TI 2.0 Payment


Payment By Year
Year 1 TI 2.0 Incentive payments are made to eligible participants contingent upon meeting annual program requirements. Participating organizations that applied for the TI 2.0 program by 9/30/2023 must meet eligibility criteria and submit baseline deliverables to be accepted into the TI 2.0 program and receive Year 1 payment. The Year 1 incentive payment is expected to be distributed in early 2025.
Year 2 & Year 3 Eligible participants must satisfy at least one process-milestone deliverable to qualify for TI 2.0 incentive payments in Year 2 and Year 3. The Year 2 incentive will be distributed by early 2026 and Year 3 incentives will be distributed by early 2027.
Year 4 & Year 5 Eligible participants must meet or exceed their annual performance measure targets to qualify for the incentive in Year 4 and Year 5. The Year 4 incentive will be distributed by early 2028, and the Year 5 incentive will be distributed by early 2029.

Eligible Medicaid provider organizations that meet annual milestones related to optimizing coordination of services designed to meet the member’s acute, behavioral, and health-related social needs (HRSN) and address identified health inequities among their patient population will receive annual, lump-sum financial incentives distributed through managed care plans. Unlike a grant, participants are not restricted in how the earned payment is used, and participants are not required to report the expenditures to AHCCCS.

The TI team cannot estimate payment, therefore a request to preview payment amounts cannot be completed. The team will notify eligible participants of the incentive amount as soon as it is calculated.

Payment by Program Type

The incentive payment calculated for each site in a participating organization is totaled. The total is allocated to the organization’s contracted AHCCCS MCOs proportional to each plan’s service utilization as a percent of the total service utilization paid by the organization’s contracted health plans. Payment methodologies vary by participating program type.

TI 2.0 Primary Care Payment Methodology

The TI 2.0 PCP incentive payment is determined by:

  1. The number of unique AHCCCS members that received primary care services at participating clinics throughout the program year; and
  2. Milestones attested to and validated, each weighted to a relative value based level resources needed each year.

TI 2.0 Behavioral Health Payment Methodology

The TI 2.0 BH incentive payment is determined by:

  1. The number of behavioral health services provided to AHCCCS members at participating clinics under a qualifying NPI throughout the program year; and
  2. Milestones attested to and validated, each weighted to a relative value based level resources needed each year.

TIP 2.0 Justice Payment Methodology

The TIP 2.0 Justice incentive payment is calculated for each participating clinic individually. Eligible, “Primary” clinics, as communicated in the acceptance letter, will receive a block payment the first year of eligibility based on the types of services available. All eligible clinics will receive a payment from Year 2 - Year 5 based on unique justice-involved members served under participating NPIs and milestone attainment in each program year.

The block payment for TIP 2.0 Justice is determined for “Primary” clinics by:

  1. The first year of eligibility for the program (either Year 1 or Year 2); and
  2. The availability of wrap-around services available for justice involved members, including:
    1. Ambulatory care,
    2. Colocation with Justice Partners,
    3. Onsite housing,
    4. Meet Me Where I Am (MMWIA) services,
    5. Medication Assisted Treatment (MAT),
    6. Forensic Peer Support (FPS),
    7. Application of Risk, Needs, and Responsivity (RNR) principles,
    8. Clinics that did not participate in the original TIP 1.0 Justice program, and
    9. Clinics in rural/ frontier geographic counties

The Year 2 - Year 5 payment for all eligible TIP Justice clinics is determined by:

  1. The number of unique justice-involved adult members served by the participating clinic NPIs, deduplicated at the TIN level, during the program year; and
  2. Milestones attested to and validated, each weighted to a relative value based level resources needed.

Program Integrity

In order to receive a Targeted Investments payment, providers must be in good standing with AHCCCS, including, but not limited to: an active registered provider, and in good financial standing. If a provider is not in good standing with AHCCCS, no payment will be made to the provider, even if the provider previously completed an attestation. If a provider is not in good standing with AHCCCS and a payment is made, AHCCCS is required to recoup the payment.