Fali Sidhva Access To Care Future Visions Being

Fali Sidhva

Access To Care Future Visions & Being Unreasonable! Fali Sidhva Helping Hands Family CEO

Disclaimers First! • The following slides represent Fali’s view of the world… • The suggestions do not imply we have invented the process, nor that we are it’s sole practitioners • Timelines and achievements are fluid (luckily they are improving constantly)

Helping Hands Family (HHF) Our company set out to achieve two objectives: Increase access to effective ABA therapy “Be there” for the parents and family of children with ASD

What we learned about increasing access Bottleneck #1: Access to Diagnosis Parents often wait 12 to 18 months for a diagnosis

What we learned about increasing access Bottleneck #2: Access to effective ABA therapy – current issues: “Wait lists” an accepted norm Admission timeframes of 72 days (!) Parents are unable to differentiate between providers Some providers are unprepared to meet therapeutic needs of the children

Addressing Access to ABA Therapy Bottleneck #2: Access to effective ABA therapy – the HHF approach: Acknowledge need for a cultural change Establish a real, mutually beneficial, relationship with payors Staff ahead of the current needs - No wait lists* Reduce admission time (First call to first therapy session) to <21 days (initially)

Speed to Therapy – breaking admissions barriers Admissions Barriers: 1 Document collection (diagnosis, records) 2 3 Insurance verification and authorizations Readiness to assess 4 Starting therapy

Speed to Therapy – breaking admissions barriers 1 Document collection (diagnosis, records) Immediate medical releases from parents Work directly with referral sources on necessary documents to prevent denials

Speed to Therapy – breaking admissions barriers 2 Insurance verification and authorizations Relationships with specific coordinators at the insurance companies VOBs completed within 24 hours Initial Auths completed within 48 hours of receiving docs (requires specific follow-up with payors/advocacy versus using portals)

Speed to Therapy – breaking admissions barriers 3 Readiness to assess Completing all initial assessments within 10 -14 days of receiving authorizations (where clinically appropriate)

Speed to Therapy – breaking admissions barriers 4 Ability to start therapy Pre-schedule services during the initial assessment so staff are “ready to go” Hiring 30 -60 days in advance of projected needs

The Results… Days from Inquiry to Starting Services - 2020 60 55 50 46 40 30 21 20 10 0 June July September

“Being There” for the parents HOW we connect: 1 2 • Geotargeted • Interest-Based • Facebook and Website inquiries receive a text • Call back within 24 hours 3 • Trained to make each call productive • Is referral viable? • Ready to engage? • Hold the parents’ hand through navigating insurance • Clarify expectations and provider / parent roles and responsibilities

Next on the HHF Agenda Next objective: Diagnosis • Timely • Convenient • Effective

Visions of the Future: Coordinated Care “We’ve Got This!” Broader Autism Services Care (Level 1) • Behavioral Health Care • Speech Therapy • Occupational Therapy • Physical Therapy

Visions of the Future: Coordinated Care “We’ve Got This!” Medical Care (Level 2) • General Health • Feeding / Eating • GI Issues • Epilepsy • Dentistry

Visions of the Future: Coordinated Care “We’ve Got This!” Other services • Sports / fitness training • Vocational / Transition Care • Adult Services • Haircuts

Visions of the Future: Coordinated Care “We’ve Got This!” Who Loves this? • Parents! • Individuals on the spectrum • Care providers • Payors

On Being Unreasonable

Kudos to the most unreasonable people I have ever met! YOU are the reason we have made progress

Admiration THANK YOU!