In March of 2016, CHLPI began a major new initiative to pursue equity in access to specialty care. Despite the enactment and ongoing implementation of the Affordable Care Act, many individuals across the nation continue to be uninsured or underinsured and are at a severe disadvantage when it comes to obtaining timely diagnosis and treatment of serious illnesses, such as cancer and HIV/AIDS. Moreover, even individuals who have adequate insurance coverage may face barriers to care from specialist providers if they are members of a minority group or live in a rural area. For example, Black and Hispanic Americans diagnosed with cancer experience significantly higher mortality rates than whites. Living far from an urban center is also associated with higher rates of cancer death.
CHLPI seeks to address these persistent disparities by identifying opportunities for legal and policy change that will increase access to health care for underserved groups and, ultimately, improve health outcomes for these populations. As part of this initiative, CHLPI will support innovative pilot projects and studies in health education, prevention, and treatment for diseases including lung cancer, skin cancer, and HIV/AIDS. These projects are led by specialty and primary care health providers, national advocacy organizations, and medical researchers, from the Association to Community Cancer Centers to Farmworker Justice to the Patient Advocate Foundation.
“This work is a crucial part of our larger mission to ensure that everyone has equitable access to the most effective treatment, regardless of race or income,” says CHLPI faculty director, Professor Robert Greenwald. “We know there are communities, especially communities of color, that experience relatively low healthcare access. When someone with commercial insurance waits an average of 10 days to see an oncologist while a Medicaid patient waits over 50 days for the same appointment, we need to take action.”
In the spring of 2016, CHLPI clinic students will travel to five states to observe and study the policy and legal context of specialty care pilot project innovations, from increasing access to highly effective screening for lung cancer to the development of mobile care teams that visit people living with HIV/AIDS who have fallen out of care. Students will use their skills and knowledge to develop strategies for scaling up and sustaining successful innovations that have a meaningful impact on increasing access to specialty care for vulnerable populations. “Our students bring a lot of creativity and passion to this work,” says Clinical Instructor, Sarah Downer. “By traveling to the project sites, they have an opportunity to interview our clients and learn firsthand how unique factors contribute to preventing certain groups of people from getting the care they need. When they brainstorm legal and policy solutions to these issues, and counsel our clients on potential opportunities for reform to address existing barriers to care, they are focused on the impact their proposed solutions have for the vulnerable populations we serve.”
CHLPI will continue this work in partnership with our specialty care project partners through at least 2019. “We recognize that policy change often takes time,” notes Professor Greenwald, “and we are committed to remaining engaged until we see meaningful reform.”