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Access to Healthcare Network. A membership based, non-profit medical discount plan for under and uninsured Nevada residents. Access to Healthcare Network. Mission

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Access to healthcare network

Access to Healthcare Network

A membership based, non-profit medical discount plan for under and uninsured Nevada residents.


Access to healthcare network1

Access to Healthcare Network

Mission

Access to Healthcare Network’s mission is to increase access to primary and specialty health care services for the under and uninsured, working poor, Nevada residents, through shared responsibility and community wide partnerships.


Ahn history

AHN History

  • Developed through Healthy Community Access Program (HCAP) grant.

  • AHN received 501(C)3 status in August of 2007

  • AHN is registered with the Nevada Division of Insurance


Ahn target population

AHN – Target Population

  • The estimated 400,000 under and uninsured Nevada residents between 100% and 250% of the Federal Poverty Level

  • The working poor

  • Children

  • Single mothers

  • Self-Employed

  • Part-time workers

  • Recently Unemployed receiving unemployment benefits


Shared responsibility model

Shared Responsibility Model

PROGRAM STRUCTURE

Hospitals

Healthcare Providers

Members

Community


Hospitals

Hospitals

  • In Patient Rate: $400 per day

    $3000 cap

  • Out Patient Rate:

    35% of Medicaid or 50% of Medicare

    $13,000 hernia surgery AHN Rate: $350

    $19,000 ankle surgery AHN Rate: $320

    $20,000 hysterectomy AHN Rate: $700


Healthcare providers

Healthcare Providers

A Network of over 700 healthcare providers:

  • Primary

  • Specialty

  • Ancillary

  • Dentists

  • Optometrists

  • Pharmacists

All providing services at greatly reduced rates.


Ahn members

AHN Members

  • Must not be insured or eligible for Medicaid, Medicare, or S-CHIP

  • Earned income within 100% and 250% of the Federal Poverty Level

  • Must Pay Cash at the time of service


Membership fee

Membership Fee


Employer based membership

Employer Based Membership

  • Small Business owners

  • Employers with part-time workers

  • Employers who cannot afford high premiums

  • Employer pays half the cost of membership for the member


Ahn program benefits integrated healthcare delivery system

AHN Program BenefitsIntegrated Healthcare Delivery System

  • Primary Care Physician (Medical Home)

  • Access to Specialty, Ancillary, Dental, Vision and Pharmacy

  • Discounted Rates

  • Care Coordination

  • Patient Care Fund


Patient care fund

Patient Care Fund

  • State and Local Governments subsidize cost of AHN membership

  • Foundations designate funds for specific illness or population of people


Susan g komen for the cure

Susan G. Komen for the Cure

Health Service

  • Primary Care Visit

  • Oncologist Consult

  • Mammogram

  • Biopsy

  • Mastectomy

  • Chemotherapy

  • Radiation Therapy

Actual Cost AHN Rate

$80$40

$130$65

$296$75

$1650$96

$5000$400

$137,000$6700

$87,000$4200


Ahn programs

AHN Programs

  • Statewide Help Line – 1.877.385.2345

  • Covering Kids and Families

  • State of Nevada Health Insurance Program

  • State of Nevada Health Assistance Program

  • Maternal Care Program

  • Health Savings Program


Ahn health savings program

AHN Health Savings Program

Charles Schwab Bank

Federal Home Loan Bank of San Francisco AHEAD Grant

Wells Fargo Bank

Pilot Project of 40 AHN Members


Health savings program

Health Savings Program

  • For AHN members wanting to save for their healthcare needs.

  • Must attend 3 -2 hour Financial Education Sessions and 1-1hour Credit Report Review Session

  • Two Financial Education Workshops during course of the saving period

  • AHN Program Orientation


Health savings program1

Health Savings Program

  • Must save a minimum of $25 per month

  • Can only be used for health related costs

  • Savings will be matched dollar for dollar up to $500

  • Deposits are made at AHN

  • Savings are monitored by Care Coordinator

  • Members will receive a monthly statement


Shared responsibility model1

  • Hospitals

  • Seed money for network startup

  • Reduced fee for service

  • Members

  • Pay cash at the time services are provided

  • Pay monthly membership fee (individual and family)

  • Providers

  • Primary Care Providers, Specialists, Hospitals, Pharmacy, Mental Health and Ancillary Services

    • Offer services for a reduced fee

  • Government

  • County and State

  • Grant funding for operating costs

  • Tax incentives for employers

  • Annual contribution for network sustainability funding and Patient Care Fund

  • Administration

  • Providing services Statewide

  • Sustainability Funding

  • Annual operation budget

  • AHN services offered :

    • Washoe County

    • Northern Nevada

    • Southern Nevada

    • (Las Vegas)

Patient Care Fund

Funding provided by local Foundations to provide financial assistance to AHN members for specific illnesses or member populations.

  • Community

  • Medical Society

  • Foundations, corporations, businesses, individual donations

  • Supports Network sustainability and Patient Care Fund

  • Banking Industry

  • Funding for development of AHN- Health Savings Program

  • Funding for match portion of Health Savings Program

  • Community Reinvestment Act activity

  • Employers

  • Pay monthly fee for uninsured employees and family members to access reduced fee Network

  • Receive tax incentive

  • Employee pays portion of monthly membership fee

  • Insurance Industry

  • First Membership based, Non Profit Medical Discount Plan in Nevada registered with the Division of Insurance

  • Partnering with Brokers

  • Marketing to employers

  • Transition our members into Insurance products

Shared Responsibility Model


Why it works

Why it Works

HOSPITALS/PROVIDERS

  • Reduced rate of ER usage among the uninsured

  • Receive payment for services up front

  • AHN puts a structure to a structure-less population


Why it works1

Why it Works

MEMBERS

  • Have access to affordable healthcare

  • Have a Primary Care (Medical Home)

  • Have access to Specialty Care

  • Have access to Dental and Vision

  • Have assistance navigating the healthcare system


Why it works2

Why It Works

Community

  • State and local government hands that are ordinarily tied can use AHN to provide services allowing their budgets to go farther

  • Local Foundations can serve a designated illness or population and their contributions go three times farther


Why it works3

Why It Works

  • AHN’s shared responsibility, integrated health care delivery model, can work anywhere:

    • Small rural area of 50,000 or less

      • (Northern Nevada)

    • Midsize Urban area of 500,000

      • (Washoe County – Reno/Sparks , Nevada)

    • Large Urban area of 2,000,000 +

      • (Las Vegas, Nevada)


Beyond 2014

Beyond 2014

  • AHN model prompted Congress to include non-profits in the Insurance Exchange

  • AHN model will be implemented within 10 states

  • AHN will be there for those in need of access to healthcare


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