Health Systems Integration

Health Systems Integration (HSI) program at NASTAD aims to bridge public health and health care systems to ensure that all systems and payers are effective partners in ending the HIV and hepatitis epidemics.

An overarching goal of this work is to support partnerships between health care system payers, delivery systems, and health departments to address social determinants of health, health care disparities, and achieve optimal population health outcomes.

The program works to build the capacity of health department staff; to engage in health system transformation and payment delivery reform activities meaningfully. We believe NASTAD members are uniquely positioned to engage state and local policymakers around new and emerging health coverage options and other health systems reforms to improve access to a range of public health prevention and care services.

The HSI program leads three Systems Coordination Provider (SCP) initiatives funded by the Health Resources and Services Administration (HRSA): 

Medicaid SCP: NASTAD serves as the SCP on the Building Capacity to Improve Collecting and Reporting Viral Suppression Data to the Medicaid Adult Core Set initiative (HRSA-21-083). This project seeks to build data sharing capacity in state HIV and Medicaid programs, with the goal of increasing the number of states that adopt the HIV viral suppression quality measure (HVL) and report it to CMS. The team is working closely with ten states to develop resources and blueprints that will support states adopt the HVL measure over life of the project. A project fact sheet is available here.

Ending the HIV Epidemic (EHE) SCP: NASTAD serves as the EHE SCP (HRSA-20-089) and collaborates with CAI Inc., the Technical Assistance Provider for the initiative, to deliver technical assistance (TA) to RWHAP funded EHE Phase I jurisdictions. The SCP project aims to support the coordination of EHE efforts across federal EHE funding streams within jurisdictions, assist in forging partnerships with key stakeholders across systems and communities, and disseminate promising models across EHE jurisdictions to advance innovation. A project fact sheet is available here.

HIV and Opioid Use Disorder SCP: NASTAD supports JSI Research and Training Institute Inc. in the implementation of the Strengthening Systems of Care for People with HIV and Opioid Use Disorder (OUD) initiative, which provides coordinated technical assistance (in nine states) across HIV and behavioral health/substance use to ensure that people with HIV and OUD have access to care, treatment, and recovery services that are client-centered and culturally responsive. Visit the project’s website for more information.

Pillars of HSI 

Population Health Data Integration 

Objectives

• Support the development of data linkage processes across public health and health care delivery data to guide HIV and hepatitis care delivery.

• Advance encounter and claims data strategies to improve population-level health outcomes for people impacted by HIV and hepatitis. 

Overview 

Health systems data sources such as public and private insurance claims, prescription fill data, and electronic health record data are becoming increasingly important for HIV and hepatitis programs to meet public health goals. This data can augment public health surveillance and ultimately improve health outcomes and advance health equity. NASTAD’s work in this area focuses on identifying and sharing best practices in data-sharing and on the use of claims and encounter data to track enrollment and health care utilization, measure health outcomes, develop data-sharing agreements across system stakeholders, and establish data-sharing agreements to augment HIV and HCV surveillance systems for prevention, linkage, retention, and re-engagement efforts. 

Health Insurance Coverage and Financing 

Objectives

• Engage health system payers to improve health care coverage for people impacted by HIV and hepatitis. 
• Support health department efforts to maximize health insurance access for people impacted by HIV and hepatitis.   

Overview 

NASTAD leads federal advocacy efforts and provides TA to ensure access to affordable, high quality, comprehensive, and non-discriminatory prevention and care for everyone. Challenges remain to ensure that coverage remains affordable and accessible to people living with HIV, drug users, and hepatitis. NASTAD advocates to ensure that plans include the necessary services and providers, and Medicaid remains a strong safety net for those who need it. To ensure that people living with and at risk for HIV and hepatitis benefit from health reform protections, public health stakeholders must take a leadership role in state, local, and federal policy and implementation decisions. Our insurance coverage and access resources and technical assistance provide information and best practices to support health department engagement in the following:  

• Payment and delivery system reform models that include HIV, hepatitis, and drug user health services and providers 
• Discriminatory plan designs and access barriers to care and treatment 
• Health insurance plan assessment and enrollment support 
• Health plan benefits management  
• PrEP assistance program models  

Public Health Partnerships  

Objectives

• Support the implementation of interventions within health care delivery settings that improve health outcomes for people impacted by HIV and hepatitis.  
• Support health departments in building strategic partnerships between local and state public health agencies and across systems of care to reduce the impact of social determinants of health on people living with HIV and hepatitis. 

Overview 

To achieve hepatitis elimination and end the HIV epidemic, public health advocates are called to develop and strengthen partnerships with health care systems and provider networks that reach key populations in primary care, pharmacies, Emergency Departments, and other settings. Coordination across local and state HIV and hepatitis programs are also core components of effective public health partnerships with providers, facilitating coordinated service delivery for patients. By establishing effective partnerships across health departments and health care delivery systems, HIV programs will maximize the resources and expertise needed to meaningfully improve health outcomes for people impacted by HIV and hepatitis at the population level.