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Health Reform


The reform of the United States health care and insurance system has been a central focus of health care policy for many years. Many changes were brought about by the 2010 passage of the Affordable Care Act. NACCHO has provided information here to help local health department leaders and staff better understand exactly how the changes in the public health and healthcare environment will impact them and their work. This website provides a one-stop to education, information, peer support, and general resources that will assist local health departments to navigate the challenging waters of health care reform.

In the Spotlight
health reform
The Affordable Care Act Webinar Series

This webinar series is a collaboration between the National Association of County and City Health Officials (NACCHO), the Health Resources and Services Administration (HRSA), and the Centers for Disease Control and Prevention (CDC). The series provides new knowledge, skills, and awareness for local health departments as they navigate the changing landscape of public health in a post-ACA environment.

The Changing Public Health Landscape: Findings from the 2014 Forces of Change Survey

NACCHO has released 2014 Forces of Change, a series of five research briefs that contain new findings on the forces that affect change in our nation's local health departments (LHDs). Two of the primary drivers of change in the local public health system are the Patient Protection and Affordable Care Act (ACA) and shrinking federal, state, and local funding. Most LHDs (86%) now bill public and private third-party payers for at least one clinical service they offer and most LHDs (81%) are seeking to increase billing efforts. Many previously uninsured people gained coverage under the ACA but the limited role played by LHDs in helping community members gain coverage illustrates a missed opportunity to improve access to healthcare. Learn more about how economic and political forces have impacted LHD billing for clinical services and LHD staff roles as navigators in their communities: Local Health Department Billing for Clinical Services, Role of Local Health Departments as Navigators

Local Health Department Experiences with the State Innovation Model Initiative Profiles

The National Association of County and City Health Officials (NACCHO), with funding from the Centers for Disease Control and Prevention, is producing a series of reports to educate local health departments (LHDs) about SIM-related activities in their states. As states reframe and redesign their financing and delivery structures, LHDs must ensure that their local perspective is represented. These profiles are just examples of the various roles that LHDs are playing the SIM work across the country.

Prevention and Public Health Fund

The Prevention and Public Health Fund (PPHF) is a dedicated federal investment in programs that prevent chronic and infectious disease at the community level. The PPHF currently provides nearly $1 billion annually to support immunizations, chronic disease grants to states and communities, lead poisoning prevention, and early and rapid detection of diseases and injury. Learn more about funding allocations here.

Highlighted NACCHO Health Care Reform Resources

Becoming an In-Network Provider: The Health Department Perspective

NACCHO hosted a webinar titled “Becoming an In-Network Provider: The Health Department Perspective” where speakers from Mississippi, New York, and North Dakota shared their contracting experiences. The recording from this webinar is available here and you can find the slides here. Participant question and answers are available here.

Affordable Care Act: Local Approaches to Outreach and Enrollment

NACCHO hosted a webinar, titled "Affordable Care Act: Local Approaches to Outreach and Enrollment," that featured three local health departments discussing their diverse experiences around Affordable Care Act (ACA) outreach and enrollment. Each presenter shared how their health department has developed creative strategies for outreach and enrollment within the context of their governmental structure. Access the webinar recording here, webinar slides here, and participant question and answers here.

Billing for Clinical Services Toolkit

NACCHO was funded by the Centers for Disease Control and Prevention (CDC) to create a toolkit with resources, templates, and tools for local health departments to use and develop capacity to bill third party payers for immunization, STD, TB and HIV services. More than 200 resources have currently been collected from state billing guides, the Centers for Medicare and Medicaid Services, state health departments, local health departments, insurance companies, and vendors of products such as electronic medical records and billing clearinghouses.

For more information on how to use NACCHO's Billing for Clinical Services Toolkit, click here.