AHCCCS (the Arizona Health Care Cost Containment System) covers roughly 1.8 million Arizonans through AHCCCS Complete Care (ACC), the state's mandatory statewide managed care program, plus separate long-term-care tracks for elderly/physically disabled members (ALTCS-EPD) and members with developmental disabilities (ALTCS-DDD, run jointly with the Department of Economic Security). Arizona was the last state to adopt Medicaid and has one of the longest-running comprehensive managed care programs in the country, dating to the 1980s.
ACC is mandatory statewide, delivered through a set of full-risk MCOs that vary somewhat by Geographic Service Area (GSA): Banner-University Family Care, Mercy Care, Molina Complete Care of Arizona, UnitedHealthcare Community Plan (contracted as Arizona Physicians IPA, Inc.), Arizona Complete Health-Complete Care Plan, and BCBSAZ Health Choice. Members with a Serious Mental Illness designation additionally interact with a separate ACC-RBHA plan for behavioral health (see behavioral_health). ALTCS-EPD, the elderly/physically-disabled long-term-care track, has been in flux: AHCCCS terminated its December 2023 procurement award to four plans after an August 2025 Administrative Law Judge decision found flaws in the process, instead extending its then-current ALTCS-EPD contracts with Mercy Care, Banner-University Family Care, and UnitedHealthcare Community Plan through September 30, 2026 while a new procurement, published August 4, 2026, determines the program's next contract cycle.
Long-term services and supports are split across two separate tracks, not integrated into a single statewide product. ALTCS-EPD serves elderly and/or physically disabled members through Mercy Care, Banner-University Family Care, and UnitedHealthcare Community Plan under contracts extended through September 30, 2026 pending a new procurement (see managed_care). ALTCS-DDD serves members with developmental disabilities, coordinated jointly with the Arizona Department of Economic Security's Division of Developmental Disabilities (DES/DDD), a structurally distinct arrangement from ALTCS-EPD's MCO-based model. Dual-eligible members generally receive Medicaid LTSS through whichever of these two tracks applies to their population, layered on top of separate Medicare coverage.
Partially integrated into managed care
Behavioral health for members with a Serious Mental Illness (SMI) designation is carved out to a separate ACC-RBHA (Regional Behavioral Health Agreement) plan, organized by three Geographic Service Areas: Mercy Care (Central GSA), Arizona Complete Health-Complete Care Plan (South GSA), and Care1st Health Plan (North GSA). Tribal Regional Behavioral Health Authorities (TRBHAs) serve American Indian members separately. Non-SMI behavioral health for the general ACC population is delivered as an in-plan benefit by each member's regular ACC health plan, not carved out; an SMI member can need to navigate as many as four different care systems (physical health MCO, ACC-RBHA, and potentially ALTCS or tribal systems) to get full coverage.
Carved out
Dental is delivered as an in-plan benefit through each member's own ACC health plan rather than a single statewide carve-out vendor; each MCO maintains its own contracted dental network. Arizona has no single statewide dental administrator comparable to other states' FFS dental vendors, plausibly reflecting its near-universal managed care enrollment, which leaves little FFS dental population to administer separately.
Pharmacy is carved in to managed care, but administered through each plan's own PBM rather than a single statewide vendor: Arizona Complete Health and Care1st (as ACC-RBHAs) use Express Scripts, Mercy Care's RBHA line uses CVS/Caremark, and the Tribal RBHAs use OptumRx. All plans are bound to AHCCCS's own uniform AHCCCS Drug List and AHCCCS Behavioral Health Drug List, maintained by the AHCCCS Pharmacy and Therapeutics (P&T) Committee, so formulary decisions are centrally governed even though claims processing is decentralized by plan.
Non-emergency medical transportation is delivered as an in-plan benefit by each ACC health plan for its own managed care members. Fee-for-service NEMT runs through a separate provider-billing structure (a Daily Trip Report process) rather than a single named broker. Arizona has no single statewide NEMT vendor comparable to other states' broker-based models.
Providers and health plans interact with AHCCCS primarily through the AHCCCS Solutions Center, a Customer Service System that is part of the agency's ongoing Medicaid Enterprise System Modernization Program. Members apply for and manage coverage through Health-e-Arizona Plus (HEAplus), the state's eligibility and benefits portal shared with SNAP and TANF.
218 agency updates tracked for Arizona. Available with Pro.
See them with ProAt a virtual roundtable, Tucson-area health providers and patients warned that federal Medicaid cuts and new work requirements taking effect in 2027 could strip coverage from hundreds of thousands of Arizonans enrolled in AHCCCS, the state's Medicaid program. Pediatrician Eve Shapiro and ICU nurse Maria Manzanarez argued that losing coverage will push people to delay care until conditions become emergencies, straining hospitals already laying off staff in anticipation of funding losses. A disabled Tucson resident, Garrett Newell, described fearing the loss of AHCCCS coverage for specialists and therapy he relies on. Rep. Adelita Grijalva tied the cuts to the federal reconciliation law passed last year and said Democrats would seek to reverse them if they win control of Congress in the November midterms.
Cronkite News reports that healthcare accounted for more than half of Arizona's net job growth over the past year, adding 12,500 of the state's 22,700 new nonfarm jobs, but providers say they cannot find enough clinicians to meet demand. Behavioral health provider Valle del Sol says it could hire 20 physicians and 100 therapists immediately if qualified candidates existed, and a 2023 Greater Phoenix Chamber Foundation report projected a shortage of 76,000 healthcare workers over the following decade. Experts cite insufficient residency slots and rural/tribal pipeline gaps as key drivers, while state training programs show modest employment gains for completers. The piece notes that safety-net clinics and hospitals, which already operate on thin margins, could face added financial strain and reduced hiring capacity if patients lose Medicaid coverage.
Ascension is expanding again after a period of hospital divestitures, with its latest deal being an Oct. 1 agreement by Ascension Seton to acquire three Family Hospital Systems care sites near Austin, including an emergency/inpatient hospital and two urgent care and imaging locations. The move follows Ascension's $3.9 billion Amsurg acquisition in June, which added over 250 ambulatory surgery centers, and a June purchase of full ownership of Cedar Park Medical Center for $436 million. The system reported a narrowed operating loss and improved margins for fiscal 2026 after years of losses and hospital sales. Separately, Ascension agreed earlier this month to sell its stake in Arizona Medicaid managed care plan Mercy Care to Aetna, signaling a pullback from insurance as it reinvests in care delivery and ambulatory infrastructure.
In an interview with Becker's Hospital Review, HonorHealth CEO Todd LaPorte says the Scottsdale, Arizona system expects more than $150 million in annual margin deterioration by 2032 due to federal legislative and CMS policy changes, including Medicaid work requirements and eligibility redeterminations beginning in 2027. HonorHealth, which has roughly $4.5 billion in annual revenue and a 1-2% operating margin, has built a multi-year improvement plan involving AI and automation partnerships with Qventus to offset the impact. LaPorte notes the system is already seeing patients shift from Medicaid to self-pay status, a trend he expects to accelerate and persist. The piece also covers a leadership transition, with incoming president John Neil set to become CEO in March 2027, and LaPorte's call for local and state governments to help fill funding gaps as federal support recedes.
In a Becker's Hospital Review interview, Banner Health EVP and CFO Staci Dickerson describes the Phoenix-based system's growth strategy of diversifying into ambulatory surgery centers, value-based care medical groups, and insurance operations rather than pursuing scale for its own sake. Banner reported $431.2 million in operating income (5.1% margin) in the first half of 2026, up from $251.2 million (3.2% margin) a year earlier, giving it a financial cushion heading into 2027. Dickerson flags looming pressures including new Medicaid work requirements, tightening federal restrictions on Medicaid funding mechanisms, and expiring enhanced ACA subsidies, all expected to push more patients into uninsured and self-pay status and increase uncompensated care and bad debt. The 33-hospital system is expanding ASC capacity through its Atlas Healthcare Partners joint venture and anticipates accelerating industry consolidation as smaller systems struggle financially.
1 active waivers tracked for Arizona. Available with Pro.
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447 managed care contracts tracked for Arizona. Available with Pro.
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