This initiative will identify ways to address barriers to reimbursement for integrated viral hepatitis prevention and care services in clinical and non-clinical settings such as syringe service programs, substance use treatment facilities, primary care, mental health facilities, correctional settings and HIV and/or STI clinics.
This is a collaborative effort across the Department of Health & Human Services (HHS) that was launched in 2021 by the Office of Infectious Disease and HIV/AIDS Policy in the Office (OIDP) within the Office of the Assistant Secretary for Health (OASH).
Viral hepatitis is a significant public health threat that puts people who are infected at an increased risk for serious disease and death. Despite the availability of effective clinical interventions, including vaccines, diagnostic tests and therapeutics, new viral hepatitis infections have increased in recent years. Lack of awareness, fragmented health care delivery, access to care, and the cost of hepatitis treatment and care pose barriers to optimal hepatitis prevention and care, as well as meeting elimination targets. Coordinated strategies at the provider and systems levels are needed to make meaningful progress towards elimination goals.
A strategy outlined in the Viral Hepatitis National Strategic Plan is the removal of insurance coverage, price, and payment barriers to viral hepatitis care and treatment. This initiative aims to develop recommendations, informed by real-world hepatitis service provision and expert input, to remove financial barriers to effective integrated services. OIDP is investigating promising and best practices to address these barriers by facilitating discussions with private and public sector payers, health professionals who serve those living with, or are at risk for viral hepatitis, and other federal agencies.
This initiative has engaged members from the Viral Hepatitis Implementation Working Group, including representatives from the Centers for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) to provide guidance in project planning and implementation. Partner meetings involved both federal and non-federal partners.
Year 1 partner meeting on hepatitis C: In July 2022, OIDP held a partner meeting with federal and non-federal experts engaged in hepatitis C work to share research findings from the environmental scan and discuss successful payment and reimbursement models for integrated viral hepatitis services with a specific focus on hepatitis C.
Year 2 partner meeting on hepatitis B: In September 2023, OIDP held a partner meeting with federal and non-federal experts engaged in hepatitis B work to share research findings from the environmental scan and discuss successful payment and reimbursement models for integrated viral hepatitis services with a specific focus on hepatitis B.
Payment and Reimbursement Models for Integrated Hepatitis C Services.* During Year 1 of this initiative, OIDP conducted a series of literature reviews, focus groups, and stakeholder interviews to identify current and historical barriers to hepatitis C payment and service delivery. This document presents an overview of Year 1 and preliminary findings that may inform final recommendations for financing models and/or policies that support integrated viral hepatitis service provision.
*People using assistive technology may not be able to fully access information in these files. For assistance, contact the HHS Office of Infectious Disease and HIV/AIDS Policy by emailing Ann.Aikin@hhs.gov.