142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

305417
Public Health Financing and New Opportunities for Reimbursement

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Alyssa Kitlas , Infectious Disease, National Association of County and City Health Officials, Washington, DC
Sarah J. Newman, MPH , Research & Evaluation, National Association of County and City Health Officials (NACCHO), Washington, DC
Rebecca Gehring, MPH , Immunization, National Association of County and City Health Officials (NACCHO), Washington, DC
Paul Etkind, DrPH, MPH , Infectious Diseases, National Association of County and City Health Officials (NACCHO), Washington, DC
Implementation of the Patient Protection and Affordable Care Act (ACA) and federal and state budget cuts are driving dramatic changes in the public health system. Discretionary funds previously designated to public health are being reallocated to other healthcare initiatives or are disappearing.  One approach public health departments are taking to adapt to these changes is to bill third-party payers (Medicare, Medicaid, and private insurers) for services provided in LHD clinical settings. Revenue earned through third-party reimbursement helps ensure that health departments continue to provide essential services, conduct core public health functions, and improve the health and well-being of their communities.

This session will describe the public health billing landscape and present findings from NACCHO’s Forces of Change Survey, distributed to 927 health departments in January 2014, to assess the changes underway in public health with the start of the ACA. Through survey results and anecdotes from the field, this session will explain what billable services are being provided at health departments, what approaches to billing they are taking, challenges, successes, what is still needed to allow health departments to expand their capacity for reimbursement, and the billing resources NACCHO has developed.  Examples will include states with decentralized and centralized governance and from rural, suburban, and urban jurisdictions.

This session will describe the importance of health departments being part of the medical neighborhood, expanding access to care beyond the private provider’s office, and discuss how the development of alternative revenue streams can ensure long-term sustainability of programs essential in the community.

Learning Areas:

Administration, management, leadership
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Explain the experience of public health departments following the implementation of the Patient Protection and Affordable Care Act, specifically as it relates to public health financing models for reimbursement by third-party payers as a way of adapting to recent changes in the health system and a method to ensure long-term sustainability. Describe the billing landscape in public health departments across the country using results from NACCHO’s Forces of Change survey. Identify what resources NACCHO has developed to support health departments wanting to build their billing infrastructure, such as the Billing for Clinical Services Toolkit. List what clinical services are billable at public health departments, the challenges to successful reimbursement that exist, strategies health departments have used to overcome barriers, and how billing third party payers is a sustainable financing model.

Keyword(s): Public Health Infrastructure, Funding/Financing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Alyssa is a Program Analyst at the National Association of County and City Health Officials (NACCHO) on the Infectious Disease team, focusing primarily on HIV/STI Prevention and billing in public health. Previously, she worked as an HIV health educator and test counselor in San Diego county.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.