Health Reform & My Practice

Health Reform will have a significant impact on the practice of HIV providers in the US and their patients.

Many patients who previously lacked health coverage, had insufficient coverage, or had to rely on safety net programs like the Ryan White program, and Community Health Centers, will have new opportunities to gain health coverage.

However, these new systems of coverage for patients will also impact the practices of HIV providers. Are you ready?

Background on the Law

The health reform law, commonly referred to as the “Affordable Care Act” (or ACA), contained many changes to Private Health Insurance and Employer-based Insurance in the US. It created new Pre-Existing Condition Insurance Plan (PCIPs) in every state. Starting in 2014, new State Insurance Exchanges (Marketplaces) will open in every state. The law also altered key parts of the Medicare Program, and gave states a new opportunity to Expand Medicaid to all low income individuals.

Health Reform Policy

What It Means For My Practice

As an HIV provider, your practice will be profoundly affected by many of these changes. Providers need to take steps now to prepare their practice for significant changes that begin in 2014.

Getting Connected

For HIV providers it will be increasingly important to get your practice connected to the various systems of coverage in your state. Connecting your practice to the state Medicaid program, Medicaid Managed Care plans, and to the new Qualified Health Plans offered in the state Insurance Exchanges will be key to retaining access to the patients in those coverage systems.

Connecting My Practice

Enrollment Counselors

Many systems have been set up to assist in Patient Enrollment nation-wide. Patient Navigators and Certified Enrollment Counselors will play a direct role in patient enrollment by helping patients understand their new health coverage options and assisting them in applying for and enrolling in appropriate coverage.

As an HIV care provider, you may be able to identify a member of your health care team to become certified as an enrollment counselor, and receive training to assist patient enrollment among your patients. Or, you may want to connect your patients with enrollment counselors in your area.

Enrollment Counselors & My Practice

What It Means For My Patients

The law established a Mandate for every citizen to obtain health coverage starting in 2014. Some patients will have new opportunities to join the Medicaid Expansion in their state. Others will purchase new Qualified Health Plans in the State Insurance Exchanges (Marketplaces). As their provider, you can help them to understand these new choices and determine the best option.

Health Reform & My Patients

What Is Happening In My State

Health Reform will be carried out differently in every state. It is vital that HIV providers know and understand what is happening with the Medicaid Expansion and the State Insurance Exchange (Marketplace) in their state.

Health Reform in My State