the 4 priorities of hhs secretary alex azar · health center program §nearly 2 million hiv tests...
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The 4 Priorities of HHS Secretary Alex Azarfor the Arizona Rural Health Conference 2019Ed Heidig, Director, HHS Region IX
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Region IXU.S. Department of Health & Human Services
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Region IXThe U.S. Department of Health & Human Services
DivisionsqAdministration for Children and FamiliesqAdministration for Community LivingqAssistant Secretary for Preparedness and ResponseqAgency for Toxic Substances Disease RegistryqCenters for Disease Control and PreventionqCenters for Medicare and Medicaid ServicesqFood and Drug AdministrationqHealth Resources Services AdministrationqIndian Health ServiceqOffice of the Assistant Secretary for HealthqOffice of Civil RightsqOffice of the Inspector GeneralqSubstance Abuse and Mental Health Services Administration
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HHS Top PrioritiesEnhance and Protect the Health and Well-Being of All Americans
• Goal 1: Prevent & Treat Opioid Abuse• Goal 2: Reduce Prescription Drug Prices• Goal 3: Increase Accessibility & Affordability of
Health Insurance• Goal 4: Transform Medicare to a Value Based
Program focused on Patients• All Goals Contain : Improve Rural Health Care• New: Reduce New HIV/AIDS Infections by 90% by 2030
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• Delivery System Reform
The Opioid Epidemic
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6Drug Overdose Deaths, 1970 - 2015Source: CDC/NCHS
The Opioid Epidemic in Context
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7Opioid Overdose Deaths at Historically High Levels
Source: CDC/NVSS
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
0
2
4
6
8
10
12
14
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Num
ber o
f Dru
g Ov
erdo
se D
eath
s
Over
dose
Dea
ths p
er 1
00,0
00 P
opul
atio
n (A
ge-A
djus
ted)
Drug Overdose Deaths Any Opioid Commonly Prescribed Opioids Heroin Synthetic Opioids
The Opioid Epidemic in Context
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8Synthetic opioid deaths closely linked to illicit fentanyl
0
5,000
10,000
15,000
20,000
25,000
30,000
35,000
40,000
2010 2011 2012 2013 2014 2015 2016
Synthetic Opioids Overdose Deaths
Fentanyl Reports DEA NFLIS
Illicit Fentanyl & Fentanyl Analogs
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Nonmedical use of Rx Opioids: A significant risk factor for heroin use
Source: Chris Jones/SAMHSA
3 out of 4 people who used heroin in the past year misused opioids first
7 out of 10 people who used heroin in the past year also misused opioids in the past year
Risk Factors for Heroin Misuse
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The National Strategy
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Opioid Investment in Health Workforce
• FY 2018: HRSA awarded $18.5 million for behavioral health workforce development
• In FY 2019, HRSA plans to award: – $105M for the National Health Service Corps
(NHSC) • Up to $50M for Rural Communities Opioids Response
Program.
– $143M to continue support for behavioral health workforce development.
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*Definition of MAT providers expanded to include physician assistances, certified nurse practitioners in 2017
Source: Uniform Data System (UDS) - Table Other Data Elements 2017. UDS 2016 Health Information Technology (HIT) Information
39,375
64,597
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
2016 2017
Pa
tie
nts
Patients Receiving MAT
64%
1,700
2,973
0
500
1,000
1,500
2,000
2,500
3,000
3,500
2016 2017
Pro
vid
ers
Providers* Eligible to
Prescribe MAT
75%
376
472
0
50
100
150
200
250
300
350
400
450
500
2016 2017
He
alt
h C
en
ters
Health Centers
Providing MAT
26%
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Increasing Access toMedication-Assisted Treatment (MAT)
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Addressing Prescription Drug Prices
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The Blueprint
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Highlights of the Blueprint
- Approval of Record Number Generics- Import Lower Cost Drugs- Prohibited Gag Clauses- Increased Transparency
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Increasing Accessibility & Affordability of Health
Insurance
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Expanded Options for Consumers
- Short Term Limited Duration Insurance Options- Can be renewed up to 3 years- Are not required to be “qualified health plans” as
on Marketplaces- Association Health Plans
- Sole Proprietorship- Geographic or Industry
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Expanded Options for Consumers
- Health Reimbursement Arrangements- Allows employers to use pre-tax dollars to
subsidize purchase of insurance in the individual market
- Final rules take effect on or after January 1, 2020
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Paying for Value not Volume
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Empowering Patients
MyHealthEData Initiative- Putting consumer data back in consumers hands, and
take it wherever you goBlue Button 2.0
- 1400 app developers building user-friendly apps for patients to take their records, understand them, and share them
Updated Meaningful Use Program- Focus on interoperability of medical records to
transfer seamlessly between healthcare systemsIncrease transparency of health care costs
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Focus on Results
• Value-Based Payment Models• Public scorecards for Medicaid &
CHIP• “Meaningful Measures” Initiative
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Unleashing Innovation
eMedicare AppTelehealth
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Increasing Access through Telehealth
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Increasing Access through Telehealth
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The HIV/AIDS Initiative
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Understanding the Goal
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Understanding How This Affects The Region
• Arizona: Maricopa• California: Alameda, Los Angeles, Orange, Riverside,
Sacramento, San Bernadino, San Diego, San Francisco
• Nevada: Clark
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Ending the HIV Epidemic:Health Center Program
§Nearly 2 million HIV tests conducted annually nationally
§More than 165,000 patients with HIV receive medical care services at health centers, including many sites co-funded by the Ryan White HIV/AIDS Program
§More than 600 health centers purchase Pre-Exposure Prophylaxis (PrEP) through the 340B Program
§FY 2020: $50 million to support increased outreach, testing, care coordination, and HIV prevention services, including PrEP, in targeted counties/cities and States.