ACN Advance: Provider Newsletter

Throughout the summer and fall, Arizona Care Network has joined forces with Mercy Care and several primary care practices throughout the Valley to help schedule and complete preventative wellness visits for adults and children.

ACN also distributed backpacks, back-to-school supplies, and other swag items to kids and families at various locations for completing Annual Wellness and Well-Child visits, including:

• • 1st Care Family Medical
  • Clinica La Familia
  • Dignity Health Medical Group
  • Life Health and Wellness Health Care
  • MY DR NOW
  • Trinity Integrated Medicine

Additional Valley-wide events are scheduled in October.

If your practice would like support in scheduling AWV, WCV, or other preventative care appointments, please contact ACN at
(602) 406-7226 or email members@azcarenetwork.org.

To improve its quality measurement and reporting, the National Committee for Quality Assurance (NCQA) updated its HEDIS measures for the 2026 measurement year.

Overall, the NCQA added three HEDIS measures, retired four measures, and made smaller changes across multiple measures as it continues the transition to Electronic Clinical Data Systems (ECDS) reporting.

New Designs

• • The technical specifications have a new format that aligns with the FHIR data standard, similar to current ECDS reported measures.
  • New terminology to align with FHR:
    • • Replaced “eligible population” with initial population.
      • Replaced “required exclusions” with denominator exclusions.
      • Replaced “measurement year” with measurement period.
      • Replaced “member” with person.

New HEDIS Measures

• • Risk Adjusted Utilization Measures: These measures evaluate the risk-adjusted ratio of observed-to-expected unplanned acute hospitalizations (inpatient and observation stays) for any diagnosis within 15 days of an outpatient surgical procedure, for persons 65 years of age and older.
    • • Acute Hospitalizations Following Outpatient Orthopedic Surgery (HFO).
      • Acute Hospitalizations Following Outpatient General Surgery (HFG).
      • Acute Hospitalizations Following Outpatient Colonoscopy (HFC).
      • Acute Hospitalizations Following Outpatient Urologic Surgery (HFU).
  • Follow-Up After Acute and Urgent Care Visits for Asthma (AAF-E): The percentage of persons 5–64 years of age with an urgent care visit, acute inpatient discharge, observation stay discharge or ED visit, with a diagnosis of asthma, who had a corresponding outpatient follow-up visit, with a diagnosis of asthma, within 30 days.
  • Tobacco Use Screening and Cessation Intervention: The percentage of persons 12 years of age and older who were screened for commercial tobacco product use at least once during the measurement period, and received tobacco cessation intervention after being identified as a tobacco user.

Changes to Existing HEDIS Measures

• • Follow-Up After High-Intensity Care for Substance Use Disorder (FUI): Updated the measure to allow substance use disorder diagnoses in any position on the follow-up claim. The measure expanded the numerator to include peer support services as an appropriate follow-up visit.
  • Statin Therapy for Patients with Cardiovascular Disease (SPC-E) and Statin Therapy for Patients with Diabetes (SPD-E): Updated the cardiovascular measure to remove sex-specific age bands. Both measures removed the “I-SNP or long-term institutional (LTI) care” exclusion, and the approach for identifying atherosclerotic cardiovascular disease (ASCVD) was updated.
  • Adult Immunization Status (AIS-E): Added a COVID-19 indicator to the measure that targets persons age 65 and older.
  • Social Need Screening and Intervention (SNS-E): Updated the measure to add codes to identify screening numerator events, intervention denominator and numerator events, and updated the I-SNP and LTI exclusions to include all ages.

Retired Measures

• • Asthma Medication Ratio
  • Medical Assistance with Smoking and Tobacco Use Cessation (MSC)

Learn more about HEDIS measure changes and formatting in 2026.

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org with any questions or feedback about HEDIS or Quality measures.

New vaccines are available to your patients this fall: a COVID-19 booster and updated flu shots.

Any Arizonan age 6 months or older can receive the newest COVID-19 booster from either Pfizer or Moderna.

In mid-September, the Arizona Department of Health Services (ADHS) and Governor Katie Hobbs announced a standing order to make the vaccine more widely available in Arizona without a prescription.

However, the standing order does not guarantee all pharmacies will offer vaccinations under the standing order, or that insurance plans will cover vaccine administration costs.

For children aged 6 months to 6 years, the vaccine is available through health care providers (not pharmacies).

In August, the U.S. Food and Drug Administration (FDA) approved the 2025-2026 COVID-19 vaccine, restricting eligibility to individuals aged 65 and older and those at higher risk of severe disease.

The CDC recommends patients receive booster vaccines beginning in late October, a few weeks before peak season for flu begins in November.

These vaccines are available at no-cost to most patients with health insurance. Those without insurance may be eligible for free vaccinations through county or state health programs.

Need additional support? ACN’s Care Coordination team can help your patients schedule any vaccine or booster appointments: Call (602) 406-7226 or email carecoordination@azcarenetwork.org.

To help your practice stay connected with important news, new initiatives, and other updates throughout the year, Arizona Care Network is requesting your provider(s) email addresses to improve ACN’s outreach efforts.

By sharing your provider(s) email addresses, they will receive this quarterly ACN Advance Provider Newsletter, along with regular network updates, and other important communications that support your practice and patient care throughout the year.

Simply click on the Provider Update Form to enter or update your provider(s) contact information.

Email address information shared with Arizona Care Network will never be shared with any outside organization and will not be used to attempt to market or solicit any product. This is strictly for informational purposes, directly from ACN.

Contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org with any questions or feedback.

To further support in-network utilization and care coordination between primary care and specialist physicians, updated Specialist Neighborhood maps are available from your Clinical Performance Consultant each quarter.

These updated listings of Specialties include areas being monitored for in-network utilization, both at the organizational and individual provider levels.

The listings include “handshake” icons which denote monitored Specialist practices within that enhanced care coordination of at least 50 percent INN utilization, which improves patient care and reduces cost.

Additional individual specialty listings Valley-wide are also available from your CPC, including:

• • Behavioral Health
  • Ophthalmology/Optometry
  • Physical Therapy
  • Radiology
  • Women’s Health

Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org if your practice would like to receive any/all of these maps and listings.

Plenty of important care gap closures are happening this Fall.

In addition to the vital importance of breast cancer, cervical cancer, depression, and blood pressure screenings for your patient population, medication adherence is a critical component toward keeping your patients healthy and reducing costs. This priority lies especially within daily or preventative medications for conditions such as:

• • Asthma
  • Blood Pressure
  • Cholesterol
  • Diabetes
  • High-risk (Beer’s Criteria)
  • Statin Therapy

Studies in the past five years suggest a lack of medication adherence contributes to more than 125,000 lives lost and cost upwards of $500 billion annually, while increasing avoidable hospital and emergency room usage.

During these difficult and uncertain economic times, medication costs are a top priority for patients. Fortunately, there are feasible alternative solutions which may benefit your patient’s overall health and finances:

Is a Biosimilar alternative available?
Cost savings resources for PCPs, Specialists and Patients
Social Determinants of Health (SDOH)
90- or 100- day prescription availability
High-risk medications (Beers criteria)

View/Download all Quality and Pharmacy Tip Sheets, Toolkits

A conversation with your patients addressing questions or concerns about their prescribed medication’s usage, cost, and potential alternatives can save everyone valuable time and money in the months and years ahead.

Need Support?

ACN can help your patients schedule a screening or medication adherence appointment with your practice by calling
(602) 406-7226 or email members@azcarenetwork.org.

Contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org with any questions or feedback.

Both Mercy Care and UnitedHealthcare Medicaid members may be eligible to receive gift card incentives for completing important screenings that close quality care gaps.

Eligible members can earn incentives of $5 up to $30 through completing – and provider’s office proper coding – a variety of screenings, health assessments, and preventative visits for themselves and any eligible dependents.

Mercy Care (.PDF)

UnitedHealthcare Medicaid (.PDF)

Additionally, Mercy Care members will have an opportunity to earn incentives and more closely monitor their health through ACN’s Care Scorecard website/app, coming in 2026. Watch for more information in the coming months via this newsletter and Bulletin email communications.

Questions about these incentive programs, proper billing codes, or other administrative needs? Contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org with questions or feedback.

• • Follow us on Facebook, LinkedIn, and YouTube for additional news, health-related content for providers and patients, organizational updates, and more.
  • Read previous ACN Advance quarterly provider newsletters anytime.
  • Learn more about ACN’s Care Coordination program and services designed to partner and support your practice in achieving healthy, cost-effective patient outcomes in this video.
  • Quality measure tip sheets are available from your Clinical Performance Consultant, including colorectal cancer screening, depression screening and follow-up, diabetes (A1C, Eye Exam, Nephropathy), Social Determinants of Health (SDOH), and Tobacco screening. These 1-page tip sheets (.PDF) include best practices, documentation requirements, and codes for your practice to help close quality gaps. Contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to receive any/all tip sheets
  • Q4 member text message outreach campaigns: Annual Wellness Visits (Adult), Asthma Medication Ratio, Preventative Cancer Screenings, High Blood Pressure, Depression Screening, Diabetes, Home Infusion Therapy, and Urgent Care vs. ER.
  • A Payer ID Card Quick Reference document (.PDF) for 2025 contains samples of ID Cards from ACN payer partners, as well as contact information. Contact your CPC or email practicetransformation@azcarenetwork.org if your practice would like copies of this document.
  • Phoenix Children’s is hosting its annual EMS and Prehospital Care Conference on Monday, Oct. 13, at 9 a.m. at the Renaissance Phoenix Glendale Hotel & Conference Center. The program features programs and discussions of pediatric emergency and first responder care, along with technology showcases and best practice exhibitions. Lunch is included and CME credits are available for EMTs, paramedics, and nurses. More information and registration.
  • Intel’s annual enrollment period for its Arizona-based employees runs from Oct. 13-31 for 2026 benefits selections. ACN and Dignity Health are proud partners within the Connected Care HDHP and PPO health plans for Intel employees and dependents.
  • Alignment Health Plan is hosting Annual Enrollment webinars Oct. 21 (Noon-1 p.m.) and Oct. 23 (8 a.m.-9 a.m.) for all PCP and Specialist providers and office admins. Each webinar features member benefit updates, plan information, and clinical information for 2026. The webinars are open to all ACN providers and administrative staff, although attending only one webinar is needed. Please contact your Clinical Performance Consultant or email practicetransformation@azcarenetwork.org to receive a meeting invitation, which will be recorded and available from your CPC in the days following each webinar.
  • Abrazo Health’s annual Heart Walk is scheduled for Nov. 15 at Goodyear Civic Square. The non-competitive 3-mile walk raises money each year to fight heart disease and stroke. You may register as an individual, with your family, or as a group of people. More information and registration are available here.
  • Dignity Health’s Norton Thoracic Institute and Creighton University are co-hosting the annual Esophageal Symposium Feb. 6-7 within St. Joseph Hospital and Medical Center, Barrow Research Library (inside SJHMC), and Creighton University School of Medicine. Organized by Dr. Sumeet Mittal, the two-day event includes hands-on courses related to Barrett’s Esophagus, dysphagia, endoscopy, endoFLIP, GERD, manometry, and more. The cost is $450 for MDs or DOs for the two-day event, $200 for APPs, and $50 for RNs. CME credit opportunities are available for providers, and breakfast/lunch are included. More information and registration are available here.
  • Abrazo Central Campus acquired its second da Vinci XI surgical system. The robot gives surgeons enhanced precision, control, and access for a wide range of complex procedures, compared to standard laparoscopic approaches, providing significant benefits to patients. The da Vinci XI system allows doctors to operate through a few small incisions, leading to reduced pain, shorter hospital stays, less blood loss, and faster recovery times.
  • Abrazo Medical Group opened its new 21,000 square-foot clinic that brings a wide range of specialty care to the West Valley. The new Verrado clinic occupies the 3rd floor of the three-story, 60,000 square-foot Abrazo Medical Office Building that opened in June on Roosevelt Street in Buckeye.
  • Alignment Health offers The Care Anywhere (CAW) program that supports vulnerable patients with 24/7 access to care through an interdisciplinary care team that conducts in-home and virtual visits. Providers may refer your Alignment Health members by calling 1-833-902-1665 Monday through Friday from 8 a.m.-5 p.m., PDT, or email careanywherecoordination@ahcusa.com.
  • Alignment Health also received a 4-star rating from CMS for its Medicare Advantage plan available in Maricopa County.
  • Mario Garner, EdD, FACHE, is the new president of Dignity Health East Valley, which includes Dignity Health Chandler Regional and Mercy Gilbert Medical Centers, and Arizona General Hospital — Mesa.
  • Dignity Health Arizona earned recognition in 2025 as a Joy in Medicine® organization by the American Medical Association (AMA). Dignity Health Arizona is the highest-ranked healthcare system in the state as the only organization to receive a rating at the silver level, which honors health systems, hospitals, and medical groups that prioritize proven methods to reduce burnout and enhance the professional fulfillment of doctors.
  • Dignity Health’s Bariatric Surgery and Weight Loss program is growing its team of providers along with advancing its services for the growing patient population in the Valley. These physicians at St. Joseph’s Westgate, Chandler Regional Medical Center, and Mercy Gilbert Medical Center, help patients achieve lasting weight loss and provide support resources for individual needs. The board certified, multidisciplinary surgeons offer a variety of bariatric surgical procedures including gastric bypass, duodenal switch, and vertical sleeve gastrectomy.
  • Phoenix Children’s named John R. Nickens IV as its next President & Chief Executive Officer, following the planned retirement of long-serving President & CEO Robert L. Meyer earlier this summer. Nickens will assume leadership of the organization no later than Oct. 1, after previously serving as Corporate President of Hospitals and CEO of University Medical Center (UMC) for LCMC Health, a large regional health system based in New Orleans.
  • Phoenix Children’s upcoming pediatric events and symposiums for health care providers.

• • Agave Center for Behavioral Health
  • Astra Healthcare
  • Family Tree Healthcare
  • Feelwell Primary Care
  • Gregg Krahn DPM
  • Mesa Family Physicians
  • Mind 24-7
  • Mountain View Pain Center
  • Spark Healing AZ

You can also view a list of provider organizations no longer participating with ACN.