How we’re making HIPP even stronger for patients

Nurse and older African American man

At the American Kidney Fund, our mission—helping people fight kidney disease and live healthier lives—is what drives every program we develop. Whether we are providing prevention services to someone at high risk for kidney disease, delivering health education materials to help a kidney patient live better with the disease, or providing financial assistance to a dialysis patient who is dealing with difficult personal economic circumstances, our goal is to deliver programs that have a tangible, measurable, positive impact on patient lives. 

Our best-known program, the Health Insurance Premium Program (HIPP), has been a vital component of the nation’s safety net for dialysis patients for the past 21 years. HIPP helps the 1 out of every 5 dialysis patients who otherwise could not afford to pay the premiums for Medicare Part B, Medigap, COBRA, employer group health and commercial health insurance policies. This program is vital to helping kidney patients get the healthcare they need, and we are dedicated to ensuring that the program stays strong for all those who depend on it.

Just as we do with all of our programs, we continually evaluate HIPP to make sure it is operating in the most effective way possible for the people who rely on it. For the past 18 months, we have been meeting with hundreds of key stakeholders, including patients, renal social workers, state regulators, Congressional offices and federal policymakers. We have received many helpful ideas about how we might strengthen the program, and today, we are pleased to announce that we will be rolling out a number of enhancements to HIPP, effective April 1. Collectively, these enhancements are designed to make the program even stronger for patients.

The first significant change we are making to HIPP is that we will continue providing charitable premium assistance to HIPP grant recipients for the remainder of the insurance plan year after they have a kidney transplant. We have always continued HIPP assistance for up to one calendar quarter post-transplant, which has allowed patients to go through the transplant workup process and have the transplant surgery. Extending the length of time for which we pay insurance premiums to the full plan year will give patients some additional support as they make the transition to life post-transplant.

The second major enhancement we are making to HIPP, effective April 1, is to eliminate the $700 quarterly cap that was previously in place for Medicare supplement (Medigap) premium assistance. In states where Medigap is available to kidney failure patients under 65, these patients are sometimes subject to higher premiums than Medicare enrollees over 65. As Medigap premiums continue to rise, AKF has expanded its funding for this type of insurance so that any dialysis patient nationwide who needs help affording Medigap can receive that help from AKF, regardless of premium amount.

Other enhancements we are rolling out will make it easier for patients to navigate their participation in the program, and will support dialysis providers’ commitment to compliance. Highlights of the new program enhancements include:

  • HIPP Patient Handbook: Our new patient handbook, written in plain language and available in both English and Spanish, addresses the questions patients most frequently ask us about HIPP.
  • Patient Rights and Responsibilities: This document explains the rights and responsibilities that individuals have when they receive HIPP assistance from AKF. For example, it explains that patients have the right to independently choose the health coverage that is best for them, and they have the responsibility to review their HIPP application for accuracy and completeness.
  • Dialysis Provider Code of Conduct: As a complement to informing patients of their rights and responsibilities, we are instituting a code of conduct form for all referring dialysis providers to sign. By signing this document, dialysis providers affirm that they are operating in a fully compliant manner when referring patients to AKF for charitable premium assistance.

In addition to the above changes, we are making several additional administrative updates to HIPP, effective April 1.

The funding for HIPP comes from voluntary contributions, primarily from dialysis providers. There is no obligation for any provider to contribute, and patient grant approvals are based solely on financial need. About 40 percent of dialysis companies with patients in the program do not contribute to it.

Because the contributions are voluntary, we have periodically encountered temporary funding shortfalls when the demand for help has exceeded our resources. Effective April 1, we will be instituting two measures to ensure the HIPP program stays strong for patients. First, we will ask all dialysis providers to inform us of their planned annual voluntary HIPP contribution level. Though not binding, these donation pledges will help us forecast HIPP funding for the year. Second, we will continue to engage in careful contingency planning for HIPP, and if the HIPP funding pool begins to experience consistent funding shortfalls, we will temporarily close the program to new applicants so that we may protect the insurance coverage of existing participants. We are hopeful that we will never have to take such an action because voluntary contributions will continue to support the needs of patients; however, we believe we need to have in place a process so that if funding shortfalls do occur, we are able to continue assisting patients already enrolled in the program.

We will provide detailed information on all of the HIPP program enhancements and updates during webinars that we are scheduling for the week of March 5. These webinars are free and open to any patient or renal professional who is a registered user in our Grants Management System. We will also communicate the enhancements to patients by placing articles in our quarterly print newsletter for patients.

These enhancements will strengthen the HIPP program and will ensure that HIPP continues to be an effective resource for patients who need it.

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About the Author

LaVarne A. Burton

LaVarne Burton is president and chief executive officer of the American Kidney Fund.

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