Supporting HIV care through education and innovation

4 Steps to Contracting with Health Insurers & Provider Networks

4 Steps to Contracting with Health Insurers & Provider Networks

March 2013
TARGET Center
ACA and Ryan White Contracting with Health Plans

Description

Many Ryan White clients will transition to new coverage under approved private health plans known as Qualified Health Plans (QHPs).  Ryan White providers will need to have contracts in place with these QHPs in order to be in a position to continue to provide care to their clients living with HIV/AIDS.  This tool outlines Affordable Care Act (ACA) provisions requiring QHPs to include Essential Community Providers (ECPs) like Ryan White agencies in their networks, HHS guidance on ECPs, and four steps agencies can take in setting up contracts with health insurers as well as provider networks that, in turn, have arrangements with health insurers. 

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