Presentation Title

ACA Enrollment of ADAP Clients: Clinic and State-level Best Practices

Abstract

This workshop will review impacts of the ACA on people living with HIV (PLWH) and focus on the enrollment of ADAP clients into ACA plans in a non-Medicaid expansion state with approximately one-fifth of PLWH in rural areas. It will examine characteristics at the state and clinic levels and will provide insights on enrollment barriers, best practices, and future directions.

Proposal Summary

Learning outcomes include that the participant will be able to (1) discuss ACA enrollment in Medicaid expansion and non-Medicaid expansion states focusing on the Southeast, (2) examine some of the challenges that state ADAPs and clinics encountered in trying to enroll clients and pay for their ACA insurance especially highlighting issues in rural regions, (3) outline best practices for ACA enrollment from one Southeast state’s viewpoint and one academic clinic’s experience, and (4) describe opportunities for improvement in ACA enrollment of ADAP clients from a statewide-view and a clinic perspective. Virginia ADAP clients accounted for about 2% of all receiving nationwide ADAP clients, but represent 58% of ADAP clients enrolled to ACA plans in southern states. The workshop will be interactive and collaborative. We will cover national trends but highlight developments in the rural Southeast. We will provide background on the current state of the health care delivery transition from direct purchase of medications by ADAP to an insurance purchase model utilizing ACA by discussing ACA enrollment of ADAP clients. We will focus on some of the challenges ADAPs face. We will provide Virginia and UVA specific examples. We will break the larger group into 5-6 smaller groups with individuals of different roles, and they will brainstorm ways to overcome state ADAP enrollment barriers over 10 minutes. Half of the groups will concentrate on Medicaid expansion states and the other half will consider these issues in non-Medicaid expansion states. We will reconvene the group to scribe their ideas and have a discussion. The small groups will then break-off to produce solutions to clinic-level enrollment barriers over 10 minutes. We will reconvene the group to scribe their ideas and have a discussion. We will outline the strengths of Virginia’s ACA enrollment plan, and additionally, we will provide insights from one successful clinic’s experience. We will also discuss our collaborative VDH-UVA research and future directions for research on this topic.

Relevance And Significance

This proposal would be suited for either the Clinical Research or Prevention and Intervention tracks. In terms of the Clinical Research track, this proposal will be based on cutting edge ACA enrollment data from our state health department and academic institution collaboration. It will highlight challenges and best practices for achieving improved health care access for PLWH with a focus on rural Southeast populations. The proposal also relates to the Prevention and Intervention track as transitioning patients from ADAP to ACA is an intervention that Virginia implemented state-wide to improve access to healthcare and actually reduce ADAP-incurred costs of care for the population. Statewide, about one-fifth of PLWH live in rural communities and we will focus on that population.

Session Format

Workshop

Keywords

HIV, Southeast, Rural, Health Insurance, Patient Protection and Affordable Care Act, Affordable Care Act, AIDS Drug Assistance Program

Publication Type and Release Option

Presentation (Open Access)

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Oct 23rd, 11:00 AM Oct 23rd, 11:45 AM

ACA Enrollment of ADAP Clients: Clinic and State-level Best Practices

This workshop will review impacts of the ACA on people living with HIV (PLWH) and focus on the enrollment of ADAP clients into ACA plans in a non-Medicaid expansion state with approximately one-fifth of PLWH in rural areas. It will examine characteristics at the state and clinic levels and will provide insights on enrollment barriers, best practices, and future directions.