TI 2.0 Program Eligibility

The Targeted Investments Program (TI 2.0) eligibility is assessed each year. TI 2.0 participants will demonstrate compliance with eligibility criteria by completing the annual application process through the AHCCCS Online TI 2.0 Application Portal at the end of each program year.

Action Items required to maintain eligibility for TI Year 2 (10/1/2023 - 9/30/2024):

  1. Participate in TI 2.0 Year 2 Milestone requirements activities for each area of concentration as applicable. Failure to participate in milestones initiatives may result in organizations being removed from the program without payment.
  2. Implement the minimum processes and procedures that your organization submitted as part of the 2.0 Year 1 Application (2 of 3 for Behavioral Health and 3 of 5 for Primary Care). Organizations are required to implement process requirements by 9/30/2024, These Year 1 application processes and procedures are essential to care coordination between healthcare providers and fundamental to implementing processes related to TI 2.0 Year 2 and Year 3 milestones. Failure to implement these may result in organizations being removed from the program without payment.

    For additional details see the TI 2.0 Year 1 Eligibility Requirements Guidelines dropdown menu option below. Go to the Year 1 web page for Process Requirement details.
  3. Maintain commitment to adopt the new Health Information Exchange and bi-directional data sharing by 2025. Your organization will maintain eligibility by:
    • Attesting in the AHCCCS Online TI 2.0 Year 2 Application Portal that all participating clinics under the participating Tax ID are on track to adopt an Electronic Health Record (EHR) system that is capable of sending and receiving data from Contexture by September 30, 2025.
    • Attesting in the AHCCCS Online TI 2.0 Year 2 Application Portal that all participating clinics under the participating Tax ID will achieve bi-directional data sharing with the new Contexture’s platform by September 30, 2025 (or within one year of availability, whichever is later).
    For additional details see the Electronic Health Record (EHR) Requirements dropdown menu option below.
  4. Be in good standing with AHCCCS and maintain active status in the AHCCCS Provider Enrollment Portal.
  5. Maintain active clinic licensure as required by Arizona Department of Health Services for your organization’s clinics provider type. For additional details see the Licensure Requirements dropdown menu option below.
  6. Maintain accurate clinic information on the National Plan and Provider Enumeration System (NPPES), National Provider Identification (NPI) Registry. AHCCCS will validate information available on the registry to make sure that your organization’s address matches the address available on clinic licensure.

All TI 2.0 applicants must complete a TI Authorized User Agreement Form. It must be signed by a CEO or project manager directly employed by the organization. The signatory is responsible for the accuracy of each attestation and serves as the primary point of contact for payment-related information and post-pay audits. Additional individuals privy to payment-related information can be added at the bottom of the form.

Eligibility Requirement: Health Information Exchange (Contexture)

Year 1 (October 1, 2023 – September 30, 2024) Year 2 (October 1, 2023 – September 30, 2024)

Year 3 (October 1, 2024 – September 30, 2025)
  • All TI 2.0 organizations completed either a Scope of Work with Contexture OR Health Information Exchange (HIE) Commitment Letter during the application process
  • All TI 2.0 Participants committed to the following:

    1. Electronic Health Record (EHR) System Requirement: No later than 9/30/2025, all participating clinics under the participating Tax ID will implement an EHR system capable of sending and receiving data from Contexture.

    2. Health Information Exchange (HIE) Requirement: By 9/30/2025, or within one year of Contexture’s new platform availability (whichever is later), all participating clinics under the participating Tax ID will achieve bi-directional data sharing with the new HIE platform.

  • Submit Year 2 and Year 3 application in the AHCCCS Online TI 2.0 Application Portal

    • Attest that your organization is meeting or is on track to meet the EHR System requirement and the HIE requirement by 9/30/2025

Bi-directional Data Exchange Requirements

Bi-directional Data Exchange between AHCCCS TI 2.0 Program participants and Contexture is defined as a TI participant sending patient health information to Contexture and the TI participant receiving patient health information from Contexture. Bi-directional data exchange is considered complete when both of these components have been operationalized by the TI participant utilizing any combination of the following standards and services:

  1. Standards
    1. HL7 v2 – can be used to send and/or receive patient information
    2. HL7 v3 - can be used to send and/or receive patient information
    3. C-CDA - can be used to send and/or receive patient information
    4. Query-Response - can be used to receive patient information
  2. Services
    1. Provider Portal - can be used to receive patient information
    2. Alerts & Notifications - can be used to receive patient information

Complete the EHR Commitment Letter and upload to the AHCCCS Online TI 2.0 Year 2 Application Portal when it becomes available.

A Medicaid Provider Enrollment with the appropriate licensure & enrollment type(s) are required to determine Medicaid eligibility and TI Program eligibility.

BH Outpatient Clinics [Provider Type 77] whose services are limited to crisis line call centers do not provide the range of services necessary to meet the Targeted Investments requirements and are not eligible to participate in the TI Program.

To ensure that the incentive is meaningful to participants and we reach as many AHCCCS members as possible, participation must be limited to organizations that serve a relatively large number of AHCCCS members.

  1. Primary Care Provider Eligibility Requirements: To participate in the TI 2.0 Program, Primary Care providers must have delivered a relatively large number of qualifying primary care health outpatient services to ACC and ACC-RBHA members during the recent program Year.
  2. Behavioral Health Provider Eligibility Requirements: To participate in the TI 2.0 Program, Behavioral Health providers must have delivered a relatively large number of qualifying behavioral health outpatient services to ACC members during the recent program year.

TI 2.0 organizations will maintain eligibility for TI Year 2 (10/1/2023 - 9/30/2024) by attesting that all participating clinics have implemented the TI 2.0 Year 1 Application Process Requirements for their area of concentration(s) by 10/20/2024.

Preparations Before the Year 2 Application Opens

  • Log into your organization's Online TI 2.0 Application Portal for Year 1 to see which Process Requirements that your organization committed to implementing by 10/20/2024. While in the portal, you will select the Eligibility Criteria section to review which process requirements and the corresponding documents that were submitted for Year 1. When the Year 2 Application opens in Fall 2024, be ready to attest that your organization is still aligned with the Process Requirements that were selected for the Year 1 application.

Changes in Year 1 Process Requirements

  1. TI 2.0 organizations can change the Process Requirements for their Year 1 application with the caveat that new TI 2.0 Year 1 application documents will need to be submitted.
  2. Those that wish to resubmit the Year 1 application Process Requirements must notify the AHCCCS TI team at targetedinvestments@azahcccs.gov.
  3. The AHCCCS Online TI 2.0 Year 1 Application portal will not be open until the AHCCCS TI team communicates the specific dates.

Process Requirements by Area of Concentration

  • Primary Care Organizations must implement three of the five Process Requirements by 10/20/2024.
  • Behavioral Health Organizations must implement two of the three Process Requirements by 10/20/2024.
  • Process requirements are not applicable for organizations participating in Justice.