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Some Considerations for Ryan White Service Providers

March 18, 2013

Nicole Johns

on 2 May 2013

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Transcript of Some Considerations for Ryan White Service Providers

Federal Funding ACA Uncertainty Goal Start What does the future hold for HIV services? More Medicaid-eligible clients Sustainable services that meet the needs of the community Quest for the Future 2013 and beyond Opportunities 51% Medicaid
13% Medicare Funding Decreases Sequester Continuing
Resolution >5% Health Homes Enhanced reimbursement for Primary Care More people insured Let's check our map 78% of Ryan White clients live at or below poverty Uninsured Private 17% Before we get started with our adventure, let's remind ourselves of a few key facts 1.5 trillion over 10 years At least 80% of RW clients will be Medicaid Eligible with expansion Health care system Ryan White System Payer of Last Resort? Eligible Services? Eligible Clients? Certain networks or teams of health care providers
can form a Health Home Enhanced reimbursement , temporarily State Medicaid oversee Health Home programs, with federal approval Eligible individuals have at least one chronic condition, includes HIV and mental health Essential Health Benefits Mental Health Maternity
and infant care Care coordination Hospitalization Ambulatory services Behavioral Health Substance Abuse
Disorder Services 7,400 ADAP clients 424,000 HIV tests Across the board cuts of >5% Includes kids' dental and vision Preventative services,
include HIV tests Tests, Labs, Xrays Emergency services Chronic disease management Prescription drugs Pediatric care Rehabilitative and habiliative services Adapting programs to fit the reimbursement models of the future health care system Preparing for the shifting tides in the Ryan White Program So what does that mean? Ryan White will not be reauthorized this fall. HRSA working on "administrative fixes" for outstanding issues Supportive Congress members and HRSA are looking for community input on the future of Ryan White White House and Congress are in support of the Ryan White program Essential Community Providers Must ensure a sufficient number and geographic distribution of community providers Must ensure reasonable and timely access to a broad range of such providers Any willing provider must be accepted into a network Patient Navigator and Assister Programs Philadelphia EMA What we stand to lose nationally: Health Insurance Plans:
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