From October 26th to 29th, 192 HTC social workers, nurses, and chapter leaders from 41 states took part in NHF's Virtual Insurance and Reimbursement Conference— Access During Uncertain Times. The focus of this conference was understanding the impact the current pandemic has had on patient access to care and the broad regulatory and administrative changes regarding insurance and reimbursement.

The conference kicked off with NHF's policy team leading the pre-conference symposium, Insurance 101: Back to Basics. This popular symposium gave first time attendees or those looking for a refresher an overview of general health policy and insurance basics. This better prepared attendees for the material presented over the remainder of the conference, which greatly benefited roughly half of the participants for whom this was their first time attending.

During the first session, attendees heard from NHF's federal policy advisor, Johanna Gray, who provided an update on our ongoing federal advocacy efforts, including what federal agencies are doing with respect to bleeding disorders and updates on our key advocacy issues, including access to skilled nursing facilities (SNFs) for Medicare beneficiaries, blood and product safety, the Affordable Care Act lawsuit before the Supreme Court, and more. Immediately following, Vanita Pindolia from Henry Ford Health System/Health Alliance Plan of Michigan gave an overview of the healthcare systems response to the pandemic, the costs and challenges related to managing COVID, and what the are strategies to optimize costs.

On the second day attendees heard from Allison Harrison from Hemophilia Federation of America, Ayesha Azam of the Pan Foundation, Mandy Herbert of Patient Services, Inc (PSI) and Gerald Lauria from The Assistance Fund about patient assistance programs. The panelists discussed some of the resources which are available to the bleeding disorders community during the COVID-19 pandemic and how to access them. Immediately following, Kollet Koulianos, NHF's senior director of payer relations, talked about the different outreach activities that NHF is working on between payers and providers to promote the HTC model of care and ensure reimbursement. Attendees also learned more about accumulator adjustor programs and how NHF is working with payers to ensure access isn't impacted.

James Kenney of JTKENNEY, LLC, kicked off the third day of the conference discussing various payer trends and cost containment strategies. Participants were walked through processes including utilization management (UM) and prior authorization (PA), to have a more robust understanding of how they work and why they are used. In addition, attendees learned what to do to help these processes along so they do not impede access to care. The day ended with hearing from JoAnn Volk, from Georgetown's Center on Health Insurance Reforms on the challenges, current status, and changes in the private insurance market and the impact such changes could have on 2021 enrollment.

The last day focused on the states, beginning with an update from NHF's state policy team. Dillon Harp, government relations specialist, Bill Robie, government relations specialist, and Nathan Schaefer, vice president of public policy, spoke about how state governments have evolved and adapted to the new reality, and what to expect in the next legislative cycle. Charlene Cowell, executive director of Hemophilia of North Carolina, and Lynne Kinst of Hemophilia Council of California, shared their experiences with virtual advocacy. The final session concentrated on state Medicaid programs. Matt Dull, COO of Artia Solutions presented findings from the NHF Medicaid project, a project that focuses on beneficiaries in all 50 states with bleeding disorders. He highlighted the impact of COVID on enrollment and state budgets, as well as the expected changes in 2021 to program operations.

This intensive, four-day virtual workshop provided participants with the necessary tools and resources to help the community maintain access to care; this is especially important during this extended period of uncertainty. The critical role HTC staff and chapters play in helping the bleeding disorders community overcome challenges to access needed healthcare services is more important than ever.

NHF would like to thank CSL Behring, Genentech, Grifols, Hemophilia Alliance, Novo Nordisk, Pfizer, Sanofi Genzyme and Takeda for their continued support of this educational opportunity.