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Richmond providers implement financial assistance programs to ensure all patients receive care

Safety net health care providers in Richmond began working together in 2014 on a new, collaborative effort to assist with the costs of deductibles and copays for newly eligible low-income individuals and families. The Richmond partners teamed up with several local partners to create the Health Exchange Financial Assistance initiative, a program that will assist with cost sharing for individuals and families who qualify for subsidies for premiums in the marketplace plans.

Providing Assistance with Cost-Sharing: The Health Exchange Financial Assistance Initiative

The implementation of the Health Insurance Exchange Marketplace in 2014 offered an exciting opportunity to enroll previously uninsured individuals and families in the Greater Richmond area in marketplace plans and increase their access to care. However, many people have been unable to afford the premiums, deductibles, and copays that were part of these health plans. This has compromised their ability to fully benefit from this new opportunity for insurance coverage.

To address this challenge, the members of this collaboration hope that their efforts will:

  • Increase the likelihood that their patients will enroll in a marketplace plan;
  • Ensure that those who enroll in a plan are able to remain covered; and
  • Improve access to care among newly covered patients.

Resources and Support from the National Partnership

To support the development of the HXFA, the National Partnership for the Health Care Safety Net conducted a series of interviews with similar financial assistance programs around the country to gain insight about the processes, challenges, and important considerations related to implementing such a program. The information collected from these interviews helped the Richmond partners make important decisions about how to design and structure the HXFA.

Increasing Coverage and Access Among New Enrollees: The Power of Collaboration

The leadership team for the HXFA initiative comprises three local health care providers that target their care to vulnerable populations in the Greater Richmond area, as well as a local medical society. Members of the leadership team quickly recognized that they would be able to accomplish more collaboratively than individually, so they chose to align their efforts in addressing this issue. Together, they hope to leverage their resources to help local low-income individuals and families fully benefit from the opportunities emerging from the implementation of the Health Insurance Exchange Marketplace.

The leadership team also hired a project manager to support their efforts and convened a group of local stakeholders to provide guidance during the development of the HXFA initiative. The stakeholder group includes representatives from:

  • Other health systems
  • Free and charitable clinics
  • Foundations
  • Research organizations

Each of the organizations in the leadership team and stakeholder group offers a unique and valuable perspective on how to implement this initiative in a way that is most beneficial for both patients and providers.

Eliminating the Costs of Copays and Deductibles

Although the Affordable Care Act increased access to health care among many people who were previously uninsured, the cost-sharing requirements for the Health Insurance Exchange Marketplaces plans may be too much of a financial burden for many low-income Americans. This has resulted in the following negative consequences:

  • Preventing many low-income individuals and families from becoming and remaining enrolled in a health plan
  • Reducing access to necessary health care services among newly eligible individuals and families who have either a) remained uninsured or b) enrolled in a plan but were unable to afford the copays and deductibles
  • Restricting revenue among safety net health care organizations because of continued reliance on their charity care programs, which limits their ability to provide comprehensive care to all of their patients, including those who are not eligible for any coverage

Numerous efforts are underway to address these challenges in other parts of the country, including HealthConnect, HealthWell Foundation, and Project Access Northwest, but before the development of the HXFA initiative, there had not been any efforts like this in the Greater Richmond area. As in other parts of the country, enrollment in marketplace plans among patients served by safety net health care providers in the Greater Richmond area has been low. Therefore, the HXFA initiative fills a crucial gap by helping cover the cost of copays and deductibles for patients, which will hopefully allow more patients to become enrolled, remain enrolled, and access the care that they need.

The Partnership for Richmond’s Safety Net

The Richmond Partnership consists of the following organizations:

In the News

Health Systems Team Up on Project to Help the Newly Insured, Richmond Times-Dispatch

The Daily Planet and Capital Area Health Network are Key Part of Health Care Safety Net, Richmond Times-Dispatch