AHS past performance and achievements are a testimony to our commitment to meeting changing State needs, providing outstanding services and mirroring States’ commitment to fiscal responsibility – all characteristics States need when partnering with a vendor.
Flexibility, Agility, and Responsiveness
Time and time again, AHS demonstrated our flexibility, agility, and responsiveness related to helping States’ meet their changing needs. We consistently rose to the challenge when asked by States to:
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- Conduct significant contract expansions – taking on new geographic areas, additional populations, and increased scopes of work; and
- Assist in designing, implementing, and transitioning to new managed care models.
Significant Contract Expansions
AHS rose to the challenge when asked by States to conduct several expansions, including when we:
- Expanded enrollment broker services statewide in Wisconsin (2005);
- Expanded enrollment broker services statewide in Ohio from the initial 15 county pilot area (2006);
- Expanded enrollment broker services in Ohio to include the ABD population (2006);
- Expanded enrollment broker services in Illinois to include the ABD population (2011);
- Expanded enrollment broker services statewide in Florida to include the 62 non-Medicaid Reform counties (2011);
- Expanded enrollment broker services in Florida to include the MediKids population (2011);
- Expanded enrollment broker services in Florida to include prepaid dental Health Plans (2012); and
- Expended enrollment broker services in Florida to include Long Term Care (2013).
New Managed Care Models
Demonstrated flexibility and proven successful performance when implementing new managed care models, make AHS a low-risk partner and is particularly critical given the impact of the Affordable Care Act.
- Assisted the State of Pennsylvania in its move to a primary care case management program called the Family Care Network (1994);
- Expanded the provider network from 1,600 to 2,500 providers necessary for the transition of the Family Care Network PCCM program (that served children ages 0-18) to the ACCESS Plus enhanced PCCM program (that served Medicaid enrollees of all ages) in Pennsylvania (2005);
- Helped to design and implement Illinois Health Connect, the State’s first-ever PCCM program (2005);
- Implemented Illinois Client Enrollment Broker Project, the state’s first-ever Medicaid managed care enrollment program (2005);
- Supported the State of West Virginia with its Medicaid Redesign initiative (2007);
- Assisted the State of Louisiana to move the CommunityCARE PCCM program to CommunityCARE 2.0, an expanded program that included additional quality metrics and pay-for-performance initiatives (2010);
- Implemented the Gateway to Better Health Project to provide health care services to an expanded population that will be covered under the Affordable Care Act, in partnership with the St. Louis Regional Health Commission (2011);
- Implemented County Care (an 1115 waiver program) in Cook County, Illinois through which AHS streamlines eligibility determination and processing while also providing applicant and member services, provider services, claims processing, prior authorization, and IT solutions to a previously uninsured individuals.
First-Class Programs and Services
AHS’ State contract monitoring staff continually praise AHS for our ability to deliver top-performing solutions, effective and efficient operations, and first-class customer service. AHS’ commitment to providing exceptional services has also been publically acknowledged.
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- The ACCESS Plus Enhanced PCCM program in Pennsylvania, jointly administered by AHS and McKesson Health Solutions was selected as one of the top 15 finalists for the Innovations for American Government Award through the Harvard Kennedy School ASH Institute for Democratic Governance & Innovation (2008).
- The Illinois Health Connect PCCM program administered by AHS was selected as the recipient of the “Provider of the Year” award by the Campaign for Better Health Care (2010).
AHS is committed to being fiscally responsible and has proven our ability to support States with their budget needs.
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- Combined savings after administrative feed from Disease Management services, for the first two years of the ACCESS Plus PCCM program totaled $62.9 million.
- AHS saved the State of Illinois $531 million dollars from 2008-2010 through the Illinois Health Connect PCCM program, according to the Robert Graham Center.