MIHS Adopts a Culture of Coverage: Helping Individuals Access Health Care by Enrolling in Arizona Medicaid or the Health Insurance Marketplace 03.31.2015 Cheri Tomlinson, Vice President of Grants and Research

THE ONLY PUBLIC TEACHING HOSPITAL & HEALTHCARE SYSTEM MIHS trains 400 physicians and provides more One of the largest burn centers in the U.S. than 3,000 clinical rotations each year 390,000 adult and pediatric visits at our family health centers and comprehensive healthcare center in 2013 Last year… MIHS treated 3,629 patients needing acute psychiatric care and provided 5,000+ hours of outpatient counseling services at no or little cost. We have 30 interpreters providing interpretation services for more than 50 languages 64.78% 81.49% In 2013, more than 47,000 people visited one of our four Family Learning Centers Patients admitted to MIHS received government sponsored care (AHCCCS and Medicare) 12 of babies born in FY2013 partially reimbursed by AHCCCS clinics 2 hospitals

History 1990 2014 190 unduplicated patients 6 staff (4.0 FTE) $70,000 of HRSA Demonstration Project funding 3,187 unduplicated patients 36 staff (32.8 FTE) $3.1 million in Ryan White HIV/AIDS Program funding (Parts A, C, & D) McDowell providers collectively have 186 years of experience including 111 years providing care to people living with HIV/AIDS.

Ryan White HIV/AIDS Program MIHS is the oldest Ryan White HIV/AIDS Program Grantee in Arizona. 1991: Awarded Part C (formerly Title III) for the first time. 1994: Awarded Part A (formerly Title I) as a sub-recipient for the first time. 1998: Awarded Part D (formerly Title IV) for the first time.

Enrolled in the Marketplace as of January 16, 2015 AFFORDABLE CARE ACT TIMELINE PRE-ACA YEAR 1 ACA YEAR 2 ACA 166,131 Enrolled in the Marketplace as of January 16, 2015 120,071 Enrolled in the Marketplace In Maricopa county alone, 228,758 107,310 6th Maricopa County, AZ = most uninsured county in the U.S. at Enrolled in AHCCCS 675,000 Enrolled in the Marketplace as of 1/16/2015 Source: ASPE.hhs.gov Source: enrollamerica.org

Summary New 16 268 284 Renewal 1 205 306 17 473 590 Category Ongoing Final Status Total New 16 268 284 Renewal 1 205 306 17 473 590

Inform Key Steps Planning council to develop 5 simple, consistent and coordinated key messages for use across the EMA to market and inform clients of upcoming ACA changes All RW Providers tasked with encouraging clients to learn about and enroll in ACA coverage If agencies did not enroll, then they would refer the client to an enrolling agency

Inform Toolkit Buckets

McDowell HCC (602) 344-6550 Outcomes and Highlights  Year one of Affordable Care Act

McDowell HCC (602) 344-6550 Outcomes and Highlights  Year one of Affordable Care Act

DATA DRIVEN PROCESS Some of MIHS’s key successes and lessons came from measuring these areas: Volume of Calls Secret Shopper Program Appointment Availability with Financial Assisters # of Scheduled Appointments Special Populations Call Center Volume # of Screenings The team knew that to transform the health care coverage experience, we had to know where we were, where we were headed, and what needed to change. This section shares some of the key measurements that we managed throughout the project, examining data for each strategy, and making adjustments to targeted approaches as needed. The team acknowledged and built upon small wins, maintained a robust communication plan throughout the project and celebrated successes.  

Poor health literacy

– Former US Surgeon General Richard H. Carmona, MD, MPH, FACS Health Literacy Classes 2 90 Minutes Each “More than 90 million Americans cannot adequately understand basic health information” – Former US Surgeon General Richard H. Carmona, MD, MPH, FACS Class curriculum based on the CMS Roadmap Classes CMS Roadmap UNDERSTANDING HEALTH INSURANCE PREVENTIVE SERVICES Why is prevention important? What are preventive services? Adult services Women services Child services AND MORE!!! Why is it important to have coverage? Top 10 definitions and terms Explanation of “cost sharing” How to make a medical appt. AND MUCH MORE!!! Classes held at Family Learning Centers and other facilities accessible to PLWHA and community members who wish to attend. For future course information, visit: grants.mihs.org All classes and course material available in English and Spanish

HEALTH LITERACY OUTCOMES Project Highlights and Attendance

88% 97% 98% 95% HEALTH LITERACY OUTCOMES Overall Class Evaluation Results Very Satisfied/Satisfied (Module 1, Module 2, Combined) Length of Class “About Right” (Module 1, Module 2, Combined) n=107 n=108 88% 97% Would Recommend the Class to Others (Module 1, Module 2, Combined) Learned How to Make a Dr. Appt. (Module 1, Module 2, Combined) n=105 n=98 98% 95%

MIHS Adopts a Culture of Coverage With the onset of health care reform, MIHS chose to transform how health care coverage information was delivered to our customers. The report describes an Arizona public hospital and health care system's experience in serving a diverse community in need of health care coverage. To Learn More http://mihs.org/uploads/sites/1http://mihs.org/uploads/sites/19/MIHSCoverStory.pdf9/MIHSCoverStory.pdf

Acknowledgements Collaborators Key Stakeholders MIHS is pleased to acknowledge these collaborators and colleagues within our organization as indispensable partners in our “Cover” Story: RWPA and Planning Council RWPB RWPC RWPD ADAP Phoenix Children’s Hospital Care Directions Southwest Center for HIV

Questions and Answers Funded in whole or in part by the United States Department of Health and Human Services, Health Resources and Services Administration, the Ryan White HIV/AIDS Treatment Extension Act of 2011, the Maricopa County Department of Business Strategies & Health Care Programs and the Maricopa Integrated Health System.