona; seven organizations, including Health Choice Arizona, Inc., have submitted proposals to AHCCCS. 

“Providers in the past have not had a voice,” Wakimoto said. “But now that we’ve brought this to the forefront, we’re getting results for health care providers that all three cities can use — not just in my district.”


http://www.mohavedailynews.com/news/supervisor-says-health-committee-already-making-a-difference/article_f9eb925e-1606-11e8-92c8-c79ba84a5c4e.html

Supervisor forms panel to address problems between health providers, AHCCCS contractor

  • DK McDONALD, The Daily News
  • Jan 22, 2018

EDITOR'S NOTE: This story has been updated to correct Sonny Borelli's office,

BULLHEAD CITY — Tri-city health care providers soon will have a more direct line of communication with state-level health care insurance providers.

Lois Wakimoto, Mohave County supervisor for District 5, is forming a provider committee with representatives of numerous health care specialties from the Tri-cities — Bullhead City, including the areas of Fort Mohave and Mohave Valley, and Kingman and Lake Havasu.

“The committee will represent providers offering services from conception to senior care to network with other providers in the area to make sure problems with claims are handled correctly and to talk about any problems they are having,” Wakimoto said. 

Trent Pike, Wakimoto’s assistant, will head the committee.

“We all want good health care providers to stay in this area and provide good health care, it’s one of our biggest issues,” Pike said. “We can’t keep quality health care in this area if they can’t get paid.”

Representatives on the committee will serve as points of communication for their health care areas.

“It was important to me that all three areas be represented,” Wakimoto said. 

The supervisor got involved in the issue after receiving numerous complaints from area health care providers regarding slow payment or no payment by Health Choice Arizona, a managed care organization and insurer contracted by the Arizona Health Care Cost Containment System for Mohave County residents enrolled in Medicare and receiving assistance under Medicaid.

“Many (local providers) had a large number of claims at least 60 days out and it was up to 120 (days outstanding) in some of them, and for one provider nearly a year,” Wakimoto said. “I believe a lot of the problems are from miscommunication and code billing problems.”

Wakimoto pulled a consent agenda item regarding a contract between the county and Health Choice Integrated Care to provide housing for homeless and seriously mentally ill people during the Jan. 2 Board of Supervisors regular meeting to highlight her concerns about the contractor. The consent agenda groups various routine business and reports into one item that can be approved in a single action.

“It’s not that I don’t want this contract — severely mentally ill people need help — but it is the company itself that is providing problems for medical care in my district,” Wakimoto said at the time.

The board voted unanimously to approve the contract.

State Rep. Regina Cobb and State Sen. Sonny Borrelli have been working on the issue, Wakimoto said. Rep. Borrelli arranged for Wakimoto and Pike, along with representatives of local health care providers, to meet in Phoenix on Thursday with AHCCCS Director Thomas Betlach and Health Choice Integrated Care CEO Shawn Nau.

“The reason for the meeting was to support continued medical care for all of Mohave County,” Wakimoto said. “AHCCCS in Mohave County (covers) 77,000 people, about a third of our population, so it’s huge. So when the doctors that I see are having problems maintaining because of delayed payments, then it affects women, children, and the elderly and it affects the whole community. Keeping doctors and hospitals open is really important for us in terms of continued growth and being able to bring people in.”

The meeting was very productive, Wakimoto said.

“AHCCCS was quite helpful in dealing with this,” Wakimoto said. “We said that we would just like to see a well-oiled machine, where providers would continually get paid, regularly, so they could continue to operate. We asked that there be customer service available for multiple problems instead of having to work with one claim at a time.”

Pike said, “Nau said they would work directly with Lois and that they would have somebody available by phone directly for providers. This area is a big issue for them and they want to make sure they have someone available all the time and that they will send people out here — that they are going to designate someone to come to our area specifically to help train if needed.”


http://www.mohavedailynews.com/news/supervisor-forms-panel-to-address-problems-between-health-providers-ahcccs/article_bb1873a6-0005-11e8-9801-5723297fc587.html