Drastic federal cuts to the 340B program. Alarming changes to Gilead’s Advancing Access Program. If your organization is a federal grantee or health system providing HIV care and/or prevention services, you know there has never been a more important time to future-proof your program—while still offering the highest standards of compassionate care.
What’s more, how entities provide care to their communities is quickly changing. Per CDC guidelines, providers are encouraged to prescribe PrEP to any patient who asks for it, and to have conversations about PrEP with all sexually active adolescent and adult patients. Telehealth is making care more accessible to rural communities, as well as eliminating some of the barriers and fears for patients who don’t feel comfortable in traditional health care settings.
What does all that mean for covered entities? It means the landscape is changing quickly, and there is an urgent need to consider the entire health care journey of all your patients, both those who are a part of the LGBTQ+ community and those who are not. Simply segmenting care into prevention and care categories is no longer going to cut it—and both the future of your business and the wellness of your patients is on the line.
Changing the conversation around wellness empowers patients; future-proofs business
One of the ways in which Avita is approaching this dilemma is by reframing the conversation on HIV care, HIV prevention, and sexual health, instead positioning Sexual Wellness as an inextricable whole. The idea is that Sexual Wellness takes a holistic view of patient care: HIV care, prevention, and sexual health services are accessible together and talked about openly, often, and as a necessary part of the overall health journey.
Adopting this holistic view, however, requires covered entities to evolve beyond the historical model of segmented care. Ryan White grantees vs. STD grantees may not be the future of sexual health care and could become unsustainable given the changing 340B and health care landscape. Additionally, this segmentation can introduce unnecessary barriers for patients. If a patient can receive testing, treatment, and related services from the same provider—in the same comfortable, affirming, cultural-competent environment—that has a tremendous effect on retention in care, health outcomes, and the potential for business growth.
Ryan White grantees who provide nonclinical services should be looking to the future and considering what it would look like to provide HIV care within the Sexual Wellness continuum. This becomes the steppingstone that allows for movement into prevention and gender-affirming care. It also helps ensure sustainable growth—and ultimately survival—as an ASO.
STD grantees with only PrEP services should consider the experiences of their patients who end up testing positive for HIV. Imagine how beneficial it would be for those patients to continue receiving services at the same places where they first sought care. Now, more than ever, diversifying 340B revenue is needed to keep your business on solid ground and ensure you can most effectively address the needs of your patients and your communities throughout the entire care continuum.
HIV prevention and HIV care do not represent different models. They are individual parts of a larger whole, working together toward a bigger purpose—effective and accessible care that reaches everyone in your community.
Let’s talk about real-life examples
A relevant real-life example of the potential success of this strategy can be found in the story of one of our partners which opened as a grassroots non-profit focused on HIV non-clinical care.
Our team worked with the partner to gain an understanding of their current business model and mission. Essentially, they were surviving year to year. Once we understood their focus and their mission, which were established over 35 years ago, we helped them to see the benefits of a change in strategy. It was an innovative pivot focused on future sustainability—growth and expansion as opposed to survival. The strategy started with a focus on PrEP and eventually moved into re-envisioning their approach to HIV care and treatment. Within 20 weeks, the partner grew from 20 to 120+ HIV patients in care and within two years increased its 340B revenue by 1,500%.
Prepare for challenges
Each covered entity will have different challenges adopting this more inclusive model of care. “STD clinics” may face uphill battles attracting a more general patient population. There are negative connotations that, frankly, may be difficult or impossible to reverse. Someone who would benefit from PrEP won’t necessarily know it. And if they don’t walk through your doors because they see you as a facility primarily for STD services, you’ll miss that opportunity to reach a patient in your community who needs the services you offer.
Similarly, a person newly diagnosed with HIV might not feel comfortable in an “HIV clinic” if they’re not comfortable having their HIV status known.
Those patients who do feel comfortable coming through your doors may still feel embarrassed discussing their sexual health with their providers. Or they may assume the providers will broach the subject if it’s important. Many individuals don’t necessarily know how to bring up these sexual topics, or they may even think their doctors don’t need the information. And that can be true of patients of any age, orientation, or gender identity.
Lastly, within the LGBTQ+ community, many individuals are uncomfortable or feel it’s unnecessary to come out to their doctors. They might also think that talking about PrEP or HIV testing makes them seem “dirty” or assume that they aren’t “at risk.” All of this can lead to missing out on critical care.
Patient outreach as a key strategy in business evolution and growth
Let there be no doubt: For covered entities looking to make it through the long haul, an expansion of services is not just a “nice to have”—it’s imperative to survival. But not every entity is appropriately staffed or funded to carry the heavy load of strategically widening their service model or creating the marketing or outreach programs needed to engage more patients. That’s where leveraging a partner who offers both 340B pharmacy expertise and culturally competent community awareness tools come into play.
One of the ways we support our partners is with exclusive marketing and outreach tools. These patient-facing programs are co-brandable, promote your services, and can be customized to speak directly to your unique patient population. The Avita team works in close collaboration with our partners to create tools that empower them to expand their services, reach new patients, and free up their limited resources to better focus on wholistic patient care.
Two crucial needs that are intrinsically linked
Covered entities increasingly need to expand their services as funding streams and the future of 340B become uncertain. Sexual Wellness conversations need to become a part of the general health conversation. For entities trying to stay relevant and bridge the funding gap, these two crucial needs are intrinsically linked. And Avita is at the forefront of both.
You don’t have to just get by year-to-year. You can achieve growth while helping your patients thrive throughout their entire Sexual Wellness journey, whether that’s HIV prevention, treatment, or anything in between or beyond.
To learn more about how Avita Pharmacy tailors our suite of services to best serve our partners—or for a customized tour of our outreach programs—contact me personally at the email address below or click here to set up a conversation with one of our experts.
Glen Pietrandoni is Senior VP, Patient and Community Advocacy at Avita Pharmacy. He can be reached at firstname.lastname@example.org.