The Alaska Medicaid Coordinated Care Initiative Is Here to Help
The Division of Health Care Services (Division)
is proud to announce an exciting new program, the Alaska Medicaid
Coordinated Care Initiative (AMCCI). The new voluntary program will
provide one-on-one case management services including care coordination,
scheduling appointments, addressing barriers, and referrals to
specialists and social service supports.
Do you know someone like Jenny? Jenny worked
regularly until, after experiencing several personal tragedies, she lost
her job. Shortly thereafter, she lost her home. She now stays with
friends when she can and shelters when she can’t. She says she’s sad
most the time and sometimes skips meals. Jenny is a middle aged diabetic
patient who doesn’t always take her medication. Jenny moves around a
lot and sometimes can’t find her pills. The hospital is nearby. She goes
to the emergency room when she feels sick.
Though Jenny’s story is an illustration, the
health care community regularly receives visits from patients with
similar complexities. With this new program, the Division hopes to help
patients like Jenny. If you know a patient who may benefit from this
program, please complete the Member Referral form linked to this
The AMCCI is designed to assist Alaska Medicaid
members who use medical services more frequently than other members.
Some members may seek care at the ER due to the lack of reliable
transportation, because they work during their provider’s regular office
hours, or they may have taken their medication incorrectly. Some
patients may go the emergency room because they do not have access to a
primary care provider. Certain patients have difficulty understanding
how important it is to follow their provider’s instruction or the
complexities of their healthcare needs. The Division hopes to gain a
better understanding of the challenges and barriers faced by these
members and the health care professionals who serve them.
The Division seeks to work closely with the
medical and social service community to support and help coordinate care
for patients with complex medical—and often social—issues. Because
these patients may have trouble navigating the health care system, they
may become frequent utilizers of the hospital emergency room for issues
that may be better treated in a primary care setting. Helping these
patients gain the ability to navigate and appropriately utilize the
health care system and take control of their health, with the guidance
of primary care providers and case managers, can make a dramatic impact
on their well-being and on overall health care costs.
The primary objective of the AMCCI is to promote
quality, cost effective health outcomes by ensuring that coordinated
medical services are provided in the most appropriate setting. Other
goals include focusing on prevention and enhanced integration of primary
medical care and behavioral health services. And most importantly, the
AMCCI hopes to make a difference by improving the health and quality of
life for members like Jenny.
During the summer of 2013 Alaska was one of six
states and one territory (Colorado, Kentucky, New Mexico, West Virginia,
Wisconsin, and Puerto Rico) selected by the National Governor’s
Association (NGA) to develop an action plan to serve Medicaid members to
ensure that their health care needs are met efficiently and
cost-effectively. Recently the NGA held an in-state retreat to provide
technical and work plan assistance.
In order to better assure appropriate use of
medical services, improved health outcomes, and to better control
increasing Medicaid costs, the State Division of Health Care Services is
undertaking this 24-month project. The Alaska Medicaid Coordinated Care
Initiative will provide case management and care coordination for this
The Division’s Quality Assurance team has issued
an RFP for case management services, which will be awarded during the
winter of 2014. The implementation of case management services is
targeted to begin during the winter of 2014-2015. Once awarded, the selected
vendor(s) will provide one-on-one case management services that will be
personalized to each member’s medical needs.