Source: http://docplayer.net/22302575-Ryan-white-health-care-reform-future-paths-for-integration-expansion-and-innovation.html
Timestamp: 2018-07-21 05:04:42
Document Index: 646082879

Matched Legal Cases: ['art 1', 'art 2', 'art 3', 'art 4', 'art 1', 'art 2', 'art 3', 'art 4', 'art 1']

Ryan White & Health Care Reform Future Paths for Integration, Expansion, and Innovation - PDF
Ryan White & Health Care Reform Future Paths for Integration, Expansion, and Innovation
Download "Ryan White & Health Care Reform Future Paths for Integration, Expansion, and Innovation"
Lambert Rogers
1 Ryan White & Health Care Reform Future Paths for Integration, Expansion, and Innovation Harvard Law School Health Law and Policy Clinic & Treatment Access Expansion Project In collaboration with: AIDS Foundation of Chicago, National AIDS Strategy Coalition, HIV Prevention Justice Alliance, HIV Medicine Association, Project Inform, Ryan White Medical Providers Coalition
2 This webinar is sponsored by the Treatment Access Expansion Project (taepusa.org), AIDS Foundation of Chicago, HIV Prevention Justice Alliance, and the Coalition for a National AIDS Strategy (nationalaidsstrategy.org). One of many groups supporting the Coalition s efforts, Bristol-Myers Squibb has generously sponsored this teleconference, with no review or editorial discretion as to topics or content discussed.
3 Presentation Outline Introduction (and moderating) Robert Greenwald, Harvard Law School & TAEP Part 1: The Changing Landscape Amy Killelea, Harvard Law School & TAEP Part 2: Opportunities for Sustaining/Expanding HIV Care under Health Care Reform Andrea Weddle, HIVMA & Amy Killelea Part 3: Next Steps and Advocacy Efforts Anne Donnelly, Project Inform Part 4: Resources
4 Part 1 The Changing Landscape The Future of Ryan White Funded HIV Care under Health Care Reform
5 Ryan White Funding is Not Enough to Meet Increased Need Number of People Living with AIDS in the US vs. Ryan White Funding (adjusted for inflation)
6 What Does Health Care Reform Mean for HIV/AIDS Care and Treatment? Medicaid Expansion Starting in 2014, no longer have to be disabled to be eligible for Medicaid Most low-income, uninsured people will now be automatically eligible for Medicaid (133% FPL = ~ $14K for an individual and $29K for family of four) Includes a new Essential Health Benefits Package
7 What Does Health Care Reform Mean for HIV/AIDS Care and Treatment? Increased Access to Private Insurance Pre-existing Condition Insurance Program State-based exchanges (starting in 2014) Subsidies for those with income up to 400% FPL Elimination of many harmful and discriminatory insurance practices E.g., No higher premiums based on health Individual and employer mandates
8 What Does Health Care Reform Mean for HIV/AIDS Care and Treatment? New Investments in Care and Prevention Community health center expansion $11 billion over five years Prevention and Public Health Fund $750 million in FY 2011 Health care workforce investments
9 What Does Health Care Reform Mean 2008 Ryan White Program 30% were uninsured 68% had incomes at or below 100% FPL 22% had incomes between 101% and 200% FPL 34% were insured through Medicaid 12% had private insurance for Ryan White Clients? Health Care Reform 2014 Medicaid Expands to most people up to 133% FPL Eliminates disability requirement Private Insurance Subsidies to purchase insurance for people with income up to 400% FPL Elimination of preexisting condition exclusions
10 What Does Health Care Reform Mean for Ryan White Providers? Starting in 2014, the Role for Ryan White Will Change Because Most People Will Have Insurance Coverage Greatest challenges Medicaid s provider reimbursement rates New reimbursement systems Greatest opportunities Relief to an increasingly underfunded Ryan White Program New investments in community-based care Potential for new reimbursement systems and funding streams for Ryan White providers (RWPs)
11 Part 2 Opportunities for Sustaining/Expanding HIV Care under Health Care Reform
12 1.) Making the Medicaid Expansion Work for People with HIV and AIDS
13 Implementation Opportunities Essential Health Benefits Floor of benefits available to newly-eligible beneficiaries Must be comprehensive enough to meet the needs of people with HIV and AIDS and other chronic conditions Comprehensive prescription drug benefit Mental health, substance abuse, and support services Prevention Demonstration Projects Center for Medicare and Medicaid Innovation (CMMI) coordinated and integrated care projects Medicaid Health Home program HRSA/CMS evaluation of RW model of care Outreach RWPs will continue to be first line of information for newlyeligible Medicaid beneficiaries
14 Opportunities Beyond Health Care Reform for Building a Robust HIV Care System Health Homes Medical home certification for RWPs Provider Reimbursement (fee for service and managed care) Advocate for enhanced rates for HIV providers Ensure payment for coordination of care Medicaid Defense Protect optional benefits and provider payment levels Limit exceptions to maintenance of effort requirements Ongoing Ryan White Advocacy To provide essential wrap-around care, treatment and support services
15 2.) Making Private Insurance Reforms Work for People with HIV and AIDS
16 Designing Insurance Exchanges that Meet the Care and Treatment Needs of People with HIV and AIDS Essential Health Benefits Package Among others, ensuring comprehensive prescription drug benefit, mental health and substance abuse services Maximizing access to support and prevention services Integration of RWPs into provider networks Patient navigation Maximize potential of 3rd-party billing and reimbursement
17 3.) Integrating HIV/AIDS Care and Treatment into the Health Center Program
18 Leverage New Investments Health Care Reform Allocates $11 Billion to Community Health Centers New Access Point Grants Enhanced Training and Technical Assistance $11 Billion Expansion of Services Construction and Renovation
19 Overlapping Populations of FQHCs and Ryan White Funded Clinics
20 Overlapping Missions of FQHCs and Ryan White Funded Clinics Health Center Program Mission Health centers are community-based and patientdirected organizations that serve populations with limited access to health care regardless of ability to pay. Ryan White Program Mission The Ryan White Program supports cities, states, and local community-based organizations that provide HIV-related services to those who do not have sufficient health care coverage or financial resources for coping with HIV disease. Ryan White fills gaps in care not covered by other sources.
21 What is an FQHC? The Basics A community health center that meets federal requirements and receives significant grant funding and other federal benefits Serves federally designated medically underserved population or located in federally designated medically underserved area Serves all residents of service area regardless of ability to pay Provides full continuum of primary and preventive care services Governed by an independent community-based board of directors, a certain percentage of which must be health center consumers Funding to become a new FQHC grantee only available when New Access Point grant funding announcements are released by HRSA What is an FQHC Look Alike? A community health center that satisfies FQHC requirements and receives many, but not all, FQHC benefits, but has not been awarded a grant Look Alikes are in a good position to apply for grant funding (and full FQHC status) when new grants are announced by HRSA
22 Becoming or Collaborating with Who can Apply? A private non-profit or public agency that serves a federally designated medically underserved area or population How Can I Collaborate with an Existing FQHC? Referral arrangement Established/contractual arrangements Co-location arrangement Purchase of services agreement Sub-recipient arrangement an FQHC
23 Benefits and Challenges Benefits of becoming/collaborating with an FQHC include: FQHC specific grant funding Enhanced Medicaid and Medicare reimbursement for services Opportunity for RWPs to continue to provide wrap-around services Opportunity for RWPs to ensure smooth transitions Opportunity to fill gaps in HIV medical provider expertise and experience Challenges of becoming/collaborating with an FQHC: Changing mission and expanding services beyond HIV and AIDS Requires bridges between Ryan White and Health Center Programs Restructuring governing board Costly and labor-intensive application process In collaboration agreement, difficult for FQHC benefits (e.g., cost-based reimbursement) to go to collaborating partners
24 4.) Other Opportunities for Integrating HIV/AIDS Care, Treatment, and Providers into Broader Health Care Systems
25 Other Opportunities Ensure that HIV/AIDS providers benefit from National Health Service Corps investments Build on federal investment in developing HIV centers of excellence Seek demonstrations, pilot projects, and grants E.g., new payment mechanisms for coordinated care E.g., medical home demonstration projects E.g., Community Transformation Grants
26 Part 3 Next Steps and Advocacy Efforts
27 What You Can Do Educate yourself about health care reform and what it means for the HIV/AIDS community Defend health care reform! E.g., Medicaid Expansion, Prevention and Public Health Fund Join the HIV Health Care Access Working Group Maximize effective state implementation of health care reform E.g., Sound implementation of Medicaid expansion and private insurance exchanges Connect with other health advocates working on the state level Start conversations on collaboration/ integration with FQHCs With Your board Your community Neighboring FQHCs Ensure you are accessing all existing resources Stay tuned Follow up T/A and webinars Guidance from HRSA
28 What Questions Should the HIV/AIDS Community Consider Going Forward? Is my organization (or where I get my care) poised to maximize funding streams/opportunities? What populations are currently served and what does it mean to expand to others? What services are currently provided and is there the capacity to expand? What models of care are already in place and do these models fit into health care reform models? What FQHCs exist in the area and what is the relationship with them? What HIV services do they provide (e.g., HIV testing)
29 Part 4 Available Resources
30 What Resources Are Available? HRSA Resources, o Planning grants o T/A NACHC Resources, o Trainings and T/A, including FQHC 101 o Guidance documents Primary Care Organizations Treatment Access Expansion Project, HIV Medicine Association,
31 What Resources Are Available? Health Care Reform Resources Kaiser Family Foundation, FamiliesUSA, Healthcare.gov,
32 What Resources Are Available? AIDS Advocacy Resources Coalition for NHAS, HIV Prevention Justice Alliance, Dose of Change AIDS Advocacy Skills Building,
PrEP and Prevention Sustainability A Health Systems Integration Approach
PrEP and Prevention Sustainability A Health Systems Integration Approach Edwin Corbin-Gutierrez, Manager, Health Equity & Prevention Amy Killelea, JD, Director, Health Systems Integration National Alliance
Health Care Reform WHAT DOES IT MEAN FOR PEOPLE WITH HIV?
Health Care Reform WHAT DOES IT MEAN FOR PEOPLE WITH HIV? Overcoming Health Disparities in the California Bay Area Using HIV/AIDS as a Model San Francisco May, 2012 ANNE DONNELLY PROJECT INFORM ADONNELLY@PROJECTINFORM.ORG
HIV Services, Ryan White Programs and the Affordable Care Act: What do we know now?
HIV Services, Ryan White Programs and the Affordable Care Act: What do we know now? Thursday April 10, 2014 Presented by Carole Treston, RN, MPH Chief Nursing Officer Association of Nurses in AIDS Care
ADAP and Health Reform: Conducting Outreach and Enrollment. Amy Killelea, JD NASTAD HRSA/HAB Grantee Webinar May 29, 2013
ADAP and Health Reform: Conducting Outreach and Enrollment Amy Killelea, JD NASTAD HRSA/HAB Grantee Webinar May 29, 2013 Presentation Overview Part 1: Nuts and Bolts of ACA Eligibility and Enrollment Part
www.targethiv.org/ace Financial Help for Marketplace Health Insurance: Tax Credits & Cost Sharing Affordable Care Enrollment (ACE) TA Center December 4, 2014 How to Ask a Question Attendees are in listen-only
Jonathan Hanft, PhD Hennepin County Human Services & Public Health Department Jonathan.Hanft@co.hennepin.mn.us
Readiness for Health Insurance Participation by Ryan White Program Providers: The Time is Now! HRSA HIV/AIDS Bureau All Grantee Meeting Session 230, November 27, 2012 Julia Hidalgo, ScD, MSW, MPH Positive
State Health Department Billing for HIV/AIDS and Viral Hepatitis Services: An Analysis of Legal Issues in Five States
HARRISON INSTITUTE FOR PUBLIC LAW GEORGETOWN LAW State Health Department Billing for HIV/AIDS and Viral Hepatitis Services: An Analysis of Legal Issues in Five States Prepared for the National Alliance
New Hampshire s Community Health Centers
New Hampshire s Community Health Centers Bi-State Primary Care Association PCA for New Hampshire and Vermont Since 1986 Vision: Healthy individuals and communities with quality health care for all. Mission:
The New Medicare Drug Benefit: An HIV/AIDS Enrollment Tool Kit
The New Medicare Drug Benefit: An HIV/AIDS Enrollment Tool Kit New Medicare Prescription Drug Benefit Starting January 1, 2006 Dear Medicare Beneficiary: As part of a new Medicare law, the Medicare program
The Affordable Care Act: Its Impact on People with Serious Chronic Diseases
The Affordable Care Act: Its Impact on People with Serious Chronic Diseases PSC Partners Annual Conference Victoria Veltri, JD, LLM State Healthcare Advocate April 26, 2013 Discussion Areas What is the
Health Resources and Services Administration Core Medical Services Waiver. April 29, 2015
Health Resources and Services Administration Core Medical Services Waiver April 29, 2015 What We Are Discussing What is the HRSA Core Medical Services Waiver? Distinction of Core vs. Support Services Data
Based on the work of Senior PharmAssist in Durham, North Carolina
A Guide for Implementing a Community-based Pharmaceutical Assistance Program Supporting healthier living for older adults through user-friendly access to appropriate medications, health education, community
Three Cornerstones of Health Care Reform
Three Cornerstones of Health Care Reform 1. Increased coverage through expansion of public programs (Medi-Cal/Medicaid) 2. Reform and redesign of insurance markets (Health Benefit Exchanges) 3. Delivery
Program Objectives 9/2/2014. Affordable Care Act: Smooth or White Waters Ahead? History of Healthcare Reform
Affordable Care Act: Smooth or White Waters Ahead? Kathleen Bradbury-Golas, DNP, RN, NP-C, ACNS-BC Assistant Professor, Felician College Family Nurse Practitioner, Virtua Atlantic Shore Family Practice
AIDS Drug Assistance Programs (ADAPs) AIDS Drug Assistance Programs (ADAPs) provide HIV-related prescription drugs to low-income people with HIV/AIDS who have limited or no prescription drug coverage.
National Multiple Sclerosis Society National Health Care Reform Principles 1 Kim, National diagnosed MS in Society 2000 > HEALTH CARE REFORM PRINCIPLES America s health care crisis prevents many people
Navigating Premium Tax Credit Reconciliation: ADAP Policies & Best Practices. Xavior Robinson and Emily McCloskey, NASTAD August 19, 2015
Navigating Premium Tax Credit Reconciliation: ADAP Policies & Best Practices Xavior Robinson and Emily McCloskey, NASTAD August 19, 2015 Participant Considerations Phone lines Lines will be muted until
How Will Health Reform Help People with Mental Illnesses?
Judge David L. BAZELON CENTER for Mental Health Law How Will Health Reform Help People with Mental Illnesses? An analysis of the Affordable Care Act passed by Congress in 2010 and how it will affect people
LaMar Hasbrouck, MD, MPH Director, Illinois Department of Public Health. Institute of Medicine of Chicago June 24, 2013
LaMar Hasbrouck, MD, MPH Director, Illinois Department of Public Health Institute of Medicine of Chicago June 24, 2013 Too many people lack health coverage & care System focuses on treatment instead of
Medical-Legal Partnership 101: An Introduction to the Benefits of Integrated Care
Medical-Legal Partnership 101: An Introduction to the Benefits of Integrated Care The problems are visible. The solutions are not. Sharena Hagins, MPH, CHES Senior Research Assistant National Center for
1115 Medicaid Waiver Programs Section1115 of the Social Security Act allows CMS the authority to approve state demonstration projects that improve care, increase efficiency, and reduce costs related to
The Affordable Care Act and the Silent Epidemic: Increasing the Viral Hepatitis Response Through Health Reform
The Affordable Care Act and the Silent Epidemic: Increasing the Viral Hepatitis Response Through Health Reform Acknowledgements The National Alliance of State & Territorial AIDS Directors (NASTAD) represents
Basic Reimbursement - Medicare Part D Specifics
Basic Reimbursement - Medicare Part D Specifics 60889-R8-V1 (c) 2012 Amgen Inc. All rights reserved 2 This information is provided for your background education and is not intended to serve as guidance
A FEDERAL STATE DISCOURSE ON PRIMARY CARE AND BEHAVIORAL HEALTH INTEGRATION. Background Material
A FEDERAL STATE DISCOURSE ON PRIMARY CARE AND BEHAVIORAL HEALTH INTEGRATION Background Material 1 The Need for Primary Care and Behavioral Health Integration Individuals with behavioral health needs often
The Affordable Care Act. Improving Grandfamily Health
The Affordable Care Act Improving Grandfamily Health Background: The Affordable Care Act Enacted March 2010 Implemented Gradually Goal: Affordable Coverage for All Paving the Way for the 2014 Exchanges
Make Medicare Work Coalition (MMW Coalition)
FEBRUARY 2005 ILLINOIS MEDICARE CONSUMER PROFILE MEDICARE PART D: WHAT IT MEANS FOR ILLINOIS In response to the growing need for prescription drug coverage for Medicare consumers, in 2003 Congress passed
Public Comment of Patricia Bass, RN, MA Chair, CAEAR Coalition Consultant, Philadelphia Department of Public Health
Public Comment of Patricia Bass, RN, MA Chair, CAEAR Coalition Consultant, Philadelphia Department of Public Health Presented to the CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment,
Health Reform Roundtables: Charting A Course Forward
Health Reform Roundtables: Charting A Course Forward MEDICAID POLICY OPTIONS FOR MEETING THE NEEDS OF ADULTS WITH MENTAL ILLNESS UNDER THE AFFORDABLE CARE ACT APRIL 2011 EXECUTIVE SUMMARY The Patient Protection
The President s FY 2017 Budget Request
The President s FY 2017 Budget Request Speakers: Steve Berg Jaime Colman Jayme Day Julie Klein Sharon McDonald Mindy Mitchell Kathryn Monet Noelle Porter Webinar materials: http://www.endhomelessness.org/library/entry/presidents-fy-2017-budget-briefing